Preg 2 Flashcards
AMA has inc risk of __ in di/di twins
reserve __ only if abnormal results or US findings
Anatomy survey performed at __
Survey for __ and soft signs of ____
also examine ___
aneuploidy
amniocentesis
20 wks GA
structural malformations, fetal aneuploidy
cervical length
Placenta previa
placenta covers ___ of the cervix or extends close enough to ___ of cervix
causes __ when cervix dilates or ___ effaces
this occurs w advanced ___ or ___
usually seen around __ wks gestation, usually __
bleeding is ___
__ and extremes of ___ inc risk for ___
Majority have ___ around 28-30 wks
internal os, internal os
bleeding, lower uterine segment
GA, labor
10-20, resolves
painless
intercourse, activity, vaginal bleed
sentinel bleed
RF for placenta previa Previous \_\_\_ Multiple \_\_\_ Previous \_\_\_ M Advanced \_\_ tx for \_\_\_ Previous \_\_\_
placenta previa gestation C section multiparity maternal age infertility IU surgery
Placental abruption
Bleeding at the __ and ___ interface
leads to partial/complete ___ of placenta from ___ prior to delivery of fetus
occurs after ___ GA
if > __% of placenta separates, this leads to
Sx include ___ and ___
__ and/or ___ uterine tone
fetal heart status is ___
Assc w __ and ___ morbidity/mortality
Bleeding is ___ in origin
Fetal distress from loss of ___ and development of __
decidua/placental
separation, uterine wall
20wks
50%, fetal distress
vaginal bleeding, ab pain
contractions, excessive
non-reassuring
maternal/fetal
maternal
placental interface/hypoxia
RF for placental abruption Previous \_\_ T P C/S P Premature \_\_\_
placental abruption trauma preeclampsia cocaine/smoking polyhydramnios rupture of membranes
Patho Placentation (aka ___)
caused be defetive ___
thin, poorly formed, absent___
usually secondary to ___
scarring/damage of decidua enables ___ to attach directly to ___
RF
Prior __/ ____/ ____
placental accreta
decidualization
decidua
prev uterine surgery
placenta/myometrium
Csection/D&C/Myomectomy
Majority are __, attaching to the ___
some are ___, invading into the ___
less are ___, invading through __/__
Risk of accreta inc w ___ and prior ___
even more w ___
Sonographic markers
loss of __ of placenta
Inc ___, __ appearance
Thinning/loss of ___ layer bw uterine wall and ___ (decidua)
Loss of continuous ___ of bladder wall interface
H
accreta, myometrium
increta, myometrium
percreta, perimetrium/serosa
placenta previa, C section
2+ prior C section
homogeneity
lacuna, swiss cheese
hypoechoic, placenta
white line
hypervasc
Complications of placentation
Second trimester ___
Preterm ___/___
__ at time of delivery
Need for ___
need for ____
inc risk of D, A, S, R, D
vaginal bleeding
labor/delivery
hemorrhage
cesarean hysterectomy
blood transfusion
DIC, ARDS, Shock, RF, death
Vasa Previa
Unsupported __ overlying cervix
Assc w __
RF \_\_ lobe of placenta \_\_\_ cord insertion Low lying \_\_ Multiple \_\_ I
Bleeding is ___, ___ of normal
Fetal __ and ___
Mx admit at ___ wks
need ___
fetal vessels
fetal mortality
succenturiate velamentous placenta gestation IVF
fetal blood
distress/demise
30-32 wks
preterm Csection
Succenturiate placenta
Results from focal areas of __ of chorion laeve
Lobes of __ connected by ___ of fetal origin
Bridging vessels w/out protection of ___
more prone to __/__/_
Bleeding is ___
non-involution
placenta, vasc bridges
Whartons jelly
tearing/shearing/compression
fetal
Velamentous cord insertion
Umbilical cord inserts into ___ instead of ___
Loss of __, lacks protecting/cushioning of __
more prone to __/__
bleeding is ___
amniotic membrane, placenta
wharton’s jelly, umbilical cord
compression/tearing
fetal
Marginal cord insertion
Insertion of ___ into __ of placenta
defined as ___ cm from edge
more common in ___
inc risk of __ and __ and __ and __
umbilical cord, margin
1-2cm
multiple gestations
IUGR, preterm delivery, preeclampsia, placenta previa
Placenta previa presents w
Mx modify ___, __ rest, __
Placenta accreta presentation: __ mid gestation
mx
Placental abruption presentation: __ vag bleeding and fetal ___
mx
Velamentous cord insertion present: growth ___, fetal __
mx: serial ___ and ___ testing
marginal cord insertion growth ___
mx w serial __
painless vag bleeding
activity, pelvic rest, Csection
spotting no warning
Preterm cesarean hysterectomy
painful, fetal distress emergent delivert (vag/C)
growth abnorm, fetal distress
growth US, antenatal testing
growth abnorm
growth US
Class D meds have risk to __
such as __ and __
Most sensitive time for majority of organs is ___ period bw __ and __ wks
Ovum period: from __ to ___
___ sensitivity to teratogens
___ connections w maternal blood
Even after cell loss, conceptus can ___ development
Development of mainly ___ structures
Insult results in ___
fetus
lisinopril, Paxil
embryonic, 3-8 wks
fert to implant
limited
no direct
regain normal development
extra embryonic structures
miscarriage
Embryonic period from __ to __ wks
__ to teratogens
critical time for ___
fetal period from \_\_ to \_\_ \_\_ time Morph effects on \_\_ and \_\_\_ and \_\_\_ \_\_\_ deficits minor \_\_\_ \_\_ effects
2-8 wks
highly susceptible
organ develop
9wks, term palate, teeth, external genitalia fxnal morph abnorm growth