Week 3: Prenatal Flashcards
What do you use for carrier screening for hemoglobinopathies?
Hb Elect
Typical Hb Elect for sickle cell carrier
MCV < 80, presence of abnormal Hb- S, C, E
Typical Hb Elect for beta thal carrier
MCV <80, Low HbA, High HbA2
Typical Hb Elect for alpha thal carrier
MCV < 80, Normal Hb elect
What diseases does ACOG recommend carrier screening for, AJ couples
Tay Sachs, Canavan, Familial Dysautonomia, CF
What method do you use for carrier screening for Tay Sachs?
HEXA enzyme analysis
What method do you use for carrier screening for CF?
23 mutation panel
What method do you use for carrier screening for Fragile X?
Molecular analysis for CGG repeat expansion
Premutation carriers of Fragile X are at risk for?
POI, FXTAS
What method do you use for carrier screening for SMA?
Molecular
What is background risk for babies to be born with birth defect or developmental disability?
3-5%
Category A teratogen
Controlled studies in humans show no risk
Category B teratogen
Animal studies show no risk
Category C teratogen
Animal studies show a risk
Category D teratogen
Positive evidence of human fetal risk
Category X teratogen
Contraindicated in pregnancy
Thalidomide critical period
34-50 days post-LMP
Complications in fetus exposed to thalidomide
Limb reduction defects
Warfarin critical period
8-11 weeks post-LMP
Complications in fetus exposed to warfarin
Nasal hypoplasia, stippled epipheses, limb hypoplasia
ACE inhibitors critical period
2nd/3rd trimester
Complications in fetus exposed to ACE inhibitors
Renal tubular dysplasia– potter sequence–pulmonary hyoplasia, IUGR, hypocalvaria
Complications in fetus exposed to SSRIs
increased risk for CHD
Complications in fetus exposed to Ondansetron
increased risk for CHD
Complications in fetus exposed to Fluconazole
craniofacial, limb, cardiac anomalies
Complications in fetus exposed to valproic acid
Meningomyelocele, CHD, facial clefts, hypospadias, limb defects, craniosynostosis, facial features
Complications in fetus exposed to accutane
CNS anomalies, ear anomalies, CHD, thymus anomalies
Complications in fetus exposed to Benzodiazepines
Neonatal adaptation syndrome
Complications in fetus exposed to Maternal Diabetes
Macrosomia, CHD, NTDs, caudal regression, polyhydramnios,
Complications in fetus exposed to Maternal PKU
IUGR, microcephaly, DD/ID, CHD, facial differences
How many primary maternal CMV infections result in fetal infections?
30-50%
How many asymptomatic CMV infections in fetus are there
10-15%