Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro / GU > SM_209b: Abnormal Pregnancy > Flashcards

SM_209b: Abnormal Pregnancy Flashcards

1
Q

Abnormalities of pregnancy often result in ____ which is defined as ____

A

Abnormalities of pregnancy often result in preterm birth which is defined as delivery < 37 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe preterm birth

A

Preterm birth

  • Birth < 37 weeks of gestation
  • Accounts for 85% of perinatal morbidity and mortality
  • Neonatal outcome primarily dependent upon gestational age
  • Etiologies: spontaneous (70-80%), iatrogenic (20-30%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe causes of spontaneous and iatrogenic preterm birth

A

Spontaneous and iatrogenic preterm birth

  • Spontaneous preterm birth: preterm PROM, preterm contraction, cervical insufficiency
  • Iatrogenic preterm birth: placental abnormalities (placenta previa, vasa previa, placental abruption), FGR, preeclampsia, isoimmunization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Preterm labor is ____

A

Preterm labor is uterine contractions associated with cervical dilation at < 37 weeks gestation

  • Potential contributing mechanisms: uterine overdistention, decline in progesterone action, cervical disease, breakdown of maternal - fetal tolerance, stress, unknown, infection, vascular disorders, decidual senescence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe prevention of preterm birth

A

Prevention of preterm birth

  • 17 OHP
  • Contraception
  • Smoking cessation
  • Screening and treating asymptomatic bacteriuria
  • Treat symptomatic BV
  • Single embryo transfer
  • Vaginal progesterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of preterm labor involves ____, ____, and ____

A

Management of preterm labor involves administering steroids for fetal benefits (consideration of tocolysis), administering PCN for GBS chemoprophylaxis, and administering magnesium for fetal neuroprotection

  • Goals of diagnosis: diagnose and treat underlying cause, transfer to facility with appropriate NICU, medically optimize fetus for potential delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cervical insufficiency is an ____ defined as ____ usually occuring in ____

A

Cervical insufficiency is an incompetent cervix defined as painless cervical dilatation in the abscence of contractions usually occurring in the mid-trimester (16-24 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Risk factors for cervical insufficiency are ____, ____, and ____

A

Risk factors for cervical insufficiency are prior history of cervical insufficiency, multiple gestation, and connective tissue disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe stages of cervical distensibility

A

Stages of cervical distensibility

  1. Softening
  2. Ripening
  3. Dilation
  4. Repair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

___ is used to treat cervical insufficiency

A

Cerclage is used to treat cervical insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe indications and contraindications for cerclage

A

Cerclage

Emergent: ultrasound or physical exam based

Prophylactic: done if history suggestive of diagnosis of cervical insufficiency

Contraindications: contractions / labor, PPROM, infection, fetal demise, and major fetal anomaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Premature rupture of membranes (PROM) is ____

A

Premature rupture of membranes (PROM) is rupture of membranes prior to the onset of labor at any gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Preterm premature rupture of membranes (PPROM) is ____

A

Preterm premature rupture of membranes (PPROM) is rupture of membranes prior to onset of labor and before 37 weeks gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Preterm premature rupture of membranes (PPROM) possible contributing mechanisms are ____ and ____

A

Preterm premature rupture of membranes (PPROM) possible contributing mechanisms are alteration in cervical stromal composition and induction of amniotic membrane matrix metalloproteinases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Preterm premature rupture of membranes (PPROM) diagnosis involves ____

A

Preterm premature rupture of membranes (PPROM) diagnosis involves sterile speculum exam

  • Vaginal pooling
  • Basic pH of fluid
  • Microscopic ferning pattern
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe expectant management and delivery of preterm premature rupture of membrane (PPROM)

A

Expectant management and delivery of preterm premature rupture of membrane (PPROM)

  • Expectant management: preterm labor (2/3 within 7 days, 1/2 of these within 2 days), infection, placental abruption, IUFZG
  • Delivery: prematurity
17
Q

Describe management of preterm premature rupture of membrane (PPROM)

A

Management of preterm premature rupture of membrane (PPROM)

  • Confirm gestational age
  • If < 34 weeks and no contraindications, expectant management w/ antibiotics ( 7 day course promotes gestational latency) and administration of steroids
  • Initiate fetal surveillance
  • Contraindications for expectant management: labor, significant vaginal bleeding, infection
18
Q

Placenta previa is ____ that presents with ____

A

Placenta previa is implantation of placenta in a location where it covers the cervical os that presents with painless bright red vaginal bleeding

  • Accounts for 20% of third trimester bleeding
19
Q

Describe risk factors for placenta previa

A

Placenta previa risk factors

  • Prior cesarean section
  • Multiparity
  • Advanced maternal age
  • Prior placenta previa
  • Smoking
  • Multiple gestation
20
Q

