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15 Cards in this Set
- Front
- Back
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Biochemical screening in pregnancy
at 10 wks |
• PAPP A – pregnancy associated protein A
• HCG –free b unit of choriogonadotropin hormone = Double test |
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Biochemical screening in pregnancy
at 16 wks |
16 wks
• Double, triple test, quadruple test • AFP – alfa-fetoprotein • HCG – free b unit of choriogonadotropin hormon = Double test + Estriol = Triple test + Inhibin= Quadruple test |
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First trimester screening in pregnancy
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• Combines ultrasound screening and examination of maternal serum markers
• Measurement NT provides information about other fetal affections than aneuploidias • Assessment of fetal anatomy • Assessment of gestational age - important for the management of pregnancy |
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Combined test in the 1st trimester
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Assessment of risk of T21, T18 , T13
• Patient´s age • PAPP-A, HCG blood screen in 9.-10wk • US - 12wk assessment of CRL, NT – nuchal transluscency – certified sonographers |
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If risk for abnormality is raised, what are other markers we may check?
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NB - presence of nasal bone - often absent in Downs
TR - Tricuspid regurgitation DV - Ductus venosus FA - facial angle (frontomaxillary angle) |
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FA / FMF interval in normal pregnancies
Higher angle may indicate? |
76-85 degrees
Over - Risk for Downs syndrome |
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Mandibular angle under 90 degrees associated with?
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Edward syndrome (T18)
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Screening of open defects of the neural tube
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Intracranial translucency IT
NTD – open spinal dysraphic syndrome |
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Screening of preeclampsia in 1st trimester
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• Personal history - BMI,age,etnicity, parity, smoking
• Pulsatility index of a.uterina • PAPP A - pregnancy asociated protein A (lower!) • Placental growth factor – PIGF (lower!) |
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Relevance of 1st trimester screening markers ( PAPPA-A and B-hCG )
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In pre-eclampsia, preterm delivery and small gestational age the concentrations of PAPP-A and B-hCG were lower.
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Gestational diabetes mellitus tested with what test
How? When is there a maximal effect of anti-insulin hormones |
OGTT - oral glucose tolerance test
glycemia under 5,5 normal, 2 hrs after 75 g glucose ingested - glycemia should be under 7,7 from 24 weeks max effect |
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Screening of risk of premature delivery
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• History
• Cervicometry – measurement of lenght of cervical canal, assessemnt of – funneling • Values below 25mm higher risk |
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What is funneling?
What is it associated with? |
Dilatation of the cervix out towards the vagina.
Length from start of dilation to stop is over 25mm increased risk of premature delivery. Cervicometry |
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Screening of cervical cancer
What are prebiotic methods? |
• Onkological cytology
• Kolposkopia + HPV testation – prebioptic methods |
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Screening of endometrial cancer
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• Transvaginal sonography
• Measurement of width of endometrium– different in pre-postmenopausal patients • Assessment of echogenicity, borders –juntion |
