ch53-54 OB

35-36

preterm is ..wks

37-38

early term is …wks

39-40

full term is … wks

41

late term is …wks

42

post term is after how many wks

placental insufficiency

fetal growth restriction describes a fetus that is abnormally small for gestational age, which is often the result of

IUGR

fetal weight at or below 10% for a given gestational age, decreased rate of fetal growth

SGA

at or below 10%, usually normal and no problems/without reference to cause

symmetric IUGR

usually the result of first tri insult like chromosomal abnormality or infection

asymmetric IUGR

begins second or third tri and is usually the result of placental insufficiency; usually displays head sparing at the expense of AC

cardiovascular lesion

what is the cause of nonimmune hydrops

Hx of previous fetus with IUGR, significant maternal hypertension or smoking, the presence of a uterine anomaly (bicornuate, leiomyoma), and significant placental hemorrhage

the most significant maternal factors for IUGR

oligohydraminos

what occurs if the fetal urine output is reduced

polyhydraminos

what develops if the fetus cannot swallow

<1-2cm

amniotic fluid pocket of … may represent IUGR

asymmetric

is asymmetric or symmetric IUGR more common

fetal size

AC is valuable for evaluating

HC:AC ratio

what helps us differentiate between symmetric and asymmetric IUGR

cardiac non stress test, observation of fetal breathing, gross fetal movement, fetal tone, AFV

five parameters of BPP

30 min

BPP time limit

2cm

evaluation of the 4 quadrant amniotic fluid volume is considered normal if the pockets of fluid measure at least … or more in two planes

15beats/min or more

two fetal heart rate accelerations

late second to early third tri

heart reactivity is the last to occur, appearing in the

decreases

in fetuses with asymmetric IUGR, vascular resistance …

3.0

S/D ratio of more than … in the umbilical artery after 30 wks is abnormal

2.6

the maternal uterine artery S/D ratio should be below

macrosomia

large neonate with birth weight of 4000g or greater

LGA

neonate with birth weight above 90th percentile

poorly controlled maternal diabetes

macrosomia is also a common result of

mechanical macrosomia and metabolic macrosomia

two terms relating to macrosomic fetuses

open neural tube defects

mothers with diabetes that are more susceptable to polyhydraminos are more prone to be associated with… (cant swallow fluid)

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plasma protein A (PAPP-A) and b-hCG

the first tri screen is performed by looking for the pattern of biochemical markers associated with

nuchal translucency and presence of nasal bone

plasma protein A and hCG are used in conjunction with ultrasound done between 11-14wks to measure

maternal serum quad screen

looks at four serum markers: AFP, hCG, unconjugated estriol (uE3) and inhibin-A

18-20

most ultrasound departments prefer to perform a detailed fetal anatomic survey exam between how many wks

advanced maternal age AMA

describes a pt who will be 35 or older at the time of delivery

hydrops fetalis

condition in which excessive fluid accumulates within at least two fetal body cavities

blood group isoimmunization

tests for the presence of variety of antibodies

immune hydrops

what is initiated by the presence of maternal serum IgG antibody against one of the fetal red blood cell antigens in a process known as sensitization

maternal antibodies can be produced against the Rh antigen

if father and fetus are Rh+ and a mother is Rh- and there is a maternal fetal hemorrhage, what happens

scalp edema, pleural effusion, pericardial effusion, ascites, polyhydraminos, thickened placenta

sonographic findings of hydrops

cordocentesis

a procedure in which a needle is placed into the fetal umbilical vein to obtain a blood sample

two methods of transfusing a fetus

intraperitoneal transfusion: uses US guidance to place a needle in the peritoneal cavity of the fetus where blood is slowly absorbed by the fetus

direct intravascular transfusion via the umbilical vein

thrombocytopenia

fetus with dangerously low platelet count

an immune response (allo

fetal platelets can sometimes cause the mother to develop

200-240

if the hydrops is a result of a cardiac tachyarrythmia, a heart rate in the range of … is common

low lying placenta

if this distance between placenta and cervix is less than 2cm, its classified as

vasa previa

a rare condition in which the umbilical cord or one of its blood vessels is the presenting part over the internal os

early/late tri pregnancy loss and congenital anomalies

mothers with insulin dependent DM are at increased risk for pregnancy complications such as

glucose

primary fuel for fetal growth

macrosomic

if glucose levels are very high and uncontrolled