fertilization occurs at the ( )
ampulla of fallopian tube.
the oocyte completes meiosis II ( )
after sperm penetration
it takes ( ) days from fertilization to implantation
6-7 days
prolactin is secreted from ( ) lobe of pituitary gland
anterior
( ) induces breast milk production and secretion
prolactin
( ) occurs in mothers after giving birth because prolactin levels increase
postpartum amenorrhea
implantation occurs at the ( ) stage of the embryo
blastocyst
at implantation, ( ) invade into the uterine wall
trophoblast
( ) produce hCG
syncytiotrophoblast
pregnancy tests detect urinary ( )
hCG
the fetus is highly vulnerable to teratogens during ( )
organogenesis
umbilical venous blood contains ( ) oxygen than umbilical arterial blood
more
the umbilical ( ) supplies blood from the fetus to placenta.
artery
the umbilical cord contains ( ) umbilical artery/arteries and ( ) umbilical vein(s)
2, 1
about ( )% of pregnancies end in a miscarriage
10-15
( ) are detected in about 50-70% of miscarriages
chromosomal abnormalities
( ) is useful for distinguishing between a threatened miscarriage and inevitable miscarriage
bleeding volume
what are the subcategories of miscarriage?
threatened, inevitable, incomplete, complete, missed
among tubal pregnancy, ampullar pregnancy is most common, followed by ( ) pregnancy.
isthmic
chlamydia infection in the pelvis causes ( ).
ectopic pregnancy
morning sickness begins around ( ) of gestation
5 weeks
morning sickness peaks at around ( ) of gestation
8-10 weeks
( ) is when symptoms of morning sickness become more severe and prolonged
hyperemesis gravidarum
hyperemesis gravidarum can cause ( ) in blood volume
decrease
the prevalence of ( ) is high among women with hyperemesis gravidarum
deep venous thrombosis
the 1st stage of labor starts when
labor pains occur regularly (every 10 mins)
the 1st stage of labor ends when
the cervix is fully dilated
when is labor pain considered effective?
if cervical status progresses as a result of the pain
the ( ) is clinically applied to evaluate a pregnant woman. it is based on changes in the cervix and the position of the baby's head
Bishop score
when labor pains come ( ) times an hour, it indicates the beginning of labor
6
the ( ) is palpable during the 1st stage of labor
coccyx, ischial spine, posterior fontanelle
what does PROM stand for?
prelabor rupture of membrane
when does PROM occur?
before full-term
what can cause PROM?
chorioamnionitis
when does normal ROM occur?
when the cervix is fully dilated
when does the uterus return to its pre-pregnant size?
6-8 weeks after delivery
breastfeeding helps the uterus to contract back to its original size. true or false?
true
afterbirth pain can happen for ( ) after delivery
2 weeks
( ) in NST shows that the fetus is healthy
acceleration
it takes ( ) from follicle development to ovulation
4-6 months
in the antral follicle, the oocyte is surrounded by ( ) cells
granulosa
the activation of dormant primordial follicles arrest when the remaining follicle number goes under ( )
1000
aromatase converts androgen to ( )
estrogen
corpus luteum produces ( ) and ( )
estrogen and progesterone
estradiol inhibits ( ) expression in the arcuate nucleus
Kiss-1
( ) is the major cause of infertility in advanced maternal age
declining residual follicles and poor quality of oocytes
( ) is often used to check a woman's ability to produce eggs that can be fertilized for pregnancy
AMH (anti-mullerian hormone) test
primary ovarian insufficiency affects ( )% of women
1
infertility is the failure to achieve a clinical pregnancy after ( ).
