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Gynaecology > Ultrasound > Flashcards

Ultrasound Flashcards

1
Q

What is the purpose of advanced ultrasound techniques in obstetrics?

A

Advanced ultrasound techniques go beyond routine scanning, providing more detailed information to guide clinical management. They offer deeper insights into fetal development, maternal health, and potential pregnancy complications.

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2
Q

What is Doppler ultrasound, and what does it assess?

A

Doppler ultrasound measures blood flow velocity through blood vessels to assess fetal and maternal circulation, placental function, and complications like fetal growth restriction (FGR), pre-eclampsia, and intrauterine hypoxia.

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3
Q

What are the types of Doppler ultrasound, and what do they assess?

A

Umbilical Artery Doppler: Assesses placental blood flow and detects placental insufficiency and fetal distress.

Middle Cerebral Artery Doppler: Evaluates brain circulation and monitors fetal anemia and FGR.

Uterine Artery Doppler: Early detection of pre-eclampsia and placental insufficiency.

Ductus Venosus Doppler: Evaluates blood flow from the umbilical cord to the fetal heart in suspected fetal compromise.

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4
Q

What is 3D ultrasound used for?

A

3D ultrasound creates three-dimensional images of the fetus, helping detect facial abnormalities, visualize abnormal fetal positions, and provide clearer images for parents.

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5
Q

How does 4D ultrasound differ from 3D ultrasound?

A

4D ultrasound adds a time element to the 3D image, providing a “live” view of the fetus in motion, including breathing, swallowing, or facial expressions. It’s used for bonding, reassurance, and detecting some fetal anomalies.

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6
Q

What is the purpose of elastography in obstetrics?

A

Elastography measures tissue stiffness and is used to assess cervical stiffness (predicting preterm labor) and placental stiffness (linked to placental perfusion issues like pre-eclampsia and IUGR).

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7
Q

What is 3D/4D Doppler imaging?

A

3D/4D Doppler imaging combines Doppler ultrasound techniques with 3D/4D imaging to assess fetal and placental blood flow, identifying complex fetal conditions like congenital heart defects and brain abnormalities.

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8
Q

What is high-resolution ultrasound, and when is it used?

A

High-resolution ultrasound uses higher frequency transducers for greater detail in visualizing small structures and abnormalities, often used in early pregnancy to detect fetal anomalies such as neural tube defects or heart defects.

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9
Q

What is fetal echocardiography used for?

A

Fetal echocardiography examines the fetal heart to detect structural heart defects, using high-resolution ultrasound and Doppler to assess blood flow, valve function, and conditions like tetralogy of Fallot.

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10
Q

What is advanced placental imaging used for?

A

Advanced placental imaging assesses placental structure, position, and function. It includes placental mapping to detect abnormalities and Doppler imaging to assess blood flow for signs of insufficiency that could lead to fetal growth restriction.

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11
Q

What is the purpose of Amniotic Fluid Index (AFI) and 3D Amniotic Fluid Mapping?

A

AFI: Measures the amount of amniotic fluid to assess risks of oligohydramnios or polyhydramnios.

3D Amniotic Fluid Mapping: Provides precise visualization of fluid distribution around the fetus to identify areas of concern, such as fetal urinary tract anomalies.

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12
Q

What is the role of ultrasound in evaluating the cervix?

A

Ultrasound is used to predict preterm labor by measuring cervical length and detecting abnormalities like a shortened cervix or cervical funnel, which increases the risk of preterm birth.

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13
Q

What procedures can be guided by ultrasound in obstetrics?

A

Amniocentesis: Genetic testing through amniotic fluid collection.

Chorionic Villus Sampling (CVS): Prenatal diagnostic test for chromosomal abnormalities.

Fetal Biopsy: Genetic analysis for suspected genetic disorders or mosaicism.

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14
Q

How does ultrasound help predict pregnancy complications?

A

Ultrasound monitors factors like cervical length for preterm labor, uterine artery blood flow for pre-eclampsia, and fetal growth for intrauterine growth restriction (IUGR), guiding early interventions.

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15
Q

How can advanced ultrasound techniques be integrated with other imaging modalities?

A

Advanced ultrasound can be combined with MRI or CT to provide a more comprehensive evaluation, particularly in complex fetal anomalies or maternal conditions, such as evaluating the brain in suspected CNS abnormalities like spina bifida.

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16
Q

What are the ethical considerations when using advanced ultrasound techniques?

