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;
36 Cards in this Set
- Front
- Back
|
IUGR/ Fetal Growth Restriction is a general term for a spectrum of fetal physiologic conditions that result in an infant weighing below the ____ percentile for GA. |
10th |
|
|
A decrease in what is thought to be major physiologic factor on IUGR? |
decrease in uterine plasma volume |
|
|
Maternal conditions which may affetect plasma volume include? |
-poor nutritional status -smoking, drug or alcohol abuse -TORCH infections -severe anemia -diabetes, chronic renal disease, severe chronic asthma, heart disease -under 17 or over 35 years of age -high altidue |
|
|
Placental conditions which may affect plasma volume include? |
-placental infarcts and hemangiomas -small placenta -single umbilical artery -abruptio placenta -placental insufficiency |
|
|
Fetal conditions which may affect plasma volume include? |
-genetic or chromosomal defects -intrauterine infection |
|
|
Maternal and placental conditions may cause ____ IUGR. |
asymmetric |
|
|
Fetal conditions may cause ___ IUGR. |
symmetric |
|
|
Growth restricted infants born with diminished stores of fat and glycogen, and are likely to be? |
hypoglycemic |
|
|
Clincal signs of IUGR include? |
-uterus measuring small for dates -history of maternal condition associated with IUGR
|
|
|
Symmetric IUGR is? |
growth restriction affecting entire fetus |
|
|
Symmetric IUGR is often ____ or due to maternal infection. |
genetic |
|
|
Sono findings of symmetric IUGR are? |
-all measurements more than 2 weeks below expected gestational age (based on firm LMP or prior study) - transcerebellar diameter consistent with dates when other parameters are less than expected -oligohydramnios -mature placenta earlier than expected -low BPP score |
|
|
Asymmetric ( "brain sparing") occurs in the last ___ to ___ weeks of pregnancy. |
8-10 weeks |
|
|
Asymmetric IUGR is asymmetry between the? |
head size and abdominal size |
|
|
Sono findings of asymmetric IUGR are? |
-asymmetry of head to body ratio > 2 SD -AC measureing more than 2 weeks behind HC -oligohydramnios -mature placenta earlier than expected -many complex formulas exist for sono diagnosing IUGR |
|
|
The most common form of IUGR is? |
Asymmetric (75%) |
|
|
A systolic/diastolic ratio of the umbilical atery > ____ is abnormal after 30 weeks. |
3.0 |
|
|
Umbilical artery ratios should be taken? |
close to the placental cord insertation because ratios are higher if measured close to fetal cord insertion |
|
|
What is the normal resistance in second and third trimesters for the uterine artery? |
low resistance |
|
|
Appearance of ___ on uterine artery Doppler waveform is abnormal, and thought to predict placental insufficiency. |
"notch" |
|
|
Normally the umbilical artery should progressively __ during the course of the pregnancy. |
decrease |
|
|
Absent or reversed diastolic flow in the umbilical artery is an ___ sign. |
ominous (bad) |
|
|
Erythroblastosis Fetalis is? |
destruction of fetal RBCs by antibodies with subsequent fetal or neonatal complications |
|
|
Causes of erythroblastosis fetalis are? |
-Rh incompatibility -ABO incompatibility (blood type incompatibility) -isoimmune disease -other minor blood group incampatibility |
|
|
Clinical manifestations of erythoblastosis? |
-chronic cheart failure (CHF) -fetal death -hydrops fetalis
|
|
|
Hydrops fetalis is? |
excessive accumulation of fluid in fetal tissues and body cavities, typically there is interstitial edema, pleural and pericardical effusions and ascites
|
|
|
Immune hydrops is due to? |
-Rh (Rhesus) incompatibility, also known as Rh immunization - occurs with Rh (-) mother and Rh (+) father, (Rh positive fetus) |
|
|
Improtant Question!!! Know this!! ____ Doppler can help determine likelihood of fetal anemia. |
middle cerbral artery (MCA) |
|
|
MCA is examined close to its orgin from the? |
ICA |
|
|
The angle of US beam and direction of blood flow in MCA should be? |
zero degrees |
|
|
Risk of anemia is highest in fetuses with pre-transfusion peak systolic velocity of ___ times the median or higher. |
1.5 |
|
|
Non-immune hydrops is? |
hydrops due to any cause other than Rh sensitization |
|
|
Causes of Non-immune hydrops include? |
-cardiac anomalies/ arrhythmia -infection (TORCH, Fifth disease) -chromosome abnormalities -congenital hematologic disorders -abdominal or pulmonary masses leading to venous obstruction -twin-to-twin transfustion syndrome |
|
|
Sono findings in hydrops fetalis? |
-pericardial effusion (earliest sign) -ascites -fetal skin thickening (anasarca) > 5mm AP - pleural effusion -hepatosplenomegaly -polyhydramnios -enlarged umbilical vein > 1cm
|
|
|
Sono findings of fetal demise are? |
-absent cardiac activity -exaggerated fetal position (i.e flexion) -Robert's sign: echogenic foci (gas) in pulmonary vessels or abdomen-delayed finding (about one week after demise) -Spaulding's sign: overlapping skull bones-also delayed finding (seen about one week after demise) -fetal maceration |
|
|
What is a halo effect seen radiographically secondary to subcutaneous scalp edema in fetal demise? |
-Deuel's sign/halo sign -NOT seen on US |