12 months or more of regular unprotected sex
today, 1 in ( ) couples suffer with infertility
6
with non-invasive prenatal tests, ( )% of antenatal diseases can be diagnosed
17
amniocentesis is applied for mothers who are ( )
carriers of a X-linked recessive disorder or 35+ years old
when is amniocentesis performed?
after 15 weeks of gestation (usually between 16-18 weeks)
when can trans-abdominal ultrasonography be performed?
after 10-12 weeks of gestation
the vertical transmission of cytomegalovirus can cause ( ) in the fetus
deafness and learning disabilities
hydrops fetalis can be caused by
viral infection
vertical transmission of syphilis can be prevented by ( )
taking antibiotics
elevated blood sugar levels are associated with ( )
congenital malformations
is the flu vaccine safe for pregnant women?
yes
are NSAIDs safe for pregnant women?
no
is amantadine safe for pregnant women?
no
3 layers of the fetal membrane and which one is derived from the mother?
decidua (mother), chorion (fetus), amnion (fetus)
changes occurring in the fetus within minutes after birth
constriction of the umbilical vessels, constriction of the ductus venosus and ductus arteriosus, and closure of the foramen ovale
the heartbeat of the fetus can be detected after...
5-6 weeks of gestation
at 9 weeks of gestation, the normal fetal heartbeat is
160-180
umbilical hernia can occur at ( ) weeks of gestation
8-10
what is presentation?
Direction of fetal trunk (体幹)(Relation of longitudinal axis of fetus and mother)
what is position?
Direction of fetal back (facing left or right)
what is attitude?
Degree of flexion of head (is it extended or flexed?)
deiscribe the cardinal movement of the fetus during childbirth.
1st rotation: engagement, flexion, descent 2nd rotation: further descent and internal rotation 3rd rotation: complete extension of head 4th rotation: external rotation
3 elements of labor?
power, passage, passenger.
what is the normal attitude of fetus?
occiput (flexed)
normal birthweight?
2500-4000
excessively large infant
4000+
low birth weight
1500-2500
very low birth weight
1000-1500
excessively low birthweight
-1000
health risks of low birthweight babies in the future?
diabetes, hypertension (lifestyle related diseases)
how is newborn condition evaluated?
APGAR score (heart rate, respiratory, muscle tone, reflex irritability, color)
APGAR score is checked when?
immediately after birth, then 5-10 minutes after birth
what is wharton's jelly?
jelly-like material inside the umbilical cord. Protects the umbilical arteries and vein.
what is amniotic fluid index? what is the normal range?
measuring the depth of amniotic fluid via ultrasonography normal range: 5-25cm w
what is station?
how far the baby descended through the birth canal
healthy (reactive) acceleration?
fetal movement occurs twice within 20 mintues
what is late deceleration?
sign to take the baby out as soon as possible by c-section
what is variable deceleration?
when the fetal HR decreases >30 seconds after the uterus contracts
what types of hormones are peptide hormones?
hypothalamic hormones
what types of hormones are steroid hormones?
sex hormones and corticosteroids
what types of hormones are amine hormones
catcholamines (epi and norepi) and thyroid hormones
what % of infertility in couples is accredited to females?
30
what % of infertility in couples is accredited to males?
30
what are causes of male infertility?
spermatogenic dysfunction (83%), sperm transport disorder (14%), erection/ejaculation problems (3%)
what are causes of female infertility?
unknown (49%), tubal (31%), ovulatory dysfunction (10%), uterine (3%).
what is affected in type I reproductive dysfunction?
hypothalamus/pituitary (low levels of FSH and estrogen) severe amenorrhea.
what is affected in type II reproductive dysfunction?
mild effect on hypothalamus (normal levels of hormones). presented w oligomenorrhea. most common.
what is affected in type III reproductive dysfunction?
ovary (high FSH but low estrogen).
what is affected in type IV reproductive dysfunction?
uterus. often amenorrhea deriving from uterine problems.
other than FSH and estrogen levels, high levels of ( ) can also cause reproductive dysfunction
prolactin
what type of reproductive dysfunction is PCOS? (polycystic ovary syndrome) what are some clinical presenting symptoms?
type II; oligo/anovulation, polycystic ovaries, hyperandrogenism (hirsutism and acne)
how can endometriosis result in the obstruction of the fallopian tube?
inflammation occurs, which leads to adhesion/scarring and the obstruction of the fallopian tube.