A

Informed consent is crucial for invasive procedures like amniocentesis. Counseling parents about abnormal findings and their implications, as well as providing follow-up, is important for appropriate management and decision-making.

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17
Q

What are the safety considerations for ultrasound during pregnancy?

A

No ionizing radiation: Uses sound waves instead of X-rays.

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18
Q

What are the thermal and mechanical effects of ultrasound?

A

Sound waves can produce heat or cause tissue vibration.

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19
Q

How do modern ultrasound machines ensure safety?

A

They operate within safe limits to avoid harm.

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20
Q

What are the safety guidelines for using ultrasound in pregnancy?

A

Use only when medically indicated.

Minimize exposure time and use the lowest power settings (ALARA principle).

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21
Q

What is the purpose of an early pregnancy ultrasound?

A

To confirm pregnancy and differentiate between intrauterine and ectopic pregnancy.

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22
Q

How is gestational age determined in early pregnancy ultrasound?

A

By measuring Crown-Rump Length (CRL).

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23
Q

Why is early pregnancy ultrasound used in case of bleeding or pain?

A

To rule out miscarriage or ectopic pregnancy.

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24
Q

What is assessed during early pregnancy ultrasound to check pregnancy viability?

A

Presence of fetal heartbeat and fetal growth.

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25
Q

How is multiple pregnancy assessed in early ultrasound?

A

By determining chorionicity and amnionicity.

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26
Q

What does an ultrasound show in suspected molar pregnancy?

A

It helps identify abnormal trophoblastic tissue.

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27
Q

What is the first visible structure in early pregnancy ultrasound?

A

The Gestational Sac (GS), seen at ~4.5–5 weeks.

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28
Q

How does the Gestational Sac (GS) appear on ultrasound?

A

A round, anechoic structure within the endometrium.

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29
Q

What is the normal growth rate of the Gestational Sac (GS)?

A

The mean sac diameter (MSD) grows ~1 mm/day

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30
Q

When is the Yolk Sac (YS) visible on ultrasound?

A

At around 5 weeks.

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31
Q

What does the Yolk Sac (YS) confirm?

A

It confirms an intrauterine pregnancy.

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32
Q

When is the Fetal Pole visible on ultrasound?

A

At around 5.5–6 weeks.

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33
Q

What does the Fetal Pole represent?

A

It represents early fetal tissue.

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34
Q

When is the fetal heartbeat visible on ultrasound?

A

From around 6 weeks.

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35
Q

What is the normal heart rate at 6 weeks?

A

100–120 bpm.

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36
Q

What is the normal heart rate after 6 weeks?

A

120–180 bpm.

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37
Q

What is the most accurate method for dating early pregnancy?

A

Crown-Rump Length (CRL) measurement.

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38
Q

What is the accuracy of Crown-Rump Length (CRL) measurement?

A

±5–7 days.

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39
Q

What measurement is used when the fetal pole or yolk sac is not visible?

A

Gestational Sac Diameter (MSD).

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40
Q

How is Gestational Sac Diameter (MSD) calculated?

A

MSD = (length + height + width) / 3.

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41
Q

What are the signs of an ectopic pregnancy?

A

Empty uterus with positive β-hCG.

Adnexal mass or free fluid in the pelvis.

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42
Q

What ultrasound technique is used for better visualization in cases of suspected ectopic pregnancy?

A

Transvaginal ultrasound.

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43
Q

What criteria indicate a non-viable pregnancy in case of miscarriage?

A

No fetal pole in a GS >25 mm (anembryonic pregnancy).

No fetal heartbeat when CRL >7 mm.

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44
Q

What are the signs of incomplete miscarriage?

A

Retained products of conception.

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45
Q

What features are suggestive of a molar pregnancy?

A

Snowstorm or cluster-of-grapes appearance.

No visible fetus in complete mole.

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46
Q

What are the characteristics of transabdominal ultrasound?

A

Non-invasive.

Requires a full bladder in early pregnancy.

Limited resolution for early findings.

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47
Q

What are the advantages of transvaginal ultrasound?

A

Provides better resolution of early pregnancy structures.

Useful for diagnosing ectopic pregnancy or miscarriage.

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48
Q

How can early ultrasound help in multiple pregnancies?v

A

Confirms chorionicity (number of placentas) and amnionicity (number of sacs).

Identifies complications like twin-twin transfusion syndrome (TTTS).

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49
Q

What is the discriminatory zone for ultrasound in early pregnancy?

A

Gestational sac becomes visible when β-hCG >1500–2000 IU/L.

