OB Proper (Fetus and Placenta) Flashcards

1
Q

Risk factors for IUGR

A

Maternal weight <10th percentile
Previous IUGR
Mat. vascular/cardiac disease
Smoker, alcoholic, drug addict mother

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2
Q

Clinical finding of IUGR

A

Poor maternal weight gain
Fundal height is >3cm less than expected
Diminished fetal movement
Reduced AFV

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3
Q

Normal AFI

A

5-24

24 poly

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4
Q

Enumerate: Key complications of Polyhydramnios (3)

Treatment of polyhydramnios (2)

A
  • abruptio
  • uterine dysfunction
  • PPH

Treatment:

  • Amniocentesis (1.5-2 L AF)
  • Indomethacin (impedes liquid production, beware premature PDA closure!)
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5
Q

Enumerate: Key complications of Oligohydramnios (3)

Treatment

A
  • Pulmonary hypoplasia
  • Potter Sequence (Pulmonary hypoplasia, oligohydramnios, twisted face, twisted skin

Treatment: amnioinfusion

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6
Q

IUFD

Gold standard diagnosis

A

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

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7
Q

When does DIC occur in IUFD?

A

Fetus > 14 weeks AOG

Death more than 4 weeks prior

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8
Q

Placental abnormalities

Multiple placenta with a single fetus

A

Bipartite

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9
Q

Placental abnormalities

One or more accessory lobes in the membranes at a distance from the periphery of the main placenta

A

Succenturiate

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10
Q

Placental abnormalities

Placenta with a central depression surrounded by thickened grayish white membrane

A

Circumvallate

Circummarginate has a thinner ring

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11
Q

UTZ finding in placenta accreta

A

lack of normal hypoechoic retroplacental zone

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12
Q

3 types of abnormal umbilical cord insertion

A
Marginal insertion (battledore placenta)
Velamentous insertion (cord inserts at a distance from the placenta)
Vasa previa (associated with velamentous insertion)
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13
Q

Cord abnormalities

True vs. false knot

A

True: from active fetal movements
False: kinking of vessels

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14
Q

Cord abnormalities

Torsion

A

Cord becomes twisted

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15
Q

Cord abnormalities

Stricture

A

extreme focal deficiency of Whartons jelly

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16
Q

Cord abnormalities

True vs. false cyst

A

True: remnant of umbilical vesicles
False: liquefaction of Wharton’s Jelly

17
Q

Cord abnormalities

Edema

A

Associated with fetal edema and maceration

18
Q

Most common form of twinning

A

Monochorionic, Diamniotic

twin-twin transfusion possible

19
Q

Timeline of twinning

A

Day 0-3: Dichorionic diamniotic
Day 4-8: Monochorionic diamniotic
Day 9-12: Monochorionic monoamniotic
>Day 13-14: Conjoined twins

20
Q

Twinning type with highest mortality

A

Mono-mono

Associated with cord entanglement, twin-twin transfusion, fetal death, abnormal vascular connection

21
Q

Fertility augmentation drugs

A

Clomiphene (8-13% rate)
HMG (42% rate)
Bromocriptine (1.2-1.8%)

22
Q

Key differences of Symmetrical IUGR and Asymmetrical IUGR

A

Symmetric
BPD, AC, HC, FL decreased
Fetal etiology

Asymmetric
only AC is decreased
Placental and maternal etiology