High Risk Pregnancy

Front 1

Advanced Maternal Age (AMA)

Back 1

A patient who will be 35 or older at the time of Delivery.

Front 2

Incidence of Down's Syndrome ___________ with age.

Back 2

Increases

Front 3

Hydrops Fetalis

Back 3

A condition in which excessive fluid accumulates within the fetal body cavities.

Front 4

Results of Fluid Accumulation

Back 4

-Anasarca

-Ascites

-Pericardial Effusion

-Pleural Effusion

-Placental Edema

-Polydramnios

Front 5

Two Classifications of Fetal Hydrops

Back 5

1.Immune Hydrops

2. Nonimmune Hydrops

 

Both types are characterized by extensive accumulation of fluids in the fetal tissues or body cavities

Front 6

Nonimmune Hydrops 

Back 6

Not related to the presence of Maternal Serum IgG antibody against one of the fetal blood cell antigens

Front 7

Immune Hydrops

Back 7

Initiated by the presence of Maternal Serum Immunoglobulin G (IgG) antibody against of the fetal red blood cell antigens 

*Mother is negative and Fetus is Positive

Front 8

Sensitization 

Back 8

Administration of an antigen to induce a primary immune response

Front 9

Antigen 

Back 9

Any substance that elicits an immunologic response, such as production of an antibody to that substance

Front 10

Immune Hydrops in Pregnancy

Back 10

This can occur anytime a mother is exposed to red blood cells antigens different from her own

 

ex. Mother Postive & Fetus Negative

Front 11

Pre-Eclampsia 

Back 11

Pregnancy induced High Blood Pressure

-Causes High Blood Pressure & Edema

Front 12

Eclampsia

Back 12

When pre-eclampsia is not controlled, it leads to eclampsia 

-Seizures & coma can occur due to High Blood Pressure

Front 13

Chronic Hypertension

Back 13

High Blood Pressure BEFORE 20 weeks

Front 14

NonImmune Hydrops (NIH)

Back 14

A group of conditions in which hydrops is present in the fetus but is NOT a result of fetomaternal blood group incompatibility.

Front 15

Disorders related to NIH

Back 15

・Cardiovascular, chromosomal, hematologic, urinary, and pulmonary problems
・malformation syndromes
・infectious diseases-toxoplasmosis, rubella, cytomegalovirus, herpes simplex type I (TORCH), syphilis, congenital hepatitis, and parvovirus

Front 16

Main cause for 3rd Trimester Bleeding is________ __________.

Back 16

Placenta Previa

Front 17

Vaginal bleeding in the 2nd & 3rd trimester can be associated with _____________ and _______________.

Back 17

Placenta Previa & Placental Abruption

Front 18

Vaginal bleeding in the 2nd & 3rd trimester can be associated with _____________ and _______________.

Back 18

Placenta Previa & Placental Abruption

Front 19

Placenta Previa

Back 19

The placenta covers the internal cervical os and prohibits the delivery of the fetus

Front 20

Most frequent cause of NIH

Back 20

Cardiovascular Lesions

Front 21

Uterine Contractions

Back 21

Should resolve within 20-30 minutes and typically have central blood flow

Front 22

Maternal Hemorrhage is a result of__________ in regards to Placenta Previa

Back 22

When the Cervical Os dilates with labor, there is a significant risk of the placenta detaching from the uterus.
・This can also cause loss of oxygen and blood supply to the fetus

Front 23

Low Lying Placenta

Back 23

In early pregnancy, the Placenta may be low lying , but as the Uterus grows the Placenta will appear to migrate away from the Cervical Os

Front 24

In the 2nd Half of Pregnancy if the distance is less than ___cm the condition may be classified as marginal or Partial Placental Previa

Back 24

less than 2cm

Front 25

Vasa Previa

Back 25

A rare condition in which the umbilical cord is the presenting part. (During delivery)

Front 26

_____ ______ is used during ultrasound to ***** for Vasa Previa to evaluate if there are any vascular structures in front of the Cervical Os

Back 26

Color Doppler

Front 27

Placental Abruption

Back 27

The premature separation of the Placenta from the Uterine Wall.