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50
Q

What should be done if ultrasound findings are uncertain (e.g., no fetal heartbeat at early stages)?

A

Repeat scans to confirm the findings.

51
Q

What should always be documented during an ultrasound exam?

A

Findings, including measurements and images.

52
Q

What is the purpose of first trimester screening?

A

Early detection of chromosomal abnormalities.

Assessment of structural abnormalities.

Evaluation of maternal and fetal health.

Planning for further investigations or interventions if necessary.

53
Q

When is first trimester screening performed?

A

Between 11 weeks 0 days and 13 weeks 6 days of gestation.

Optimal timing for Crown-Rump Length (CRL) measurement: 45–84 mm.

54
Q

What is Nuchal Translucency (NT) measurement?

A

Fluid-filled space at the back of the fetal neck.

Measured on a sagittal midline view.

Normal range: <3 mm.

55
Q

What are the conditions associated with increased Nuchal Translucency (NT)?

A

Chromosomal abnormalities (e.g., trisomy 21, 18, 13).

Cardiac anomalies.

Genetic syndromes.

56
Q

What factors can affect Nuchal Translucency (NT) measurements?

A

Maternal age.

Gestational age.

57
Q

What does elevated Free β-hCG suggest?

A

What does elevated Free β-hCG suggest?

58
Q

What does decreased Free β-hCG indicate?

A

Possible trisomy 18 or 13.

59
Q

What is the significance of low PAPP-A (Pregnancy-Associated Plasma Protein-A) levels?

A

Associated with trisomy 21, trisomy 18, fetal growth restriction, and pre-eclampsia.

60
Q

What does combined risk assessment for first trimester screening include?

A

NT measurement.

Biochemical markers (β-hCG, PAPP-A).

Maternal age.

61
Q

How are results from combined risk assessment expressed?

A

As a risk ratio, such as 1 in 1000 or 1 in 50.

62
Q

What should be done for high-risk pregnancies identified in the combined risk assessment?

A

Further diagnostic tests (e.g., CVS, amniocentesis) may be required.

63
Q

What does the absence or hypoplasia of the nasal bone suggest?

A

It may indicate trisomy 21 (Down syndrome).

64
Q

What is the significance of abnormal ductus venosus Doppler flow?

A

It is associated with chromosomal or cardiac anomalies.

65
Q

What does tricuspid regurgitation indicate?

A

Increased risk of chromosomal abnormalities.

66
Q

What are the indications for first trimester screening?

A

Advanced maternal age (>35 years).

Family history of genetic conditions.

Abnormal findings in prior pregnancies.

Maternal anxiety or request for screening.

67
Q

What are the advantages of first trimester screening?

A

Early detection allows timely decision-making.

High sensitivity (~85–90%) for trisomy 21.

Non-invasive compared to diagnostic tests.

68
Q

What are the limitations of first trimester screening?

A

False positives and false negatives.

Requires expertise for NT measurement.

Cannot detect all chromosomal or structural abnormalities.

69
Q

What are the follow-up options for high-risk results in first trimester screening?

A

Diagnostic testing:
- Chorionic Villus Sampling (CVS) at 11–13 weeks.
- Amniocentesis in the second trimester.

Non-invasive Prenatal Testing (NIPT):
- Cell-free fetal DNA from maternal blood.
-High sensitivity for trisomies 21, 18, and 13.

70
Q

How does combined first-trimester screening compare to standalone NT or biochemical markers?

A

Combined screening is more effective than standalone NT or biochemical markers.

71
Q

What is the increasing role of NIPT in prenatal screening?

A

In regions with advanced screening access, NIPT is increasingly used as a primary screen.

72
Q

When is the second trimester anatomy scan (anomaly scan) typically performed?

A

Between 18–22 weeks of gestation.

73
Q

Between 18–22 weeks of gestation.

A

To assess fetal anatomy, identify anomalies, and evaluate placental and uterine structures.

74
Q

What are the indications for a second trimester anatomy scan?

A

Routine screening for fetal anomalies.

Detailed assessment in high-risk pregnancies:
- Family history of congenital anomalies.
- Abnormal first-trimester screening results.
- Maternal health conditions (e.g., diabetes, hypertension).

Evaluation of pregnancy complications (e.g., growth restriction, oligohydramnios).

75
Q

What are key structures assessed in the fetal head and brain during the anatomy scan?

A

Skull shape and integrity.

Brain structures: Lateral ventricles, choroid plexus, cerebellum, cisterna magna

Abnormalities: Hydrocephalus, anencephaly, spina bifida.

