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OB/GYN review > Test 3 > Flashcards

Test 3 Flashcards

1
Q

when does pregnancy enter the second trimester?

A

after the first 12 weeks of pregnancy

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2
Q

by 20 weeks, what are the primary biometric parameters?

A
  • biparietal diameter
  • head circumference
  • abdominal circumference
  • femur length
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3
Q

when does a fetus enter the growth stage of pregnancy?

A

after midterm or 20 weeks gestational weeks?

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4
Q

what are measurements in thr 2nd and 3rd trimester more accurate for?

A

gestational size rather than age

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5
Q

what is considered to be one of the best predictors for gestational age?

A

BPD

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6
Q

what is the BPD?

A

a biometric measurement preformed in the transaxial view of the fetal head just above the level of the ears

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7
Q

how is the sound beam faced when looking for BPD?

A

from the lateral aspect of the fetal head, with the sound beam perpindicular to the interhemispheric fissue, also known as the cerebral falx

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8
Q

what should be seen when looking for BPD near the center of the cranium?

A

the diamond shaped hypoechoic thalmus

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9
Q

what should the BPD not show?

A

orbital rims anteriorly or the cerebellum posteriorly

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10
Q

how should the calipers be placed for BPD?

A

placed on the outer edge of the near fiels cranium and the inner edge of the far-field cranium

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11
Q

what is brachycephaly?

A

an abnormally widened BPD

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12
Q

what is dolichocephaly?

A

an abnormally shortened BPD

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13
Q

what plane is used when calculating head circumferance?

A

same as BPD

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14
Q

how should the ellipse tracing be placed for head circumferance?

A

placed along the outer border of the fetal cranium and should not include the soft tissues of the fetal scalp

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15
Q

why is HC helpful in cases of abnormal fetal head shape?

A

becuase it is least influenced by shape

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16
Q

what is calculation of AC used for?

A

estimation of fetal size or weight

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17
Q

how should the AC be obtained?

A

with the true transverse plane of the fetal abdomen at the level of the umbilical vein junction with the left portal vein

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18
Q

what should not be seen in the image of the AC?

A

kidneys should not be seen

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19
Q

what are the limitations for assessment of gestatinal age?

A
  • fetal crowding can alter the fetal abdomen shape and its size
  • oligohydramnois and advanced gestational age may influence the AC
  • the fetal abdomen also has a large variation during the 3rd trimester because of biologic influences
  • fetal AC is influenced more by fetal size than fetal age, especially in the 3rd trimester
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20
Q

can gestational age be relied on by the AC?

A

no, particullary in the 3rd trimester

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21
Q

what is the second to the BPD in accuracy for prediction of gestational age in the 2nd trimester?

A

femur length

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22
Q

what is least affected by surrounding structure?

A

femur length

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23
Q

should both or 1 femur be visualized be examined?

A

both femurs in the presence of ossification and gross symmetry

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24
Q

what femur should be examined?

A

the femur closest to the trasducer

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25
Q

how may occipital frontal diameter (OFD) be used?

A

may be used along with the BPD to determine the fetal head shape and size

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26
Q

what is the cephalic index calculation?

A

CI=(BPD/OFD) x 100

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27
Q

what is a normal cephlaic index?

A

76 to 84

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28
Q

what does a high cephalic index indicate?

A

brachycephalic

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29
Q

what does a low cephalic index indicate?

A

dolichocephalic

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30
Q

how is OFD demonstrated?

A

by the caliper line over the cerebral falx

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31
Q

what is the binocular measurement?

A

measurement across the distance of both orbital rims

32
Q

what may binocular measurment assist in diagnosing?

A

facial abnormalities such as:

  • hypotelorism
  • hypertelorism
33
Q

what is the transcerebellar (TCD) measurment?

A

the posterior fossa region of the fetal head evaluated for evidence of pathology (cerebellar hypoplasia)

34
Q

what may be used as a secondary biometric measurement to assess gestational age?

A

TCD

35
Q

what can be visualized when measureing the TCD?

A
  • cerebellum
  • cerebral peduncles
  • thalmus
36
Q

how are the cerebrellar hemispheres identified?

A

as 2 hypoechoic circular structures with echogenic borders on both sides of midline

37
Q

what is the vermis?

A

brightly echogenic wedge shaped between the cerebellar hemispheres

38
Q

what are the other structures included in the posterior fossa?

A
  • cisterna magna

- nuchal fold

39
Q

when does the cerebral hemispheres correlate with gestational age?

A

between 15-25 weeks

40
Q

what is the cisterna magna?

A

anechoic space located in the posterior fossa immediately posterior to the cerebellum

41
Q

what may an abnormal sized cisterna magna (1cm) suggest?

A
  • ventriculomegaly
  • cerebellar hypoplasia
  • dandy-walker malformation
42
Q

what is absence of obliteration of the cisterna magna associated with?

A

fetal spinal dysraphism

43
Q

what is the nuchal fold measured for?

A

in the 2nd trimester to identify a risk for trisomy 21

44
Q

what is the nuchal fold?

A

skin at the posterior edge of the fetal cranium

45
Q

what measurments of nuchal fold suggest trisomy 21?

A

thickness of 5-6mm or more between weeks 18 and 24

46
Q

where is the atrium of the lateral ventricle located?

A

inferior to the level of the BPD

47
Q

what is the atrium of the lateral ventricle?

A

junction of the anterior, occipital, and temporal horns

48
Q

what is the measuerment of the atrium of the lateral ventricles?

A

6-10mm throughout pregnancy

49
Q

what does the choroid plexus produce?

A

CSF

50
Q

what does thoracic circumferance get measured for?

A

diagnosis of potentially lethal fetal abnormalities

51
Q

what can comparison of thoracic and abdominal provide information about?

A

skeletal dysplasias

52
Q

what may an abnormally small thoracic to AC ratio assist in the assessment of?

A

risk of pulmonary hypoplasia

53
Q

what is the normal heart circuferance>

A

1/3 of the thoracic circumferance

54
Q

what does biophysical profile indirectly test for?

A

fetal hypoxia

55
Q

how long is the fetus observed for in biophysical profile?

A

30 minutes

56
Q

what are the 5 parameters assesed in biophysical profile?

A
  • fetal tone
  • fetal breathing
  • body movements
  • amniotic fluid volume
  • nonstress test or placenta grade
57
Q

placental grading-grade 0

A

<18 weeks

58
Q

placental grading-grade 1

A

occasional parenchymal calcification (18-29 wks)

59
Q

placental grading-grade 2

A

occasional basal calcifications with indentations of chorionic plate

60
Q

placental grading-grade 3

A

significant basal calcifications with chorionic plate indentations to the basal layer (>39 wks)

61
Q

what is fetal tone?

A

one complete episode of flexion to extension and back to flexion

62
Q

what is fetal movement?

A

three seperate fetal movements within 30 minutes

63
Q

what is fetal breathing movement?

A

movement of the diaphragm >30s

64
Q

what is amniotic fluid volume?

A

amniotic pocket >2cm OR

amniotic fluid index >5cm

65
Q

what is a nonstress test?

A

exhibits two fetal heart accelerations within 20 min or placental grade >2

66
Q

what are the total points in biophysical test?

A

> 8

67
Q

what are markers for acute fetal hypoxia?

A
  • nonstress findings
  • fetal tone
  • breathing and body movements
68
Q

what is a marker for chronic fetal hypoxia?

A

amniotic fluid volume

69
Q

what is fetal presentation?

A

realtionship of the fetal head with the internal cervical os

70
Q

when does fetal position change less frequently?

A

after 34 weeks

71
Q

what is cephalic or vertex position?

A

fetal head lies most inferior, closest to the cervical os

72
Q

what is the transverse postion?

A
  • fetal head and body lie across the maternal abdomen

- check for signs of placenta previa

73
Q

what is the oblique presentation?

A

-fetal head and body are lying at a 45 degree angle to the maternal sag plane

74
Q

what is breech presentation?

A
  • fetal head located in the superior portion of the uterus

- presenting part should be determines after 36 weeks gestation

75
Q

what is frank breech presentation?

A
  • fetal buttocks are presenting with the feet near head

- hips flexed and knees extended (most common)

76
Q

what is complete breech presentation?

A
  • fetal buttocks are presenting with the knees bent and feet down
  • both hips and knees are flexed ( most common)
77
Q

what is an incomplete breech presentation?

A
  • footling breech-fetal foot is the presenting part
  • one or both hips and knees are extended
  • greatest risk for prolapsed cord

OB/GYN review (8 decks)

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