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High Risk Pregnancy-Martin's Notes & Images
High Risk Pregnancy-Martin's Notes & Images
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06/16/2011

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Term
This type of pregnancy has an increased chance for adverse outcome
Definition
High-Risk Pregnancy
Term
Extreme adverse outcome=maternal or fetal injury or ________
Definition
death
Term
Ultrasound has an important role in the _____________ of the high-risk OB patient
Definition
management
Term
AMA stands for what?
Definition
advanced maternal age
Term
AMA is age ______ or greater at delivery
Definition
35
Term
AMA leads to an increased risk of _________
Definition
Down's Syndrome
Term
What Maternal Conditions can be risk factors of pregnancy?
Definition
AMA & Vaginal Bleeding
Term
With this maternal condition the placenta covers (fully or partially) the internal os & prohibits delivery of the fetus. The risk is that the placenta will detach from the uterus resulting in maternal hemorrhage & loss of oxygen & blood supply to fetus. C-section should be performed.
Definition
Placenta Previa
Term
With this maternal condition the vessels cross the internal cervical os. It is life threatening to the fetus.
Definition
Vasa previa
Term
Maternal Risk Factors: This maternal condition is the premature separation of the placenta from the uterine wall. The risk is fetal distress.
Definition
Placental abruption
Term
This maternal disease of pregnancy has an increased risk of congenital anomalies, early or late pregnancy loss, macrosomic fetus, caudal regression (lack of development of caudal spine & cord NTD's), cardiac & renal anomalies, polyhydramnios, placentomegaly, & SUA (Single Umbilical Artery)
Definition
Insulin-dependent diabetes mellitus (IDDM/Type I)
Term
This maternal disease of pregnancy has an increased risk of macrosomia, polyhydramnios, & placentomegaly AND has onset during pregnancy (usually the 2nd trimester).
Definition
Gestational diabetes
Term
Diabetic Pregnancies are ______ risk
Definition
High
Term
Maternal Hypertension=Systolic>_____mmHg
Definition
140
Term
Maternal Hypertension=Diastolic>_____mmHg
Definition
90
Term
Maternal Hypertension that is pre-existing
Definition
Essential or Chronic hypertension
Term
pregnancy induced hypertensive disorder
Definition
PIHD
Term
Preeclampsia, HELLP, & Eclampsia are all forms of __________
Definition
Toxemia
Term
pregnancy disorder in which high blood pressure develops with proteinuria, edema, rapid weight gain (> 5 lbs per wk) (US: Oligo, IUGR, abruption, small placenta, advanced placental maturity; Treatment: bedrest, htn meds, BPP)
Definition
Preeclampsia
Term
This variant of Preeclampsia is associated with Hemolysis, Elevated Liver enzymes, & Low Platelets
Definition
HELLP
Term
pregnancy disorder characterized by htn, proteinuria, edema, convulsions, headaches, blurred vision, coma, death of mother or fetus (US: Oligo, IUGR, abruption, small placenta, advanced placental maturity; Treatment: bedrest, htn meds, BPP)
Definition
Eclampsia
Term
US: Oligo, IUGR, abruption, small placenta, advanced placental maturity Tx: bedrest, htn meds, BPP
Definition
Preeclampsia/Eclampsia
Term
Severe, systemic __________ infection (TORCH) may cause: spontaneous ab, fetal death, premature L & D, growth retardation, fetal abnormalities
Definition
maternal
Term
maternal infection that crosses placenta & results in fetal infection causing varying abnormalities (Part of Torch)
Definition
Toxoplasmosis
Term
syphilis, chlamydia, varicella (chickenpox), Parvovirus (virus can cross placental barrier & affect fetus; fetus may need transfusion) (Part of Torch)
Definition
Other
Term
results in fetal defects; most teratogenic during early 1st trimester (Part of Torch)
Definition
Rubella
Term
German Measles (Part of Torch)
Definition
Rubella
Term
most common infection in pregnancy-causes tri abnormalities/demise if early exposure (Part of Torch)
Definition
Cytomegalovirus
Term
may be transmitted to fetus during vaginal delivery; possible eye issues/can cause death
Definition
Herpes
Term
excessive vomiting leads to dehydration and electrolyte imbalance/check for trophoblastic disease (High HCG)
Definition
Hyperemesis gravidarum
Term
pyelonephritis and hydronephrosis: progesterone has dilatory effect on smooth muscle of ureter & enlarging uterus compresses ureters
Definition
Urinary tract disease
Term
can affect placenta=abortion, IUGR(intra-uterine growth restriction), stillbirth
Definition
Lupus
Term
increased incidence of neural tube defects, diabetes, htn, multiples, UTI's
Definition
Obesity
Term
estrogen can stimulate growth which can obstruct the birth canal, can necrose (leading to pain/premature labor)
Definition
Uterine fibroids
Term
can cause dystocia or torsion
Definition
Ov cysts
Term
Onset of labor before 37 weeks
Definition
PTL (PreTerm Labor)
Term
Which of the following is NOT an etiology of preterm labor: 1.Premature rupture of membranes (PROM), 2.lack of prior uterine surgery, 3.Ut anomalies, 4.Bleeding, 5.Fetal anomalies, 6.Polyhydramnios, 7.Multiple gestations, 8.Unkown
Definition
2 (Prior uterine surgery)
Term
This is the Spontaneous rupture of the membranes prior to the onset of labor and leads to Increased risk for chorioamnionitis and fetal distress
Definition
PROM (Premature rupture of membranes)
Term
Inability of cx to prevent premature expulsion of uterine contents. It is a risk factor for preterm birth. Can be caused by trauma to CX, congenital (ut malformations), or DES exposure. Clinical signs include recurrent 2nd trimester pregnancy loss (habitual ab).
