Placental Path 2

Question 1

What are the components of an APGAR score?

Answer 1

• Appearance (pink, extremities blue, all blue)
• Pulse (over 100, under 100, no pulse)
• Grimace
• Activity
• Respiration (strong cry, weak cry, no cry)

Question 2

Define gestational hypertension, preeclampsia, and eclampsia

Answer 2

• Gestational HTN: BP>140/90 without pre-existing HTN (after 20th wk)
• Pre-eclampsia: gestational HTN + proteinuria
• Eclampsia: Pre-eclampsia + maternal seizures

Question 3

What is the treatment for eclampsia? (3)

Answer 3

Magnesium sulfate, anti-HTN meds, delivery

Question 4

What causes pre-eclampsia?

Answer 4

Trophoblasts don’t invade deeply enough, so maternal vessels still have musculature and constrict blood flow to fetus

Question 5

What is Abruptio Placenta?

What are risk factors? (4)

Answer 5

• Premature separation of placenta from uterine wall (before delivery of infant)
• Risk: Trauma, smoking, HTN, cocaine

Question 6

Name 4 causes of post-partum hemorrhage

What is the most common?

Answer 6

• Tone (uterine atony most common)
• Trauma
• Thrombin (coagulopathy)
• Tissue (retained products of conception)

Question 7

What causes miscarriages in the first, second and third trimesters?

Answer 7

• First trimester: chromosomal abnormalities
• Second/third: placental or structural defects

Question 8

What are the hCG, AFP, and estriol levels associated with Trisomy 21, 18, 13?

Answer 8

• Trisomy 21: low AFP, high hCG, high inhibin
  
  • Low average face prominence (all else high)
• Trisomy 18: all low except inhibin may be normal
  
  • Inhibited a normal election
• Trisomy 13: all normal except hCG may be low

Question 9

Compare closed spina bifida, meningocele, myelomeningocele, and anencephaly

Answer 9

• Closed spina bifida: malformation of spinal bone
• Meningocele: malformation of bone with meninges protruding
• Myelomeningocele: malformation of bone with meninges and spinal cord protruding
• Anencephaly: cranial end of neural tube doesn’t close -> no telencephalon development

Question 10

What does a high AFP suggest?

Answer 10

Neural tube defect

Question 11

Which is associated with an underlying genetic defect: omphalocele or gastroschisis?

Answer 11

Omphalocele

Question 12

Which 46 chromosomal karyotype is not viable?

Answer 12

46 YY

Question 13

What 4 drugs can be used for gestational HTN?

Answer 13

1. Hydralazine
2. Alpha-methyl dopa
3. Labetalol
4. Nifedipine

(Hypertensive moms love nifedipine)

Question 14

What placental complication is associated with pre-eclampsia?

Answer 14

Placenta abruptio

Question 15

A patient presents in her third trimester with abrupt, painful bleeding.

Diagnosis?

Answer 15

Abruptio placenta