76
Q

What is checked on the fetal face during the anatomy scan?

A

Orbits and eyes.
Lips and palate (to check for cleft lip/palate).

77
Q

What is evaluated in the fetal spine during the anatomy scan?

A

Vertebral alignment in longitudinal and transverse views.

Abnormalities: Spina bifida, scoliosis.

78
Q

What aspects of the fetal thorax are assessed during the anatomy scan?

A

Lungs: Symmetry and echogenicity.

Heart:
- Four-chamber view.
- Outflow tracts.
- Abnormalities:
-Congenital heart defects.

79
Q

What is evaluated in the fetal abdomen during the anatomy scan?

A
  • Stomach and bowel: Presence and position.
  • Kidneys: Size, number, and echogenicity.
  • Bladder: Presence and filling.
  • Umbilical cord: Vessel number (normal = 3 vessels).
80
Q

What is assessed in the fetal limbs during the anatomy scan?

A

Presence of all bones (e.g., humerus, femur, tibia).

Hands and feet for abnormalities (e.g., talipes or polydactyly).

81
Q

How is the fetal genitalia assessed during the anatomy scan?

A

Identify sex (optional based on parental request)

82
Q

What biometric parameters are used to estimate gestational age and fetal growth?

A
  • Biparietal diameter (BPD).
  • Head circumference (HC).
  • Abdominal circumference (AC).
  • Femur length (FL).
83
Q

What are the possible locations of the placenta assessed during the anatomy scan?

A

Anterior, posterior, or fundal.

Low-lying or placenta previa.

84
Q

What are some abnormalities related to the placenta that can be detected during the anatomy scan?

A

Placenta accreta or infarction.

85
Q

What is assessed about the umbilical cord during the anatomy scan?

A

Insertion site into placenta.

Number of vessels.

86
Q

How is amniotic fluid assessed during the anatomy scan?

A

Assessed using the amniotic fluid index (AFI) or single deepest pocket.

Abnormalities:
- Oligohydramnios (low fluid).
- Polyhydramnios (excess fluid).

87
Q

What is the significance of cervical length in the second trimester anatomy scan?

A

Short cervix (<25 mm) increases the risk of preterm labor.

88
Q

What uterine anomalies are evaluated during the second trimester anatomy scan?

A

Fibroids or other structural abnormalities.

89
Q

What are common fetal anomalies detected during the second trimester anatomy scan?

A

Neural tube defects: Spina bifida, anencephaly.

Chromosomal anomalies: Markers like nuchal fold thickening, echogenic bowel, or short femur.

Congenital heart defects: Ventricular septal defect (VSD), tetralogy of Fallot.

Abdominal wall defects: Gastroschisis, omphalocele.

Renal anomalies: Multicystic dysplastic kidney, hydronephrosis.

Limb anomalies: Clubfoot, polydactyly.

90
Q

What are the benefits of the second trimester anatomy scan?

A

Early detection of anomalies allows:
- Parental counseling and decision-making.
- Planning for specialized care at delivery.
- Referral for further testing (e.g., amniocentesis or fetal MRI).

Provides reassurance about normal fetal development.

91
Q

What are the limitations of the second trimester anatomy scan?

A

Not all anomalies are detectable (e.g., some heart defects or genetic conditions).

Operator and equipment-dependent.

May require follow-up scans for unclear findings.

92
Q

What follow-up steps should be taken for abnormal findings in the second trimester anatomy scan?

A

Referral to maternal-fetal medicine specialists.

Additional tests:
- Genetic testing (e.g., NIPT, amniocentesis).
- Advanced imaging (e.g., fetal echocardiography or MRI).

Multidisciplinary team management.

93
Q

What is the purpose of the growth and wellbeing assessment in pregnancy?

A
  • Monitor fetal growth patterns.
  • Assess fetal health and detect any complications.
  • Identify pregnancies at risk of adverse outcomes (e.g., fetal growth restriction, macrosomia).
  • Plan for delivery and intervention if necessary.
94
Q

When is the growth and wellbeing assessment typically performed in pregnancy?

A

Performed during the second and third trimesters, typically from 24 weeks gestation onward.

Repeat assessments at 2–4 week intervals for high-risk pregnancies.

95
Q

What fetal biometric measurements are used to evaluate growth and estimate fetal weight?

A

Biparietal Diameter (BPD): Assesses the width of the fetal head.

Head Circumference (HC): Evaluates brain growth.

