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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
What makes up the double bleb sign?
Amnion and yolk sac
26
What is a normal measurement for a yolk sac?
6 mm
27
What is produced by the yolk sac?
Alpha fetoprotein (AFP)
28
Where can the embryo be found in relation to the yolk sac?
Right next to it
29
How does chorionic fluid appear sonographically?
Echopenic; low level echoes
30
What is chorioamniatic separation?
When the amnion does not fuse with the chorion by 16 weeks
31
What is the allantois?
Part of connecting stalk; Gives rise to umbilical cord
32
What connects the embryo to the yolk sac?
Viteline duct
33
What is the function of the yolk sac?
Hematopoiesis and transfer of nutrients
34
What does the chorion secrete?
hCG
35
What is a pseudosac associated with?
ectopic pregnancy
36
formula for MSD? formula for gestational days? gestational weeks?
-(length+thickeness+width)/3+=MSD (mm) -MSD+30= gestational days -gestational days/7=gestational weeks
37
The GS grows _______ a day.
1-2 mm
38
When should you measure the GS?
When there is no embryo
39
The hindbrain is also known as the __________ and appears ______ sonographically.
rhombencephalon; anechoic
40
The hindbrain is also known as the __________ and appears ______ sonographically.
rhombencephalon; anechoic
41
When is the rhombencephalon seen?
10 weeks
42
When do you stop using the mean sac diameter? and what is used instead to measure?
When fetal pole is seen; CRL (crown to rump length)
43
What is the most accurate measure of the first trimester?
CRL
44
Around when is the fetal pole seen?
6-7 weeks TAS
45
When the primary yolk sac persists, what is it called?
Meckel’s diverticulum
46
CRL formula for GA
cm —> mm +6.5 =gestational weeks
47
When should you stop measuring CRL?
end of first trimester (14 weeks)
48
Nuchal translucency is filled with?
lymphatic fluid
49
The measurement for nuchal translucency cannot exceed ______.
3 mm
50
How much does the embryo grow per day?
1-2 mm
51
Physiological midgut herniation should resolve at ?
12 weeks
52
Gastroschesis
intestines extend outside abdomen past week 12 within a sac; good prognosis (can be put back in)
53
Omphalocele
intestines are outside body; poor prognosis (no sac)
54
Do not mistake physiological midgut herniation for ______ or _______.
omphalocele or gastroschisis
55
hCG is present by?
Day 28
56
hCG ______ every ______.
doubles; 48 hours
57
Excessive hCG can cause excessive vomiting also known as
hyperemesis gravidarum
58
Threatened abortion
closed cervix and vaginal bleeding
59
Incomplete abortion
RPOC; requires D&C
60
Complete abortion
No RPOC; clean endo stripe
61
Inevitable abortion
dilated cervix; baby falls out of
62
Habitual abortions
incompetent cervix; 2+ consecutive pregnancy losses; can be from DES
63
missed abortion
intrauterine fetal death
64
anembryonic abortion
large GA with no embryo (>25 mm); aka blighted ovum
65
What is the most common location of an ectopic pregnancy?
ampulla
66
What is the most dangerous location for an ectopic pregnancy?
interstitial
67
What is the triad of an ectopic pregnancy?
pain, bleeding, adnexal mass; ring of fire
68
heterotopic
ectopic pregnancy with IUP pregnancy
69
Gestational Trophoblastic Disease is also called?
GTD, molar pregnancy, hydatidiform mole
70
What is GTD?
a benign tumor in the uterus
71
What causes GTD?
An extra set of paternal chromosomes in the zygote
72
Sonographic appearance of GTD?
grapes, snowstorm, swiss cheese
73
Signs of GTD?
hyperemesis gravidarum, theca lutein cysts, elevated hCG

OB/GYN (13 decks)

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