Definition
Incompetent Cervix
Term
Fetal Factor: Fetal ______ may occur in any trimester in pregnancy
Definition
death
Term
Incidence of pregnancy loss in the 1st trimester is _____ to 20 per 100 pregnancies
Definition
15
Term
Excessive movement between 16 to _____ weeks of gestation should be present
Definition
20
Term
Which of the following is NOT an US Finding of fetal death: 1. Absence of fetal heart motion; 2. Spalding's sign-overlap of skull bones (appx 1 wk after demise); 3. Robertson's sign-echogenic foci (gas) in pulmonary vessels or abdomen (appx 1 wk after demise); 4. Exaggerated curvature of the fetal spine; 5. Absent fetal movement
Definition
3 (It is Robert's Sign)
Term
LGA-evaluate for ______________
Definition
macrosomia
Term
SGA - evaluate for chromosomal abnormalities & ____________________
Definition
placenta insufficiency
Term
Which of the following is NOT a maternal complication of multiple gestation pregnancy: 1.Prematurity; 2.Htn; 3.Pre-eclapmsia or eclampsia; 4.Anemia; 5.Post-partum hemorrhage
Definition
1 (This is a Fetal Complication)
Term
Which of the following is NOT a fetal complication of multiple gestation pregnancy: 1.Cord entanglement or compression; 2.IUGR; 3.Post-partum hemorrhage; 4.PREMATURITY; 5.Congenital anomalies (MonoZygotic)
Definition
3 (This is a maternal Complication)
Term
Which Nasal Bone Criteria as used by the Nuchal Translucency Quality Review?...There is a 45-degree angle of insonation with the fetal profile.
Definition
4
Term
Which Nasal Bone Criteria as used by the Nuchal Translucency Quality Review?...The fetus occupies the majority of the image.
Definition
2
Term
Which Nasal Bone Criteria as used by the Nuchal Translucency Quality Review?...The ultrasound image must be clear with the fetal facial profile well defined.
Definition
1
Term
Which Nasal Bone Criteria as used by the Nuchal Translucency Quality Review?...The brightness of the nasal bone is greater or equal to that of the overlying skin.
Definition
5
Term
Which Nasal Bone Criteria as used by the Nuchal Translucency Quality Review?...The fetal face is in the mid-sagittal plane with the tip of the nose seen in fetal profile and the third and fourth ventricle seen in the fetal central nervous system.
Definition
3
Term
NT Measurement Criteria: The fetus should occupy >______% of the image
Definition
50
Term
NT Measurement Criteria: Decrease depth, narrow sector width, use fetal echo settings, use magnification box, magnify then freeze, & avoid membrane shadows in order to keep the margins of the NT edges ________.
Definition
Clear
Term
Midsagittal view of fetal spine in cervical & _______ region.
Definition
Thoracic
Term
Tip of ______ seen in face area.
Definition
Nose
Term
Third & Fourth Ventricle seen in fetal _____
Definition
CNS
Term
Should not see ribs, ________, or heart.
Definition
Stomach
Term
Fetal head in _______ position
Definition
Neutral
Term
Fetus observed away from ________
Definition
Amnion
Term
Use the ______ calipers
Definition
+
Term
Measure at the ______ space of the NT
Definition
widest
Term
Place calipers on the _____ borders of the nuchal space with none of the horizontal crossbar protruding into the space
Definition
inner
Term
A vertical line connecting the two calipers should be __________ to the long axis of the fetus.
Definition
perpendicular
Term
Measure the NT _____ times and report the largest of the acceptable measurements
Definition
3
Term
Edge of the placenta
Definition
Marginal Sinus
Term
Why should you examine the cervix transvaginally with color if you are unable to see due to fetal parts?
Definition
To rule out vasa previa
Term
Is preeclampsia or eclampsia more severe?
Definition
eclampsia
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