Pathologies of Pregnancy

Question 1

problem with warfarin in pregnancy

Answer 1

it’s teratogenic (harms baby in 1st trimester)

Question 2

low BP and high heart rate is what

Answer 2

schock

Question 3

what features of an ectopic pregnancy predisposes it to haemorrhage

Answer 3

lack of decidual layer and a small tube

Question 4

what cells in the decidual layer are procoagulant

Answer 4

stromal cells

Question 5

what is a chorionic villi

Answer 5

projection of developing placenta into the mother’s blood supply. Tends to be covered in trophoblasts

Question 6

what condition sees an excess of chorionic villi on microscopy

Answer 6

molar pregnancy

Question 7

what scan shows nuchal thickening and what does it indicate

Answer 7

ultrasound - down’s syndrome

Question 8

what chromosome abnormality is down’s

Answer 8

trisomy 21 (a 3rd 21 chromosome)

Question 9

what follow up test can be done to confirm diagnosis of down’s

Answer 9

amniocentesis

Question 10

what is duodenal atresia

Answer 10

a loss or closure of part of the duodenum

Question 11

what is IUD in obstetrics

Answer 11

intrauterine death

Question 12

why do babies get so big when mum has diabetes

Answer 12

glucose crosses placenta and into baby. Baby’s insulin goes up to deal with all the glucose but can’t bring it back down because more keeps coming from mum. Baby grows lots and lots

Question 13

risks of a diabetic mother on baby

Answer 13

big baby, still birth, malformations, neonatal hypoglycaemia

Question 14

why do diabetic mum babies die intrauterine

Answer 14

sudden metabolic and hypoxic problems brought on by the glucose

Question 15

why do neutrophils have segmented nuclei

Answer 15

allows them to squeeze between other cells and travel to site of injury

Question 16

how might infection reach the amniotic sac

Answer 16

ascending through vagina from perineum or anus

Question 17

what cell is abnormally present in the placenta, cord or membrane in acute inflammation

Answer 17

neutrophils

Question 18

name for infection of placental membranes

Answer 18

chorioamnionitis

Question 19

if baby survives chorioamnionitis how will it progress postnataly

Answer 19

ill in first days of life and cerebral palsy late in life

Question 20

describe the damage of chorioamnionitis on the baby’s brain

Answer 20

neutrophils –> cytokine storm –> activate brain cells –> +normal hypoxia of labour = damage

Question 21

do opiates cross the placenta

Answer 21

yes - because they are very small molecules

Question 22

examples of opiates

Answer 22

heroin, methadone, morphine

Question 23

result of an overtwisted cord

Answer 23

intrauteirne death

Question 24

what score is used to assess a newborn baby

Answer 24

APGAR (appearance, pulse, grimace, activity, respiration)

Question 25

what is abruption

Answer 25

separation of placenta on uterine side resulting in hypoxia of baby and a collection of blood (haematoma), common cause of antepartum haemorrhage

Question 26

true/false - abruption can result in vaginal bleeding

Answer 26

true

Question 27

causes of abruption

Answer 27

hypertension
trauma
cocaine

Question 28

main issue with a baby just born to a heroin using mother

Answer 28

heroin withdrawal, needs treated in neonatal unit

Question 29

what type of withdrawal does the baby have at 3 weeks

Answer 29

methadone - overfeeding with constant mouthing movements