OB abnormal 1st trimester

what is a threatened abortion

cervix is long and closed, but with vaginal bleeding

what percentage of bleeding is normal due to implantation

25%

what is a complete abortion

Empty uterus, no adnexal mass, with beta hCG

what is an incomplete abortion

intact gestational sac with non living embryo

what is the most common cause of first trimester bleeding

subchorionic hemorrhage

what does PUL mean

pregnancy of unknown location

what does detachment of frondosum cause

vaginal bleeding and hematomas

what percentage of hematomas in the first trimester cause fetal demise

>50%

If the hematoma is greater in size than the gestational sac, what does that mean

high probability of loss

The MSD should be seen measuring 5mm at how many weeks

between weeks 4-5

what is the threshold level for seeing a gestational sac

as early as 4.3 weeks

what is the discriminatory level for seeing a gestational sac

must be seen by 5.2 weeks

at 8mm gestational sac, what MUST we see

A yolk sac

At what MSD must we absolutely see an embryo

25mm

if there is an embryo measuring 7mm w/o heart tones, what does this mean

pregnancy failure has occurred

What also indicates pregnancy failure

MSD of 25mm w/o yolk sac

what is a blighted ovum or anembryonic pregnancy

Embryo fails to develop usually before even seen with ultrasound

what do hCG levels do in the case of a blighted ovum

they rise but do NOT double like normal

What is GTD (gestational trophoblastic disease)

proliferative disease of trophoblastic after pregnancy

what is the benign form of a GTD

hydatidiform mole

what is the cancerous form of GTD

invasive mole or choriocarcinoma

what are hallmark signs of GTD

HIGH HCG, vaginal bleeding, hyperemesis, preeclampsia

what is the sonographic appearance of GTD

snowstrom appearance, cystic and studded

when should beta hCG levels decline in GTD cases

10-12 weeks after evacuation

What is a very important test to have when discovering trophoblastic disease

Positive pregnancy test

what is blood flow like in trophoblastic disease

strong blood flow

what occurs in half of molar pregnancies

bilateral theca lutein cysts

what can large theca lutein cysts cause

torsion

what is the 1st trimester FHR range

90-170 bpm

a FHR below 90 bpm sustained is termed

bradycardia

a FHR of over 170 sustained is termed

tachycardia

FHR with endovaginal scanning should be seen by what day

46 menstrual days

if the crown lump length is 4mm what should we see

heart tones

if the CRL is 7mm w/o FHR what does that mean

pregnancy has failed

if the gestational sac is 5mm less than the CRL what is happening

poly (oligohydraminos)

the normal yolk sac should have a diameter across of what

6mm

What are clinical symptoms of an ectopic pregnancy

pain, palpable adnexal mass

how do you rule out appendicitis vs. ectopic

pregnancy test

what percent of ectopic pregnancies occur in the tube

95%

10% of maternal deaths are caused by what

ectopic pregnancies

what is the most concerning site for ectopic pregnancy that can lead to hysterectomy or death

interstitial

we NEED to see something if the hCG level is what

800-1000

if hCG is 800-1000 and nothing is seen, we must assume what

an ectopic pregnancy has occurred

When scanning for ectopic, why is it important to not assume fluid is always a gestational sac

because a pseudo gestational sac can be there

what is the sonographic sign of ectopic pregnancy

power donut sign

What are the three KEY signs leading to ectopic concern

adnexal mass, free fluid in pelvis, and positive pregnancy test

what weeks gestation must embryo be to accurately do a nuchal translucency test

11-14 weeks gestation

what does the CRL have to be in order to do a nuchal test

between 45mm and 84mm

if there is a cystic hygroma in the 2nd and 3rd trimesters what does that most likely mean

Turner’s syndrome

what is Acarina

partial or complete absence of cranial bones

what is anencephaly

absence of the brain/ cranial vault

what is cephalocele

herniation of brain and meninges

why do we not evaluate cranial structures before 18 weeks

because they are still forming

prior to 9 weeks gestational age how many ventricles does the embryo appear to have

one single ventricle

normal bowel herniation occurs between which weeks

8-12 weeks

what weeks is the bladder able to be visualized

10-12 weeks

how do you tell the difference between uterine synechia vs amniotic band

uterine synechia will connect and not be able to wrap around baby

what is the most common ovarian mass

corpus luteum cyst

what week does the corpus luteum regress by

18 weeks

what locations do we really pay attention to fibroids

relaton to placenta and cervix