teratogens and other nongenetic riskfactors

syphilis

snuffles, hutchinson teeth, saber shins, saddle nose

anemia, hyrdrops

parovirus

ACE inhibitor

renal anomalies/potter sequence, IUGR
critical period: 2 and 3 trimesters

anti-convulsants

ONTS, clefting, CHD, limbs, DDr

lithium

ebstein anomaly

maternal PKU

microcephaly, ID, heart defect

thalidomide

limb reduction

hydrocephalus, intracranial calcifications, chorioretinitis (eye inflammation that can damage vision)

toxoplasmosis

varicella (chickenpox)

skin scarring, hypo plastic extremities, ventriculomegaly

rubella

deafness, cataracts, CHD, blueberry muffin rash, salt and pepper retinopathy

Cytomegalovirus (CMV)

IUGR, cerebral calcifications, hearing loss, seizures

accutane

Severe anomalies: CNS, ear, heart, thymus

alcohol

learning and behavioral differences, ptosis, short palpebral fissures, smooth philtrum

maternal diabetes

caudal regression, transportation of great vessels, VSD, truncus arteriosus

mercury

minimal disease (neurological disorder)

radiation

fetal malignancy, miscarriage, IUGR, ID

SSRIs

temporary neonatal jitteriness, irritability, respiratory distress

torch screening can be done on what kinds of samples

infant blood, maternal blood, amnio sample

consider torch screening for which indications

IUGR, microcephaly, intracranial calcifications, hearing loss, seizures ,cataracts

herpes

no issues prenatally, but babies exposed during birth can develop severe CNS and organ damage

what does it mean if IgM antibodies are present

recent infection, there is a risk to the baby because a recent infection could have been during the pregnancy

what does it mean if IgG antibodies are present

from a past infection or vaccination (likely before pregnancy)

blood type is coded by what gene

ABO

what is the Rhesus (Rh) factor

protein found on the surface of red blood cells

what happens when a pregnant patient is Rh- and the fetus is Rh+

if the two types of blood come in contact, the mother's Rh- blood will produce antibodies which could attach Rh+ fetal blood (Rh sensitization)

when can Rh sensitization occur

After:

- Delivery of baby
- Miscarriage
- Induced abortion
- Ectopic pregnancy
- Amniocentesis
- Chorionic villi sampling
-transfusions

what should a pregnant patient be given if they are Rh-

immune globulin shot (Rhogam)

after anti-D antibodies are formed, future Rh+ fetuses are at risk of ___________ ___________

Rh disease

symptoms of Rh disease

hemolytic anemia, jaundice, liver failure, heart failure, stillbirth

what effect does Rh disease have on maternal health?

no effect

which testing methods can be ordered during pregnancy to check for fetal Rh status

NIPS or amnio

If the pregnant patient was Rh- and sensitized, what next information would be important for the GC to know?

if the other parent was Rh negative or positive

If both parents were Rh- would the fetus be at risk of Rh disease?

no

If the pregnant patient is Rh- and the other is Rh+, what is the next step in determining the risk for the baby having Rh disease?

-offering Rh genotyping to determine if they are homozygous (+/+) or heterozygous (-/-)
-if they are homozygous, there is a 100% chance the fetus is Rh+ and needs to be monitored for fetal Rh disease
- if they are heterozygous, there is a 50% chance the fetus is Rh+

If the pregnant patient is Rh- and the other is a Rh+ heterozygote (+/-), what is the next step in determining the status of the fetus

ordering NIPS or amnio for fetal Rh status

what is done to check the mother's Rh status and what is the test looking for

antibody screen looking for Anti-D antibodies

heart defects that can be associated with rubella infection in fetus

pulmonary stenosis, VSD, ASD, patent ductus arterosis