Front 28

When evaluating Placenta Abruption, the sonographer should be looking at the area between the _________ & ________ _________

Back 28

Placenta & Uterine Wall

Front 29

Normal space between the Placenta & Uterine wall should be:

Back 29

1-2cm thick and Hypoechoic

Front 30

If space between the Placenta & Uterine Wall is thicker than ________ , it may be by an Abruption or Uterine Contraction

Back 30

Thicker than 1-2cm

Front 31

Insulin-Dependent Diabetes Mellitus (IDDM)

Back 31

Mothers with this disease are at an increased risk for pregnancy-related complications, including Early and Late Trimester Pregnancy loss and Congenital Anomalies

Front 32

Complications of a Diabetic Pregnancy

Back 32

・Frequent Hospitalizations Glucose Control
・Serious Infections: Pyelonephritis
・Problems at time of Delivery

Front 33

Complications of a Diabetic Pregnancy

Back 33

・Frequent Hospitalizations Glucose Control
・Serious Infections: Pyelonephritis
・Problems at time of Delivery

Front 34

The Primary Fuel for Fetal Growth is _________

Back 34

Glucose

Front 35

If glucose levels are extremely high and uncontrolled during pregnancy, the fetus may become _____________

Back 35

Macrosomic

Front 36

If glucose levels are extremely high and uncontrolled during pregnancy, the fetus may become _____________

Back 36

Macrosomic

Front 37

Macrosomia

Back 37

Defined as a fetus who's weight is greater than the 90% percentile for Gestational Age

Front 38

Shoulder Dystocia

Back 38

Difficulty delivering the shoulders of the baby after the head is delivered

Front 39

Shoulder Dystocia

Back 39

Difficulty delivering the shoulders of the baby after the head is delivered

Front 40

Anomalies associated with Diabetes:

Back 40

・Congenital Heart & Neural Tube Defects

Front 41

Most Common Defect with Diabetic Fetuses is ___________

Back 41

Caudal Regressive Syndrome

Front 42

Most Common Defect with Diabetic Fetuses is ___________

Back 42

Caudal Regressive Syndrome

Front 43

Caudal Regression Syndrome

Back 43

Lack of development of the Caudal Spine (toward the feet) and Cord

Front 44

Hypertensive Pregnancies are associated with ___________ ____________

Back 44

Small Placentas because of the effect of the hypertension on the blood vessels

Front 45

If the placenta develops poorly, the _______ ________ to the fetus may be restricted and ___________ __________ may result

Back 45

Blood Supply to the Fetus may be restricted and growth restriction may result

Front 46

Hypertensive States during pregnancies

Back 46

1. Pregnancy-Induced Hypertension
2. Chronic Hypertension

Front 47

Chronic Hypertension

Back 47

Hypertension present Before the woman was pregnant

Front 48

Preeclampsia

Back 48

High blood pressure that develops with proteinuria

Front 49

Systemic Lupus Erythematosus (SLE)

Back 49

A chronic autoimmune disorder that can affect almost all organs systems in the body.

Front 50

How SLE affects the Placenta

Back 50

The placenta is affected by the immune complex deposits and inflammatory responses in the placental vessels and May account for the increased number of spontaneous abortions, stillbirths, and IUGR fetuses

Front 51

Hyperemesis Gravidarum

Back 51

Exists when a pregnant woman vomits so much that she develops dehydration and electrolyte imbalance

Front 52

Hyperemesis Gravidarum

Back 52

Exists when a pregnant woman vomits so much that she develops dehydration and electrolyte imbalance

Front 53

Causes for for vomiting while pregnant other than Hyperemesis

Back 53

・Gallstones
・Peptic Ulcers
・Trophoblastic Disease

Front 54

Hyperemesis Gravidarum

Back 54

Exists when a pregnant woman vomits so much that she develops dehydration and electrolyte imbalance

Front 55

Causes for for vomiting while pregnant other than Hyperemesis

Back 55

・Gallstones
・Peptic Ulcers
・Trophoblastic Disease

Front 56

Pseudohydronephrosis

Back 56

Pregnancy induced hydronephrosis (false)

Front 57

Hyperemesis Gravidarum

Back 57

Exists when a pregnant woman vomits so much that she develops dehydration and electrolyte imbalance

Front 58

Causes for for vomiting while pregnant other than Hyperemesis

Back 58

・Gallstones
・Peptic Ulcers
・Trophoblastic Disease

Front 59

Pseudohydronephrosis

Back 59

Pregnancy induced hydronephrosis (false)

Front 60

Symptoms of Pyelonephritis

Back 60

・Flank Pain
・Fever
・White Blood Cells in the Urine
・Hydronephrosis

Front 61

Adnexal Cyst

Back 61

Range from 8-10cm
-Should diminish as pregnancy progresses

Front 62

Premature Labor

Back 62

Onset of labor before 37 weeks of gestation

Front 63

Premature Infants are at greater risks for:

Back 63

・Respiratory Distress Syndrome
・intracranial Hemorrhage
・Bowel Immaturity
・Feeding Problems

Front 64

Premature Infants are at greater risks for:

Back 64

・Respiratory Distress Syndrome
・intracranial Hemorrhage
・Bowel Immaturity
・Feeding Problems

Front 65

Causes for Preterm Labor

Back 65

・Premature Rupture of Membranes
・Intrauterine Infections
・Bleeding
・Polyhydramnios
・Multiple Pregnancy
・Growth Restriction
・Maternal Illness such as : diabetes or hypertension
・Incompetent Cervix
・Uterine Anomalies

Front 66

Incompetent Cervix

Back 66

Also known as "funneling"

Front 67

Incompetent Cervix

Back 67

Also known as "funneling"

Front 68

Sonographic Findings of Fetal Death:

Back 68

・Absent Heart Beat
・Absent Fetal Movement
・Overlap of Skull Bones
・Exaggerated Curvature of the Fetal Spine
・Gas in the Fetal Abdominal

Front 69

Spalding's Sign

Back 69

Overlap of Skull Bones

Front 70

Maternal Serum Alpha-Fetoprotein (MSAFP)

Back 70

Screening performed routinely to detect Neural Tube defects

Front 71

Twin pregnancies are associated with elevations of ____________

Back 71

MSAFP

Front 72

Evaluating Placental Type

Back 72

Refers to the number of Chorions and Amnions

Front 73

If division occurs after 13 days ________________________

Back 73

The division may be incomplete and conjoined twins may result

Front 74

Conjoined Twins sites of Fusion

Back 74

・Head
・Thorax
・Abdomen
・Pelvis

Front 75

Two Types of Twins

Back 75

1. Dizygotic
2. Monozygotic

Front 76

Dizygotic

Back 76

Fraternal Twins

Front 77

Monozygotic

Back 77

Identical Twins

Front 78

Dizygotic Twins

Back 78

Arise from 2 separately fertilized ova
Both ovum implant separately in the uterus and develops its own Placenta, Chorion, and Amniotic Sacs

Front 79

Diamniotic

Back 79

2 Amniotic Sacs

Front 80

Dichorionic

Back 80

2 Chorions

Front 81

Monozygotic Twins

Back 81

Arise from a single fertilized egg, which divides, resulting in two genetically identical fetuses

Front 82

If division of eggs occurs between 0-4 days post conception ________________________

Back 82

There will be 2 Amnions and 2 Chorions

Front 83

If division of eggs occurs at 4 to 8 days _____________________

Back 83

There will be one Chorion and 2 Amniontic Sacs

Front 84

Vanishing Twin

Back 84

Occurs when one twin dies in utero and the other one continues to grow

Front 85

Vanishing Twin

Back 85

Occurs when one twin dies in utero and the other one continues to grow

Front 86

In cases of a "vanishing twin" :

Back 86

If demise occurs very early, complete reabsorption of both embryo and gestational sac or early placenta may occur

Front 87

Fetus Papyraceuos

Back 87

When fetus dies after reaching a size too large for reabsorption, the fetus is markedly flattened from loss of fluid and most of the soft tissue

Front 88

Fetus Papyraceuos

Back 88

When fetus dies after reaching a size too large for reabsorption, the fetus is markedly flattened from loss of fluid and most of the soft tissue

Front 89

Poly-Oli Sequence

Back 89

Also known as "stuck twin" syndrome

Front 90

Characterization of Poly-Oli Sequence

Back 90

A diamniotic pregnancy with Polyhydramnios in one sac and severe Oligohydramnios and a smaller twin in the other

Front 91

Characterization of Poly-Oli Sequence

Back 91

A diamniotic pregnancy with Polyhydramnios in one sac and severe Oligohydramnios and a smaller twin in the other

Front 92

Twin-to-Twin Transfusion Syndrome

Back 92

Exists when there is an arteriovenous shunt within the Placenta

Front 93

Twin-to-Twin Transfusion Syndrome

Back 93

Exists when there is an arteriovenous shunt within the Placenta

Front 94

Acardiac Anomaly

Back 94

A rare anomaly occurring in Monochorionic Twins, in which one twin develops without a heart and often absence of the upper half of the body.

Front 95

Starting Point for labeling Multiple Pregnancies

Back 95

The sac and fetus directly over the Internal Os is labeled 'Baby A' and so on