Describe goals of diagnosis and possible complications of placenta previa

A

Diagnosis and possible complications of placenta previa

  • Awareness: pelvic rest
  • Expectant management: administration of antenatal corticosteroids if appropriate
  • Planned c-section at 37 weeks gestation
  • Possible complications: maternal hemorrhage, placenta accreta
21
Q

Placenta accreta is ____ that commonly results from ____

A

Placenta accreta is when the placenta grows too deeply into the uterine wall that commonly results from placenta previa

  • May cause severe blood loss after delivery
22
Q

Vasa previa is ____ that presents with ____

A

Vasa previa is a fetal vessel transversing the cervical os that presents with vaginal bleeding that is arising from fetal vessels (i.e. fetal blood)

  • Fetal blood volume: ~ 100 cc/kg
23
Q

Describe diagnosis of vasa previa

A

Vasa previa

  • Apt test shows fetal Hb resistant to lysis by alkaline solution
  • Crash c-section
  • Improved prenatal diagnosis with ultrasound
24
Q

Apt test demonstrating fetal Hb resistant to lysis by alkaline solution is ____

A

Apt test demonstrating fetal Hb resistant to lysis by alkaline solution is vasa previa

25
Q

Placental abruption is ____ characterized by ____

A

Placental abruption is premature separation of placenta from uterine characterized by vaginal bleeding in the presence of uterine contraction

26
Q

Describe risk factors for placental abruption

A

Risk factors for placental abruption

  • HTN
  • Prior placental abruption
  • Abdominal trauma
  • Smoking
  • Cocaine
  • Submucosal fibrois
  • PPROM
27
Q

Placental abruption management involves ____ and ____

A

Placental abruption management involves administration of antenatal steroids if appropriate and delivery based upon maternal and fetal status

28
Q

Fetal growth restriction is ____

A

Fetal growth restriction is fetus < 10% percentile for given gestational age

29
Q

Describe causes of fetal growth restriction

A

Fetal growth restriction causes

  • Fetal: aneuploidy, anomalies, infection (TORCH), multiple gestation
  • Placental: uteroplacental insufficiency
  • Maternal: malnutrition, illicit drug use, smoking, maternal medical conditions
30
Q

Describe diagnosis of fetal growth restriction

A

Fetal growth restriction diagnosis

  • Suspected size < dates on fundal height measurement
  • Ultrasound
  • Goals of diagnosis: counseling patients regarding prognosis and if applicable options regarding pregnancy management, institution of appropriate antenatal surveillance, administration of steroids if appropriate
31
Q

Preeclampsia is ____

A

Preeclampsia is new-onset HTN accompanied by proteinuria

32
Q

Describe severe preeclampsia

A

Severe preeclampsia

  • BP > 160/110 on two occassions at least 4 hours apart
  • Maternal symptoms: headache, visual changes, RUQ pain
  • Hepatic injury / failure
  • Renal dysfunction / failure
  • Pulmonary edema
    Coagulopathy
  • HELPP syndrome
  • Eclampsia
33
Q

Definitive therapy for preeclampsia is ____

A

Definitive therapy for preeclampsia is delivery

  • Need to balance risks of prematurity with risks to maternal and fetal health with expectant management
  • Control BPs
  • Prevent eclampsia -> MgSO4
34
Q

Rh alloimmunization is ____

A

Rh alloimmunization is exposure of Rh negative mother to Rh positive fetal blood resulting in maternal production of antibodies against the D antigen

35
Q

Rh alloimmunization is prevented by ____

A

Rh alloimmunization is prevented by administration of Rh immune globulin to all pregnant women who are Rh negative (unless certain that father is Rh negative)

  • 28 weeks
  • After delivery
  • Concerns for breakage in feto-maternal barrier
36
Q

Describe Rh alloimmunization management strategies

A

Rh alloimmunization management strategies

  • Paternal phenotype / genotype
  • Fetal antigen status (amniocentesis, cell free DNA)
  • Serial antibody titers
  • Fetal MCA doppler peak systolic velocity indices
  • Periumbilical cord blood sampling with intrauterine transfusion
37
Q

Spontaneous abortion is ____ that presents as ____, ____, and ____

A

Spontaneous abortion is pregnancy loss < 20 weeks gestation that presents as vaginal bleeding, pelvic pain, or as an incidental finding on ultrasound

38
Q

Stillbirth is ____, which is when ____

A

Stillbirth is intrauterine fetal demise, which is when pregnancy loss is at ≥ 20 weeks gestation

Repro / GU (46 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions