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OB/GYN review > Test 4 Part 1 > Flashcards

Test 4 Part 1 Flashcards

1
Q

where does the umbilical vein enter?

A

left portal vein

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2
Q

where do the umbilical arteries arise from?

A

internal iliac (hypogastric) arteries

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3
Q

what is the umbilical cord bathed in?

A

wharton jelly

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4
Q

what does the umbilical artery do?

A

return venous blood back to the placenta

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5
Q

describe umbilical artery resistance

A
  • low resistance near the fetal insertion

- high resistance near the placental inserton

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6
Q

what does the umbilical vein do?

A

carries oxygenated blood

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7
Q

describe the flow in the umbilical vein?

A
  • continuous low flow through systole and diastole

- flow is directed from the placenta to the fetus

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8
Q

what does having a single umbilical artery increase the risk of?

A

associated fetal anomalies and IUGR

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9
Q

what does having a single umbilical artery associated with?

A

malformations of all major organ systems, chromosomal abnormalities

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10
Q

what is a nuchal cord?

A

-cord completely surrounds fetal neck with more than one loop

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11
Q

how does nuchal cord occur?

A

fetus will turn in and out of the umbilical cord throughout the pregnancy

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12
Q

what is a prolapsed cord?

A

cord precedes the fetus in the birth process

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13
Q

what is a battledore placenta (marginal)?

A

cord inserts into the end margin of the placenta

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14
Q

what is a circumvallate placenta?

A

abnormal placental shape in which the membranes insert away from the placental edge toward the center

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15
Q

what does having a circumvallate placenta increase the risk of?

A
  • abruption
  • IUGR
  • premature labour
  • perinatal death
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16
Q

what is a succenturiate placenta?

A

a result of the lack of the adjacent chorionic villi to atrophy

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17
Q

how many pregnancies does succeturiate placenta occur in?

A

5%

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18
Q

what does succenturiate placenta have an increased risk of?

A

velamentous cord and vasa previa

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19
Q

what is a chorioangioma?

A

placental hemangioma (no clinical significance when small)

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20
Q

how does a chorioangioma occur?

A

arises fromt he chorionic tissue of the amniotic surface of the placenta

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21
Q

what is a choriocarcinoma?

A

malignant form of trophoblastic disease

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22
Q

how does choriocarcinoma occur?

A

50% are preceeded by a molar pregnacy

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23
Q

what may a complete molar pregnancy may develop into?

A

choriocarcinoma

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24
Q

is a partial mole malignant?

A

carries little malignant potential

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25
Q

what is a velamentous cord insertion?

A

umbilical cord inserts into the membranes before entering the placenta

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26
Q

what is a velamentous cord not protected by?

A

wharton jelly

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27
Q

what is velamentous cord associated with?

A
  • preterm labour
  • abnormal fetal heart pattern
  • low Apgar scores
  • low birth weight
  • IUGR
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28
Q

what is hydrocephaly?

A

a dilated ventricle with enlargment of the head

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29
Q

what is ventriculomegaly?

A

dilation of the ventricles without enlargment of the head

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30
Q

what is the most common intracranial abnormality detected by US?

A

ventriculomeglay

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31
Q

what terms are sometimes used interchangeably?

A

hydrocephaly and ventriculomegaly

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32
Q

what is associated with hydrocephaly and ventriculomegaly?

A

high morbidity and mortality

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33
Q

what may be the result of a congenital anomaly or aquired?

A

hydrocephalus

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34
Q

what does hydrocephaly lead to?

A

intracranial pressire compromising brain parenchyma

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35
Q

what may ventricular enlargment result from?

A

compensation for atrophy or abnormal development of brain parenchyma

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36
Q

what are causes of hydrocephaly?

A
  • holoprosencepahly
  • spina bifida
  • encephalocele
  • dandy-walker malformation
  • aqueductal stenosis
  • arachnoid cysts
  • agenesis of the corpus callosum
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37
Q

what can hydrocephaly be associated with?

A
  • congenital infections
  • neoplasms
  • MSK anomalies
  • aneuploidy
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38
Q

what is holoprosencephaly?

A

encompasses a rangle of severity characterized by incomplete or lack of cleavag of the forbrain

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39
Q

what is the most severe holoprosencephaly?

A

alobar holoprosencephaly

40
Q

describe alobar holoprosencephaly

A
  • complete failure of separation of the forebrian

- fusion of the thalami, a single ventricle, and fusion of the cerebral hemispheres

41
Q

what is absent in alobar holoprosencephaly?

A
  • flax
  • corpus callosum
  • olfactory bulbs
  • optic tracts
42
Q

what is semilobar holoprosencephaly?

A

partial cleavage of the forebrain and absence of the corpus callosum and olfactory bulbs

43
Q

describe lobar holoprosencephaly?

A
  • mildest form
  • seperation of the cerebrum
  • fusion of the lateral ventricles
  • absence of the corpus callosum
44
Q

what is holoprosencephaly associated with?

A
  • severe facial abnormalies
  • including cyclopia
  • ethmocephaly
  • cebocephaly
  • facial clefts
45
Q

what chromosomal is holoprosencephaly associated with?

A

trisomy 13

46
Q

what syndromes may holoprosencephaly be seen in?

A
  • edwards syndrome (18)
  • Smith-Lemli-Opitz syndrome
  • Pallister Hall syndrome
47
Q

who is holoprosencephaly more common in?

A

females

48
Q

how is hydrancephaly characterized?

A

destruction of the brain parenchyma with replacement by cerebrospinal fluid

49
Q

what are the causes of hydrancephaly?

A
  • vascular malformation
  • congenital infections
  • cocaine abuse
50
Q

how is dandy walker malformation characterized?

A

by absence or dysplasia of the cerebellar vermis and maldevelopment of the 4th ventricle with the replacement by a posterior fossa cyst

51
Q

what is DWM associated with?

A

ventriculomagaly

52
Q

what may DWM be isolated or associated with?

A

syndromes
aneuploidy
maternal infection

53
Q

what intracranial anomalies is associted with DWM?

A

ACC

54
Q

out of all infants who survive DWM, how many are intellectually impaired?

A

40%-70%

55
Q

what is the purpose of the corpus collosum?

A

connects the cerebral hemispheres and aids in learning and memory

56
Q

ACC may be found in ________

A

isolation

57
Q

what can ACC be associated with?

A

other anomlaies of central nervous system, a variety of chromosomal anomlies, syndromes, and metabolic diseases

58
Q

what are the symptoms of ACC?

A

asymptomatic or have a grave prognosis when severe anomalies are identified

59
Q

what cysts in the brain resolve?

A

choroid plexus cysts

60
Q

what are choriod plexus cysts associated with?

A

aneuploididy (mostly 18)

61
Q

what should be done when a choroid plexus cyst has been identified?

A

a targeted sonogram to search for additional anomalies should be preformed

62
Q

A new risk for aneuploidy can be given that combines ____________

A

the targeted scan and serum screen with maternal age and family history

63
Q

what is the most comon congenital defect of the face?

A

cleft lip/palate

64
Q

cleft palate occurs in approx ____ of cases of cleft lip

A

80%

65
Q

what side are unilateral cleft more commonly?

A

left sided

66
Q

what are median clefts and bilateral cleft associated with?

A

cleft palate

67
Q

what does cleft lip/palate have an increased frequency of?

A
  • aneuploidy
  • skeletal anomalies
  • syndromes
68
Q

what is micrognathia?

A

small or recessed chin

69
Q

what is micrognathia associated with?

A
  • aneuploidy
  • skeletal anomalies
  • multiple syndromes
70
Q

what are the most common anomalies associated with micrognathia?

A

trisomy 13 and 18

71
Q

what plane is micrognathia identfied on US?

A

sag plane

72
Q

what may be identified in associated with micrognathia?

A

polyhydramnois

73
Q

what is congenital diaphrahmatic hernia?

A

herniation of abdominal contents into the thorax through a defect in the diaphragm

74
Q

what has been assosiated with CDH?

A

gentic and teratogenic factors

75
Q

which side is CDH more common on?

A

left side

76
Q

what is CDH associated with?

A
  • chromosomal anomalies

- defects of the central nervous system and heart

77
Q

what is the most common sonogrpahic finding in CDH?

A

stomach above the diaphragm

78
Q

what is congenital cystic adenomatoid malformation?

A

a rare lung abnormality charcterized by an overgrowth of terminal bronchopulmonary tissue

79
Q

what is type 0 CCAM?

A

acinar dysplasia

80
Q

what is type 1 CCAM?

A

macrocystic masses that consist of multiple large cyst

81
Q

what is type 2 CCAM?

A

single large cyst and smaller cysts less than 1cm

82
Q

what is type 3 CCAM?

A

a microcystic variety that appears as a large echogenic mass

83
Q

what is a type 4 CCAM?

A

a peripheral cyst

84
Q

is CCAM usually bilateral or unilateral?

A

unilateral involving one lung

85
Q

what may CCAM be associated with?

A
  • hydrops
  • polyhydramnois
  • pulmonary hypoplasia
86
Q

what is pulmonary sequestration?

A

a rare abnormality characterized by a mass of lung tissue

87
Q

what does pulmonary seqstration not connect with?

A

tracheobronchial tree

88
Q

what does pulmonary sequestration have that is seperate?

A

seperate blood supply that usually originates form the abdominal aorta

89
Q

which type of pulmonary sequestration has the most anomalies?

A

extralobar (may appear above or below the diaphragm)

90
Q

what is pulmonary sequestration associated with postnatally?

A
  • mediastinal shift
  • pleural effusion
  • hydrops
91
Q

what are the outcomes for pulmonary sequestration?

A

newborns may die of pulmonary hypoplasia or be completely asymptomatc and need respiratory support or surgery to resect the sequestered lung

92
Q

what is pulmonary effusion? (EF-hydrothorax)

A

a rare entity characterized by an abnormal accumulation of fluid in the fetal thorax

93
Q

what is the outcomes of pulmoary effusion?

A
  • resolve spontaneously
  • lead to pulmonary hypoplasia
  • progress to hydrops
  • fetal death
94
Q

what is pulmonary effusion associated with?

A
  • CCAM
  • pulmonary sequestration
  • CDH
  • cardiac defects
  • chromosomal anomalies
  • other structural defects
95
Q

how can sonographic diagnosis be made of PE?

A

when fluid is identified in the fetal thorax surrounding lung tissue

OB/GYN review (8 decks)

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