OB Proper (Fetus and Placenta) Flashcards
Risk factors for IUGR
Maternal weight <10th percentile
Previous IUGR
Mat. vascular/cardiac disease
Smoker, alcoholic, drug addict mother
Clinical finding of IUGR
Poor maternal weight gain
Fundal height is >3cm less than expected
Diminished fetal movement
Reduced AFV
Normal AFI
5-24
24 poly
Enumerate: Key complications of Polyhydramnios (3)
Treatment of polyhydramnios (2)
- abruptio
- uterine dysfunction
- PPH
Treatment:
- Amniocentesis (1.5-2 L AF)
- Indomethacin (impedes liquid production, beware premature PDA closure!)
Enumerate: Key complications of Oligohydramnios (3)
Treatment
- Pulmonary hypoplasia
- Potter Sequence (Pulmonary hypoplasia, oligohydramnios, twisted face, twisted skin
Treatment: amnioinfusion
IUFD
Gold standard diagnosis
UTZ: absence of fetal heart activity, scalp edema, fetal maceration
Radiographic signs
Robert sign: gas bubble in fetal heart, super sagittal sinus
Spalding sign: overlapping skull bones
Ball sign: exaggeration of fetal spinal curvature
When does DIC occur in IUFD?
Fetus > 14 weeks AOG
Death more than 4 weeks prior
Placental abnormalities
Multiple placenta with a single fetus
Bipartite
Placental abnormalities
One or more accessory lobes in the membranes at a distance from the periphery of the main placenta
Succenturiate
Placental abnormalities
Placenta with a central depression surrounded by thickened grayish white membrane
Circumvallate
Circummarginate has a thinner ring
UTZ finding in placenta accreta
lack of normal hypoechoic retroplacental zone
3 types of abnormal umbilical cord insertion
Marginal insertion (battledore placenta) Velamentous insertion (cord inserts at a distance from the placenta) Vasa previa (associated with velamentous insertion)
Cord abnormalities
True vs. false knot
True: from active fetal movements
False: kinking of vessels
Cord abnormalities
Torsion
Cord becomes twisted
Cord abnormalities
Stricture
extreme focal deficiency of Whartons jelly