Abdominal Circumference (AC): Sensitive marker of fetal growth, reflecting liver size and fat deposition.

Femur Length (FL): Indicator of long bone growth.

Estimated Fetal Weight (EFW): Calculated using biometry measurements and compared with gestational age-specific growth charts.

96
Q

How is amniotic fluid volume assessed and what abnormalities can be detected?

A

Amniotic Fluid Index (AFI): Sum of the deepest pockets in all four quadrants of the uterus.

Single Deepest Pocket (SDP): Maximum depth of fluid pocket.

Abnormalities:
- Oligohydramnios: Reduced fluid (AFI <5 cm or SDP <2 cm).
- Polyhydramnios: Excess fluid (AFI >24 cm or SDP >8 cm).

97
Q

What are the key Doppler studies used in fetal growth and wellbeing assessment, and what do they indicate?

A

Umbilical Artery Doppler: Elevated resistance indicates fetal growth restriction. Abnormalities include absent or reversed end-diastolic flow.

Middle Cerebral Artery (MCA) Doppler: Low resistance suggests fetal anemia or hypoxia.

Ductus Venosus Doppler: Used in severe growth restriction to evaluate fetal cardiac function.

Uterine Artery Doppler: Abnormal waveform (e.g., notching) may indicate placental insufficiency or pre-eclampsia risk.

98
Q

What does fetal movement assessment involve, and what may reduced movements suggest?

A

Maternal perception of fetal movements (kick count).

Reduced or absent movements may suggest fetal compromise.

99
Q

What are the components of placental location and function assessment?

A

Check for:
- Normal placental position.
- Placenta previa or abruption.
- Placental calcifications or infarctions (indicators of aging or pathology).

100
Q

What are the fetal heart rate (FHR) monitoring guidelines?

A

Monitored using ultrasound or non-stress tests.
Normal range: 110–160 bpm.

101
Q

What is the Biophysical Profile (BPP), and what does it evaluate?

A

The BPP combines ultrasound and non-stress testing to evaluate:
1. Fetal breathing movements.
2. Gross body movements.
3. Fetal tone.
4. Amniotic fluid volume.
5. FHR reactivity (via NST).
Scored out of 10. A score ≥8 indicates normal wellbeing.

102
Q

What is the difference between symmetrical and asymmetrical fetal growth?

A

Symmetrical Growth:
- All parameters (BPD, HC, AC, FL) grow proportionally.
- Suggests normal development.

Asymmetrical Growth:
- Disproportionate AC reduction compared to HC and FL.
- Suggests fetal growth restriction due to placental insufficiency.

103
Q

What are the characteristics of Fetal Growth Restriction (FGR)?

A

Estimated fetal weight <10th percentile for gestational age.

Types of FGR:
- Symmetrical FGR: Early-onset, often due to chromosomal or congenital anomalies.
- Asymmetrical FGR: Late-onset, usually due to placental insufficiency.

104
Q

What is macrosomia, and what are its associations?

A

Macrosomia: Estimated fetal weight (EFW) >90th percentile or >4,000 g.

Associated with maternal diabetes and obesity.

105
Q

What are the risk factors for growth abnormalities in pregnancy?

A

Maternal: Hypertension, diabetes, malnutrition, substance abuse.

Fetal: Chromosomal abnormalities, infections (e.g., TORCH).

Placental: Insufficiency, infarction, abruption.

Environmental: Smoking, altitude, medications.

106
Q

How should abnormal growth patterns be followed up?

A

Frequent growth monitoring (e.g., every 2 weeks).

Additional tests:
- Doppler studies.
- Non-stress test (NST).
- Biophysical profile (BPP).

Consider early delivery for severe FGR or other complications.

107
Q

What is the importance of growth and wellbeing assessment in pregnancy?

A

Early detection of growth deviations allows:
- Intervention to improve outcomes.
- Prevention of complications (e.g., stillbirth, preterm birth).
- Timely referral to maternal-fetal medicine specialists.

108
Q

What is the definition of pregnancy completion?

A

Refers to the process of bringing a pregnancy to its natural or managed conclusion, either at term or earlier, depending on maternal or fetal conditions.

109
Q

What is term birth, and what are its characteristics?

A

Term Birth: Occurs between 37 and 42 weeks of gestation.

Characteristics:
- Most common and physiologically ideal completion of pregnancy.
- Can be spontaneous (natural labor) or managed (induction or planned cesarean).

110
Q

What is preterm birth, and how is it classified?

