test review Flashcards
Decidua basalis
the myometrial or burrowing side of the conceptus
Decidua capsularis
the villi covering the developing embryo
Double decidual sac sign
interface between the decidua capsularis and the echogenic decidua on the opposite wall of the endometrial cavity
good indication of intrauterine pregnancy
Secondary Yolk sac
earlist gestational anatomy seen normally seen at 5 weeks gestation
growth rate .1mm/ml of growth of the MSD hwen the MSD is less than 15mm
detaches from yolk stalk at approx 8 weeks gestation
provides nutrients, hemotopoiesis and embryonic endoderm which forms the primitive gut
Gestational sac size
mean sac size correlates closely with menstrual age during early pregnancy remains accurate through first 8 weeks of gestation
Bradycardia
heartbeat less than 90 bpm
Tachycardia
heartbeat more than 170 bpm
Oligohydramnios
insufficient amount of amnionic fluid in the sac
if sac is 5mm less than CRl oligohydramnios may be suspected
demise is highly probable
Heteroectopic
one pregnancy in the uterus and another outside of the uterus
Acrania
abnormal mineralization of bony structures
abnormally shaped “mickey mouse” head
results in no brain no skull
Anencephaly
absence of cranium from superior to orbits with preservation of base of skull and face
brain may project from open cranium
results in face but no skull or brain
Cephalocele
Midline cranial defect
herniation of brain and meninges
Iniencephaly
defect in occiput involving the foramen magnum
extreme retroflexoin of spine
open spinal defect
very rare
Ventriculomegaly
dilation of ventricular system without enlargement of cranium
compression of choriod plexus
increased cerebrospinal fluid
dangling choroid in dilated lateral ventricle
Holoprosencephaly
failure of prosencephalon to differentiate into cerebral hemispheres and lateral ventricles between 4th and 8th weeks
complete to partial failure of cleavage of prosencephalon
facial dysmorphysim
3 tyupes alobar, semilobar and lobar
it is important to remember that before 9wks the normal fetal brain appears to have a single ventricle until the falx cerebri develops
Dandy-walker malformation
6th to 7th week gestatoin
cystic dilatoin of fourth ventricle
dysgenesis or agenesis of cerebellar vermis and hydrocephaly
elevated tentorium
Spina bifida
occurs when neural tube fails to close after 6 weeks gestation
appearance includes spinal irregularites or bulging within the posterior contour of the fetal spine
Turners syndrome
most common karyotype abnormality non lethal endochrine disorder cause by failure of the ovaries to respond to pituitary hormone
only im females
no ovaries
short growth
webbing around neck and digits
Uterine fibroids
common throughout pregnancy may increase in size throughout first trimester and early 2nd because of estrogen stimulatoin
Diamnitoic
multiple pregnancies with two anmiotic sacs
Dichorionic
multiple pregnancies with two chorionic sacs
Monoamniotic
multiple pregnancies with one anmiotic sacs
Monochorionic
multiple pregnancies with one chorionic sacs
Hematopoiesis
the formation of RBC’s starts in the yolk sac and then moves to the liver
gestational sac
1
amnion
gestational sac
2
connecting stalk
gestational sac
3
embryonic disc
gestational sac
4
yolk sac
gestational sac
5
chorion
gestational sac
6
chorionic cavity
gestational sac
7
amniotic sac
gestational sac
8
umbilical cord
gestational sac
9
yolk sac
gestational sac
10
amnion
gestational sac
11
connecting stalk
gestational sac
12
yolk sac
gestational sac
13
chorionic cavity
gestational sac
14
smooth chorion
gestational sac
15
amnion
gestational sac
16
amniotic sac
gestational sac
17
umbilical cord
gestational sac
18
yolk sac remnant
Which holonecehphaly is the worst
Alobar
consists of a single ventricle, cmall cerebrum, fused thalami, agenesis of corpus callosum and falx cerebri
remember that before 9 wks normal fetal brain appears to have single ventricle until falx cerebri developes after 9 wks
Which cavity is where the fetus exists
fetus exists in the amionic cavity
lab test that indicates pregnancy
test for human chorionic gonadotropin level
hCG test
hCg levels plateaus at
9- 10 weeks
subsequently decline while gestation continues
Chorion and amnion fuse at this time
16 weeks
Fetal heartbeat detected
day 36 heart beat begines to beat
Gestational sac MSD is _________an no yolk sac is visualized this should provoke suspicions of ___________
12 mm
abnormal pregnancy
proper measurement of MSD
L + W + H /3
Hernation of the mid gut loop decends into the abdomen at about the
11th week
normal cystic area in the fetal skull
rhombencephalon
divides into two segments, cephalic (metencephalon) and caudal (myelencephalon) component
once it divides it forms the cystic rhomboid fossa
fetal membrane and uterine wall
1
Decidua basalis
fetal membrane and uterine wall
2
amniotic fluid
fetal membrane and uterine wall
3
yolk sac
fetal membrane and uterine wall
4
placenta
fetal membrane and uterine wall
5
chorion laeve
fetal membrane and uterine wall
6
decidua capsularis
fetal membrane and uterine wall
7
amnionic cavity
fetal membrane and uterine wall
8
chorionic cavity
fetal membrane and uterine wall
9
decidua parietalis
Conception
1
Zygote
Conception
2
fertilization
conception
3
ovum
conception
4
developing follicle
conception
5
implantation
conception
6
blastocyte
conception
7
marula
Subchorionic hemorrhage
The most common occurrence of bleeding in the first trimester. These low process bleeds are from implantation of the fertilized ovum into the endometrial cavity and myometrial wall. Found between the myometrium margins of the gestational sac and may or may not be associated with placenta.
