second and third trimester Flashcards
clinicaal manifestations Toxoplasmosis
dx
First trimester - death
Second - hydrocephalus, intracranial calcifeications, chorientiitis
Third - asymptomatic at birth
dx via IgM (igG is more indicative of chronic)
CMV infection histology
owl eye basopihlilc inclusions in nucleus
second trimester complications
TORCH
cervical insufficiency
fetal anomalies
rubella, virus and clincical
Togavirus
deafness
eye - cataracts or retinopathy
cns defects
cardiac malformations
fetal HSV cliinical
Congenital (rare)
microcephaly
ventriculomegaly
spasticity
echogenic bowel
hepatosplenomegaly
flexed extremities
Preterm premature rupture of membrane =
risk factors
dx
chorioamniotic rupture before onset of labor in
Risk: preterm labor, shortcervix,advanced cervical dilation
dx: direct visualization of fluid and ferning on microscopy
macrosomia =
risk factors
estimated weight >4500g
incorrect dates, maternal diabetes, excessive weight gain, maternal obesity
fetal clincial manisfestation parvovirus
anemia
acute muycarditis
edema/hydrops
intrauterine demise
Tzanck smear
wrights stain with vescular materia showiing multinucleated giant cells and viral inclusions in HSV infection
dx fetal syphillis
screening - RPR and vDRL
FTA-ABS and MHA test confirm
placenta previa =
presentation
risk factors
placenta over or near intternal os
painless, no contractions
risk: smoking, advanced age, multiple gestation, uterine anomlies, scaring from previous pregnancies
TORCH infections
Toxoplasmosis
Other (Syphillis, Parvovirus B19)
Rubella
Cytomegalovirus
Herpes simplex virus
hemorrhage secondary to placental abnls (placenta previa. accreta, abruption, velamentous cord isertion) occur duing
third trimester
intrauterine growth restricion =
estimated fetal weight
placenta abruption -=
resentatoin
risk factors
placental separation due to heorrhage into decidual basalis before birth
presents: vaginal bleeeding, uterine tenderness, contractions (with or without hearttones)
risk: prior abruption, trauma, PPROM, HTN, smoking, cocaine
velamentous cord insertion =
cord to chroion and amnior rather than placenta
fetal CMV clinical
periventricular calcifications
intrauterine growth restriction
developmental delay
microecephaly
senosrineural hearing lsos
retinitis
Jaundice + hepatospenomgaly
trhombocytopenia
hypotonia
risk factos for preterm
dx
premature activation of maternal or fetal hypothalamic =-pituitary - adrenalaxis
exaggerated inflammatory respoinses or infection
abruption
pathological uterine distension
dx: regular contarctions resulting in cervical dilation
placenta accreta
placenta increta
placenta percreta
implantation extends into basal zonne of endometrium
risk for heorrhage and hysterectomy after delivery
increta - into myometrium
percreta - into uterine serosa or other organs
(risk factors = multiple c-sections, placenta previa)
risk factor cervical insuffieicny
collagen abnls
uterine anomalies
prior obstetric trauma
mechaniical dilation
prior 2nd trimester loss
trasmission CMC
transplacental
perinatal
contact with body fluids
syphillis fetal infection presentations
spontatnesous abortion (first trimester)
still birth
non-immune hydrops
preterm
heaptomegaly
ascites
anemia, thrombocytopenia
toxplasma gondii transmission
fecal oral
transplacental
