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OB/GYN > The First Trimester > Flashcards

The First Trimester Flashcards

1
Q

What is the purpose of a first trimester ultrasound ?

A

Ascertain the pregnancy is progressing normally; date the pregnancy

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2
Q

The gestational age is calculated using?

A

1st day of LMP

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3
Q

The conceptual age is calculated using?

A

Fertilization (usually 2 wks less)

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4
Q

The embryonic period ends at which week GA?

A

10

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5
Q

At what week is organogenesis complete?

A

Week 10 GA

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6
Q

When in the menstrual cycle does ovulation occur?

A

Day 14 (mid cycle)

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7
Q

Where does fertilization occur?

A

Ampulla

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8
Q

What is a zygote?

A

Fertilized ovum

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9
Q

The blastocyst is developed from?

A

The morula

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10
Q

What are the two layers of the blastocyst? What does each layer become?

A
  • Outer cell mass → Trophoblast → chorion → placenta
  • inner cell mass→ embryoblast → yolk sac and amniotic cavity
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11
Q

What does the trophoblast produce?

A

hCG

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12
Q

What is hCG? Its function?

A

Human chorionic gonadotropin; stimulates corpus luteum to thicken endo to support the embryo and stop menstruation

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13
Q

Define decidua

A

Transformed endo during pregnancy

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14
Q

What are the 3 decidual layers?

A
  • Decidua basalis
  • Decidua capsularis
  • Decidua parietalis or vera
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15
Q

What is the decidua basalis?

A

only the place in the decidua that is in contact with the chorion frondosum

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16
Q

What is the decidua capsularis?

A

Completely covers blastocyst

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17
Q

What is decidua vera?

A

Lines uterine cavity

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18
Q

What is in direct contact with the decidua basalis?

A

Chorion frondosum

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19
Q

How can you identify a true GS?

A

Double decidual sac sign (DDSS); two echogenic rings (decidua capsularis and decidua parietalis); if yolk sac is not seen

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20
Q

The embryo is surrounded by the ______ in the _____________.

A

Amnion; amniotic cavity

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21
Q

What fills the amniotic cavity?

A

Amniotic fluid

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22
Q

What is the sonographic appearance of amniotic fluid?

A

Anechoic

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23
Q

The yolk sac is located in the ___________.

A

Chorionic cavity

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24
Q

Which yolk sac is seen sonographically and when?

A

Secondary; 5-6 weeks

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25
Q

What makes up the double bleb sign?

A

Amnion and yolk sac

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26
Q

What is a normal measurement for a yolk sac?

A

6 mm

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27
Q

What is produced by the yolk sac?

A

Alpha fetoprotein (AFP)

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28
Q

Where can the embryo be found in relation to the yolk sac?

A

Right next to it

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29
Q

How does chorionic fluid appear sonographically?

A

Echopenic; low level echoes

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30
Q

What is chorioamniatic separation?

A

When the amnion does not fuse with the chorion by 16 weeks

31
Q

What is the allantois?

A

Part of connecting stalk; Gives rise to umbilical cord

32
Q

What connects the embryo to the yolk sac?

A

Viteline duct

33
Q

What is the function of the yolk sac?

A

Hematopoiesis and transfer of nutrients

34
Q

What does the chorion secrete?

A

hCG

35
Q

What is a pseudosac associated with?

A

ectopic pregnancy

36
Q

formula for MSD? formula for gestational days? gestational weeks?

A

-(length+thickeness+width)/3+=MSD (mm)
-MSD+30= gestational days
-gestational days/7=gestational weeks

37
Q

The GS grows _______ a day.

A

1-2 mm

38
Q

When should you measure the GS?

A

When there is no embryo

39
Q

The hindbrain is also known as the __________ and appears ______ sonographically.

A

rhombencephalon; anechoic

40
Q

The hindbrain is also known as the __________ and appears ______ sonographically.

A

rhombencephalon; anechoic

41
Q

When is the rhombencephalon seen?

A

10 weeks

42
Q

When do you stop using the mean sac diameter? and what is used instead to measure?

A

When fetal pole is seen; CRL (crown to rump length)

43
Q

What is the most accurate measure of the first trimester?

A

CRL

44
Q

Around when is the fetal pole seen?

A

6-7 weeks TAS

45
Q

When the primary yolk sac persists, what is it called?

A

Meckel’s diverticulum

46
Q

CRL formula for GA

A

cm —> mm +6.5 =gestational weeks

47
Q

When should you stop measuring CRL?

A

end of first trimester (14 weeks)

48
Q

Nuchal translucency is filled with?

A

lymphatic fluid

49
Q

The measurement for nuchal translucency cannot exceed ______.

A

3 mm

50
Q

How much does the embryo grow per day?

A

1-2 mm

51
Q

Physiological midgut herniation should resolve at ?

A

12 weeks

52
Q

Gastroschesis

A

intestines extend outside abdomen past week 12 within a sac; good prognosis (can be put back in)

53
Q

Omphalocele

A

intestines are outside body; poor prognosis (no sac)

54
Q

Do not mistake physiological midgut herniation for ______ or _______.

A

omphalocele or gastroschisis

55
Q

hCG is present by?

A

Day 28

56
Q

hCG ______ every ______.

A

doubles; 48 hours

57
Q

Excessive hCG can cause excessive vomiting also known as

A

hyperemesis gravidarum

58
Q

Threatened abortion

A

closed cervix and vaginal bleeding

59
Q

Incomplete abortion

A

RPOC; requires D&C

60
Q

Complete abortion

A

No RPOC; clean endo stripe

61
Q

Inevitable abortion

A

dilated cervix; baby falls out of

62
Q

Habitual abortions

A

incompetent cervix; 2+ consecutive pregnancy losses; can be from DES

63
Q

missed abortion

A

intrauterine fetal death

64
Q

anembryonic abortion

A

large GA with no embryo (>25 mm); aka blighted ovum

65
Q

What is the most common location of an ectopic pregnancy?

A

ampulla

66
Q

What is the most dangerous location for an ectopic pregnancy?

A

interstitial

67
Q

What is the triad of an ectopic pregnancy?

A

pain, bleeding, adnexal mass; ring of fire

68
Q

heterotopic

A

ectopic pregnancy with IUP pregnancy

69
Q

Gestational Trophoblastic Disease is also called?

A

GTD, molar pregnancy, hydatidiform mole

70
Q

What is GTD?

A

a benign tumor in the uterus

71
Q

What causes GTD?

A

An extra set of paternal chromosomes in the zygote

72
Q

Sonographic appearance of GTD?

A

grapes, snowstorm, swiss cheese

73
Q

Signs of GTD?

A

hyperemesis gravidarum, theca lutein cysts, elevated hCG

OB/GYN (10 decks)

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