Normal cardiac activity
125-160 at week 12 it is slower early in the pregnancy and rises until 12 weeks
Heteroectopic
Simultaneous intrauterine and extrauterine pregnancy
Interstitial pregnancy
Pregnancy occurring in the fallopian tube near the cornu of the uterus
most dangerous if ruptures mother can bleed out
Cervical pregnancy
reported incidence of 1 in 16,000 pregnancies.
distinction between this and spontaneous loss, established concentric shape with dicidual reaction. Color doppler flow around the trophoblast
Increased risk of complete hysterectomy because of uncontrollable bleeding caused by increased vascularity of the cervix
Ovarian pregnancy
Very rare, accounting for less than 3% of all ectopic pregnancies.
May be difficult to distinguish from hemorrhagic ovarian cyst
Adenexal pregnancy
pregnancy in the abdominal cavity other than uterus, fallopian tube or ovary
if ruptures mother can bleed out
no viable as no way to sustain or deliver
What is the courpus luteum secerate
progesterone to help sustain the pregnancy
regresses at 16-18 weeks
< 5 cm normally
occasionally up to 10 cm
What a gestational sac should look like (normal)
round or oval shape
positioned fundal or middle portoin of uterus, center position relative to the endometrium
smooth contour
echogenic wall
yolk sac present when larger than 12mm
embryo present when larger than 18mm
growth 1mm/day
1800ml for hcG level
normal gestational sac consistently demonstrated
CRL crown rump length
obtained as early as 5.5 weeks using transvaginal probe
visualizatoin of heart motion is marker signifying the beginning of CRL measurement
considered the most accurate method of dating through 12 weeks gestation
at that time fetal position starts to curl making it more difficult to measure
rise in hCG levels
normal itrauterine pregnancy less than 7 weeks double every 2 days
low hCG levels
relative to gestational sac size demonstrate an abnormal pregnancy
hCg levels fall before spontaneous expulsoin of nonviable gestations
CRL is performed up until 12 weeks then how is fetus measured
biometric measurements
biparietal diameter
femur length
anembryonic pregnancy
blighted ovum
gesatoinal sac in which the embryo faisl to develope or stops developing at such an early stage that it is imperceptible by ultrasound
hcg levels and gestatoinal sac may continue as normal, but not at expected rate
pseudogestational sac
gestatoinal sac within the uterus along with an ectopic pregnancy
do not coantain living embryo or yolk sac
centrally located within endometrial canal
homogeneous level echoes are commonly observed unlike normal sacs
Ectopic pregnancy symtoms/signs
vaginal bleeding
empty uterus
presence of adnexal mass
postitive pregnancy test
found in nearly 45% of cases
tubal ectopic pregnancy
about 95% of all cases
diagnosed by invasoin of trophoblastic tissue wtihin the fallopian tube mucosa
causes bleeding which may cause hematosalpinx, hemoperitoneum or both
When does the bladder become visualized
10-12 weeks gestation
hCG levels with trophoblastic disease
hydatidiform mole
levels drastically elevated and are often greater than 100, 000 IU/ml
accompanied by vaginal bleeding in early first/second trimester
also may experience hyperemesis gravidarum or preeclampsia
serum alpha-fetoprotein levels will be notably low
identification of a uterine fibroid in first trimester
leiomyomas are very common throught pregnancy
identify location of fibroid in relation to placenta and cervix
may increase in size due to estrogen stimulatoin
could block cervix and birth canal
rapidly growing fibroids may compress the gestatoinal sac causing spontaneous abortion
polygodramnios
too much amniotic fluid in the sac
gastroshisis
Congenital defective opening in the wall of the abdomen just to the right of umbilical cord; bowel and other organs may protrude outside the abdomen from this opening. Isnt’ that serious the baby can live with this defect
omphalocele
Congenital effect of the abdominal wall with protrusion of abdominal content into the base of the umbilical cord; the cord appears to enter the mass
