Week 1 maternal and fetal part 4 of 4 Flashcards

1
Q

name the most common cause of polyhydramnios

A

esophageal atresia

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2
Q

which nerve is most commonly injured during abdominal hysterectomy

A

femoral nerve

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3
Q

which nerve may be injured during vaginal hysterectomy

how does this manifest?

A

common peroneal nerve

leads to foot drop

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4
Q

which nerve is commonly injured during vaginal delivery

A

lumbosacral nerve

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5
Q

what is the most common cause of anesthesia related maternal mortality

A

airway complications

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6
Q

fetal development size at 2-3 weeks post fertilization

A

fetus is microscopic in size.

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7
Q

fetal development

length at 12 weeks

A

10cm long

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8
Q

fetal development length at 20 wks

A

25cm long

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9
Q

fetal development 40 wks term length

A

53cm (21in)

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10
Q

fetal development weight reaches 1 lb at how many months

A

5.5mo

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11
Q

weight reaches 3 lbs at what month

A

7mo

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12
Q

weight reaches 4.5lbs at what month

A

8mo

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13
Q

term fetal weight

A

7lb

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14
Q

mother typically gains 11kg due to increase in what three things?

A

increased blood volume

size of fetus

placenta

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15
Q

heart rate close to term

A

140 bpm

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16
Q

when does fetal heart begin beating?

what is the average bpm at that point?

A

4 weeks

65bpm

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17
Q

fetal development cardiac output is constant at what Fetal heart rate?

A

constant from 120-180bpm

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18
Q

between what two weeks does surfactant production begin

A

23/24 weeks

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19
Q

** exam** how much pressure is needed to open airways

A

25-40mmhg

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20
Q

fetal development characteristic of liver metabolism

A

decreased liver metabolism

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21
Q

*** where does the spinal cord end in the fetus

A

L3

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22
Q

smaller airways leads to

A

high risk of obstruction

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23
Q

is fetal development lung compliance and FRC increased or decreased

A

decrease lung compliance

decrease FRC

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24
Q

fetal lungs have ____ closing capacity

A

increased closing capacity

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25
Q

fetal large tongue=

A

high risk of obstruction

difficult intubation

26
Q

HR fetal development

A

100-180bpm

27
Q

what does cardiac output depend on

A

heart rate

28
Q

fetal pC02=

A

40-45mmhg

29
Q

fetal p02=

A

30mmhg

30
Q

describe fetal shivering

A

unable to shiver meaning they are higher risk of hypothermia

31
Q

how does the fetus produce heat

A

by burning brown fat

32
Q

maintain room temp at

A

26c

33
Q

fetal development 3rd week- nucleated RBC’s formed where?

A

nucleated RBC’s formed in yolk sac and mesothelium of placenta

34
Q

fetal development 4 weeks

non - nucleated RBC’s formed

A

formed by fetal mesenchymal and endothelial cells.

35
Q

at 6 weeks blood cells are formed where?

A

liver forms blood cells

36
Q

at 12 weeks. what happens to RBC development

A

spleen and lymphoid tissue, also bone marrow: red and white blood cells, other structures lose ability to form blood cells.

37
Q

diffusion through placental membrane

A

simple diffusion from sinuses through villus membrane down pressure gradient to fetus

38
Q

simple diffusion from sinuses through villus membrane down pressure gradient to fetus

mean p02 in fetal blood pressure

A

30mmhg

39
Q

simple diffusion from sinuses through villus membrane down pressure gradient to fetus

mean p02 in villus

A

50mmhg

40
Q

simple diffusion from sinuses through villus membrane down pressure gradient to fetus

from maternal blood pressure

A

100mmhg

41
Q

what is the fetal Hb affinity for 02

A

very high affinity

42
Q

fetal Hb can carry how much more 02 % than maternal Hgb

A

20-30% more 02

43
Q

which way does newborn oxygen-hb curve shift

A

left shift

44
Q

fetal Hb concentration in blood is what % greater than in mother

A

50%

45
Q

anemia when Hb< ___ newborn

A

13

10- g/dl in >3mos

46
Q

name the two ways nutrients go from mother to fetus

A

similar to oxygen- higher to low gradient

electrochemical gradients.

47
Q

CO2 builds up until it is slightly higher in fetus umbilical arteries (___mmhg)

A

48mmhg

48
Q

co2 is higher in fetus umbilical arteries at 48mmhg than in intervillous space (___mmhg)

A

43mmhg

49
Q

fetal affinity for co2

A

affinity for c02 is lower in fetus- favoring transfer from fetus to mother

50
Q

receptor mediated endocytosis from mother:

A

LDL

what does this mean

51
Q

renin increases late in gestation due to what three things

A

Renal sympathetic nerve activity

Reduction in Na and blood volume

Change in renal perfusion pressure

52
Q

fetal GFR and concentrating ability

A

low GFR

Low Concentrating ability

53
Q

due to decrease GFR and decrease concentrating ability can the fetus tolerated volume overload

A

no they cannot tolerate volume overload.

54
Q

fetal aldosterone level?

A

low, rapid clearance

55
Q

angiotensin II not directly related to

A

renin (LOW ACE, HIGH CLEARANCE)

56
Q

noninvasive diagnosis of fetal well being

A

transvaginal ultrasound: visualize vertebrae, kidneys, bladder, fingers and toes by 12 wks gestation

57
Q

invasive diagnosis of fetal well being

A

amniocentesis
14-16 weeks: when amniotic cavity contains 150-200ml remove 20ml; with simultaneous ultrasound karyotyping, biochemical analyses, dna

58
Q

diagnosis of fetal well being

Chorionic villus sampling

A

cytogenetic and biochemical testing recommended after 10 wks gestation; usually 2nd and 3rd trimester

59
Q

Chorionic villus sampling - when is this testing recommended

A

recommended after 10 wks gestation, usually 2nd and 3rd trimester

60
Q

diagnosis of fetal well being

Fetal blood sampling

A

transabdominal; from 17 wks into umbilical vein about 1 cm from placental cord insertion site