Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
Pregnancy Blood changes
|
– Increase in fibrinogen, and all coag factors except II, V, XII
– Fall in protein S and sensitivity to APC (these are anti-coagulants) – Fall in platelets and factor XI and XIII - increase in WBCs |
|
|
Quinidine and pregnancy
|
increased uterine activity
|
|
|
Digoxin and pregnancy
|
way increased doses required
|
|
|
ASA and pregnancy
|
low dose OK
|
|
|
b-blockers and pregnancy
|
increased risk for IUGR (growth restriction)
|
|
|
ACEI’s and ARBs in pregnancy
|
- OK in 1st trimester
- avoid in 2nd and 3rd trimesters due to oligohydramnios and renal dysplasia |
|
|
Indomethacin
|
used for Superficial Thrombophlebitis
|
|
|
Warfarin and pregnancy
|
– in 1st trimester it causes embryopathy
– in 2nd trimester it causes optic atrophy, IVH |
|
|
hydantoin syndrome
|
- from Dilantin, phenobarbital/carbamazepine (anti-seizure)
- Craniofacial defects (Hypertelorism, Cleft palate, Broad nasal bridge) – Fingernail hypoplasia – Developmental delay |
|
|
renal diseases that Worsen with Pregnancy
|
– Reflux nephrology
– IgA nephropathy – Focal glomerular sclerosis – Membranoproliferative glomerulonephritis |
|
|
cholestasis tx in pregnancy
|
– Cholestyramine is a bile resin you can try
– Ursodiol (Actigall) is a newer one but costs almost $500 a month |
|
|
Chorion
|
– outermost membranous sac enclosing the embryo
– maternal blood fills villus space – inside the villus are the fetal vessels |
|
|
Amnion
|
innermost membranous sac enclosing the embryo
|
|
|
Chorionic villus
|
– placental structure where nutrient and gas exchange occurs
– core made of loose mesenchyme and fetal BVs and the villus - surfaced by cytotrophoblast (CT) and syncytiotrophoblast (ST) |
|
|
Accessory Placental Lobes
|
– risk of fetal bleeding when membrane ruptures
– may -> retained placental tissue |
|
|
Chorioamnionitis
|
– Ascending infection from lower GU
– Maternal PMNs in fetal membranes respond to bacteria in amniotic fluid – associated w/ PPROM – Chorionic villi uninvolved – from GBS, (-) enteric, anaerobes |
|
|
Funisitis
|
– inflamm of umbilical cord
– Neutrophils in fetal vessels are fetal in origin and indicate that the fetus is responding to the bacteria in the amnionic cavity |
|
|
Villitis
|
– Transplacental hematogenous dissemination
– bacteria, viruses, parasites, fungi – TORCH most common (toxo, other, rubella, CMV and HSV) – unknown etiology – chronic inflamm in the villi – can cause infection, IUGR, Fetal distress or demise |
|
|
Atherosis
|
– maternal vessels in decidua
– Acute atherosis occurs in preeclampsia and causes a reduction in uteroplacental blood flow – micro shows foamy histocytes |
|
|
Abruptio placenta
|
clinical term for premature separation of placenta characterized by pain, uterine tetany, fetal distress & +/- DIC
|
|
|
Retroplacental hematoma
|
- pathologic correlate to abruption
– hematoma along maternal surface that can compress it – associated with pre-eclampsia, trauma, ocaine use – can cause maternal blood loss, fetal hypoxia, preterm delivery, fetal death |
|
|
Complete Hydatidiform mole
|
– Diploid, 46XX (46 XY) all paternal
– High HCG – Diffusely hydropic villi – Diffuse trophoblastic proliferation & atypia – Embryo absent – 20% persist post Rx – 2% (1:40) develop choriocarcinoma |
|
|
Partial Hydatidiform mole
|
– Triploid, 69XXX or XXY, dispermy
– Less elevated HCG – Focal hydrops – Focal trophoblastic proliferation – Embryo present – 7% persist post Rx – Choriocarcinoma very rare |
|
|
Maternal Serum Screen
|
– 2nd trimester (15-20 weeks)
– AFP, Estriol, bHCG (+/-inhibin A) - good for detecting Spina bifida, Trisomy 18 and 21, and Smith Lemli Opitz |
|
|
1st trimester Screening
|
– In Nuchal translucency, CRL is 39-79 mm and 10.5-14 wks gestation
– Serum analytes are PAPP-A and free beta hCG |
