OB second/third trimester registry review

Question 1

Second trimester

Answer 1

Weeks 13-26

Question 2

Lab screening in second trimester

Answer 2

-15-20 weeks maternal serum
-Most common cause of abnormal serum screening is incorrect dating

Question 3

Quadruple screen

Answer 3

hCG, AFP, estriol, inhibin-A

Question 4

Placenta produces

Answer 4

hCG, estriol, inhibin-A

Question 5

Fetus produces

Answer 5

AFP for “open” or protruding fetal abnormalities

Question 6

Longitudinal lie

Answer 6

Baby parallel to mother

Question 7

Cephalic or vertex

Answer 7

Head presenting or closest to cervix

Question 8

Complete breech

Answer 8

Feet first

Question 9

Frank breech

Answer 9

Buttocks closest to cervix

Question 10

Footling breech

Answer 10

One leg closest to cervix

Question 11

Transverse lie

Answer 11

Fetus lie is perpendicular to mother. Head is maternal’s right or left

Question 12

Situs

Answer 12

Heart and stomach on correct side

Question 13

Fetal demise 2nd/3rd trimester

Answer 13

-Spaulding sign: overlap skull bones/collapsing brain
-Roberts sign: air trapped in abdomen and lungs, increased echogenicity
-Exaggerated curvature of spine

Question 14

Hydrops

Answer 14

Fluid found in TWO fetal cavities
-Pericardial effusion: around heart
-Pleural effusion: around lungs
-Ascites: abdominal cavity
-Subcutaneous edema/anasarca: edema of skin (>5mm)
-

Question 15

Immune hydrops

Answer 15

Rh incompatibility/ Rh isoimmunization (mother is Rh negative and baby is Rh positive in 2nd pregnancy)

Question 16

Cause of Rh incompatibility

Answer 16

Rh negative mother and 1st pregnancy fetus is Rh positive creating antibodies. Next pregnancy that is Rh positive, moms antibodies attack
*prevented via RhoGAM at 28 weeks

Question 17

Erythroblastosis fetalis

Answer 17

Antibodies destroy fetus’ red blood cells leading to fetal anemia and hydrops

Question 18

Non immune hydrops

Answer 18

Caused by any other reason for hydrops, usually fetal conditions
-system/organ abnormalities
*Pericardial effusions usually first finding