A

Preterm Birth: Birth before 37 weeks of gestation.

Subtypes:
- Extremely preterm: <28 weeks.
- Very preterm: 28–32 weeks.
- Moderate to late preterm: 32–36 weeks.

Common causes:
Preterm labor, preterm premature rupture of membranes (PPROM), or maternal/fetal complications (e.g., pre-eclampsia).

111
Q

What is post-term birth, and what are its associated risks and management?

A

Post-term Birth: Occurs after 42 weeks of gestation.

Risks:
Macrosomia, oligohydramnios, placental insufficiency, stillbirth.

Management:
Induction of labor or planned cesarean after 41+0–41+6 weeks.

112
Q

What is pregnancy loss, and how is it categorized?

A

Pregnancy Loss includes miscarriage, stillbirth, and termination:
- Miscarriage: Loss before 20 weeks.
- Stillbirth: Fetal death at or after 20 weeks.
- Termination: Intentional ending of pregnancy for medical or personal reasons.

113
Q

What is spontaneous vaginal delivery (SVD)?

A

Spontaneous Vaginal Delivery (SVD):
- Natural delivery without interventions.
- Benefits: Shorter recovery, fewer surgical risks.
- Preferred: When there are no complications

114
Q

What is assisted vaginal delivery, and when is it indicated?

A

Assisted Vaginal Delivery:
- Use of instruments like forceps or vacuum extraction to aid delivery.

Indications:
- Prolonged second stage of labor.
- Maternal exhaustion.
- Fetal distress.

115
Q

What is induction of labor, and what are the methods and indications?

A

Induction of Labor:
Stimulation of uterine contractions before the spontaneous onset of labor.

Methods:
- Pharmacological: Prostaglandins, oxytocin.
- Mechanical: Foley catheter, membrane sweep.

Indications:
- Post-term pregnancy.
- Pre-eclampsia.
- Fetal growth restriction.
- Premature rupture of membranes (PROM).

116
Q

What is a cesarean section, and what are the types and indications?

A

Cesarean Section (C-Section): Surgical delivery of the fetus through an abdominal incision.

Types:
- Elective: Planned before labor starts.
- Emergency: During labor for complications.

Indications:
- Fetal distress.
- Abnormal presentations.
- Previous C-section.
- Placenta previa.
- Failure to progress.

117
Q

What is the ideal timing for pregnancy completion at term?

A

Term Pregnancy: Planned delivery between 39–41 weeks is ideal for uncomplicated cases.

118
Q

How is timing decided for preterm or post-term pregnancies?

A

Preterm/Post-term Timing:
- Decisions based on maternal and fetal risks.
- Guided by clinical assessments.

119
Q

What are the maternal factors indicating early pregnancy completion?

A

Maternal Factors:
- Severe pre-eclampsia or eclampsia.
- HELLP syndrome (hemolysis, elevated liver enzymes, low platelets).
- Maternal infections (e.g., chorioamnionitis).
- Uncontrolled gestational diabetes or hypertension.
- Placental abruption or previa.

120
Q

What are the fetal factors indicating early pregnancy completion?

A
  • Fetal growth restriction (FGR) with abnormal Doppler findings.
  • Non-reassuring fetal heart rate patterns.
  • Oligohydramnios or polyhydramnios.
  • Intrauterine fetal demise (IUFD).
121
Q

What complications should be monitored postpartum?

A

Maternal:
- Postpartum hemorrhage.
- Infection.
- Thromboembolism.
- Psychological well-being (e.g., postpartum depression).

Neonatal:
- Breathing issues.
- Temperature regulation.
- Feeding problems.
- Infections.

122
Q

What is essential for postpartum follow-up?

A

Ensure appropriate follow-up for both mother and baby to detect and address complications early.

123
Q

What are the key goals of ultrasound in multiple pregnancies?

A

Determine chorionicity and amnionicity:
- Dichorionic-diamniotic: Separate placenta and sacs.
- Monochorionic-diamniotic: Shared placenta, separate sacs.
- Monochorionic-monoamniotic: Shared placenta and sac.

Monitor fetal growth for discordance:
- Regular biometry measurements.
- Growth discordance >20% is concerning.

Assess for complications:
- Twin-to-Twin Transfusion Syndrome (TTTS) in monochorionic twins.
- Twin Anemia-Polycythemia Sequence (TAPS).
- Increased risk of preterm labor.

Delivery planning:
- Based on chorionicity and gestational age.

Gynaecology (25 decks)

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