Week 2 Facts Flashcards
Prenatal Care Tests: Time Duration!
1) Multiple Marker Tests
2) Gestational Diabetes
3) RBC Antibody
4) STI Check (GBS)
5) FHR Patterns
1) Multiple Marker Tests = 15 - 20 weeks
2) Gestational Diabetes = 24 - 28 weeks
3) RBC Antibody = 26 - 28 weeks + within 72 hrs of delivery
4) STI Check (GBS) = 35-37 weeks, GBS antibiotics at labor
5) FHR Patterns = > 28 weeks.
Screening: alpha-fetal protein (Yolk Sac, then Fetal liver/GI)
Low = Down Syndrome High = Neural tube defect, fetal abdomen wall defect, or placenta
Screening: hCG (Synctiotrophoblasts in placenta)
Low = Ectopic or Failed Pregnancy, Edward/Patau Syndrome High = Multiple Gestation, Down Syndrome VERY High (100,000+) = Molar Pregnancy or Choriocarcinoma
Screening: Estriol (E3, only from placenta)
Low: Adrenal hypoplasia, fetal growth restriction, down syndrome
High: Nothing
Screening: Inhibin (Corpus Luteum/placental synctiotrophoblats)
High : Preeclampia, fetal growth restriction, Down syndrome
Rupture of Membrane DX
1) U/S to see if fluid is around the fetus
2) Pooling of fluid on the bottom blade of speculum
3) Nitrazin Test (+) = amniontic fluid > 7.1 pH
4) Ferning = wet mount
Non Stress Test + Contraction Stress Test
Non Stress Test = if nonreactive, could mean hypoxia or cardiac/neurologic anomalies. (meaning movement doesn’t show an acceleration in FHR)
Contraction Stress Test (via oxytocin) = Negative CST means that there is good compensation and labor should be fine. If Positive CST = could be difficult for labor.
Fetal Circulation:
Umbilical Vein Ductus Venosum Ductus Arteriosum Foramen Ovale Umbilical Artery
1) Umbilical Vein = 80% saturated O2 blood
2) Ductus Venosum = bypass liver to IVC
3) Ductus Arteriosum = Take blood from Pulmonary trunk to right atrium
4) Foramen Ovale = Take blood from Left atrium to Right Atrium
5) Umbilical Artery = take 50% deoxygenated blood back to the mother.
Maternal Complications in Pre-eclampsia
HELLP Syndrome: Hemolysis, Elevated Liver Enzymes, Low Platelet. = Shistocytes (helmet cells) for hemolytic anemia
Thrombocytopenia, Placental abruption, pulmonary edema
MGSO4 = Use + Contraindication
Used for epilepsy in eclampsia but contraindicated in women with myastenia gravis (weakness and rapid fatigue of voluntary muscles)
Histology Preeclampsia
Placental: Chorionic villi surrounded by trophoblasts (underperfusion)
Renal: enlarged + endothelial cells are swollen within glomeruli. Fibrin also present.
hPL
Secreted by Placenta, “growth hormone” for fetus, induces lipolysis
Anti Rh (IgG) effects on fetus
Phagocytosis: hyperbilirubinemia/jaundice, hemolytic anemia, hepatosplenomegaly
Nontensive Pregnancy: Immunology
IL-12 = normal TH1 > TH2 Treg = elevated, T17 = depressed IL-6 and endoglin = normal/depressed IL-10 = normal
HTN (preeclampsia) pregnancy: Immunology
IL-12 = Increased (involved in Th1 differentiation Th2 > Th1 Treg = depressed, T17 = elevated IL-6 and endoglin = elevated IL-10 = depressed (antiinflammatory)
