High Risk Pregnancy and Fetal Anomalies

Flashcards covering high-risk pregnancy screening, hydrops, placental anomalies, diabetes, hypertension, maternal diseases, and fetal complications.

High Risk Pregnancy

A pregnancy with potential for or increased risk for adverse outcomes, including maternal or fetal injury or death.

1st Trimester Screens

Screening tests performed at $11\text{-}14\text{ wks}$ measuring PAPP-A, Free BhCG, nuchal translucency, nasal bone, and profile view.

NIPT (Non-Invasive Prenatal Testing)

Maternal blood tests performed as early as $10\text{ wks}$ to screen for Trisomy 21, 18, 12, and sex chromosome abnormalities.

Turner syndrome

A sex chromosome abnormality characterized by XO and YO chromosomal configurations.

Triple X syndrome

A sex chromosome abnormality characterized by XXX chromosomal configuration.

Kleinfelter syndrome

A sex chromosome abnormality characterized by XXY chromosomal configuration.

Quad Screen

A screening test measuring AFP, hCG, UE3, and inhibin-A performed at $18\text{-}20\text{ wks}$; elevated AFP indicates neural tube defects.

Advanced Maternal Age (AMA)

Maternal age $>35\text{ yo}$ at the time of delivery, associated with an increased incidence of Down syndrome.

Hydrops

Fluid accumulation in fetal tissues or body cavities, manifesting as ascites, pleural effusions, pericardial effusion, polyhydramnios, and placental edema.

Immune Hydrops

Hydrops (erythroblastosis fetalis) caused by blood incompatibility where an Rh negative mother produces antibodies that fight against an Rh positive fetus.

Isoimmunized fetus

A severely sick fetus affected by Rh blood incompatibility requiring blood transfusions via amniocentesis or cordocentesis to prevent in utero death.

Alloimmune Thrombocytopenia

A condition where the mother develops an immune response to fetal platelets, resulting in a low fetal platelet count.

Non-immune Hydrops

Hydrops caused by conditions unrelated to fetomaternal blood group compatibility, with cardiovascular lesions being the most frequent cause (e.g., tachyarrhythmia with $\text{HR } 200\text{-}240\text{ bpm}$).

Placenta Previa

A placental anomaly where the placenta covers the internal os of the cervix, or the distal end is $<2\,\text{cm}$ from the internal os.

Vasa Previa

A life-threatening condition where the umbilical cord presents first, frequently associated with velamentous cord insertion.

Velamentous Cord Insertion

Insertion of the umbilical cord into the lateral portion of the placenta.

Placental Abruption

Premature detachment of the placenta from the uterine wall, appearing hypoechoic and $1\text{-}2\,\text{cm}$ thick on ultrasound.

IDDM (Insulin Dependent Diabetes Mellitus)

Type 1 diabetes present from birth, in which glucose serves as the primary fuel for fetal growth.

Macrosomic Fetus

A fetus weighing $4000\,\text{grams}$ or $>90\%$ percentile, associated with risk of shoulder dystocia and brachial plexus nerve injuries.

Gestational Diabetes

Diabetes occurring during pregnancy, controlled by insulin or diet, and associated with polyhydramnios and LGA (large for gestational age).

Caudal Regression Syndrome

A condition almost exclusive to diabetic mothers, characterized by sacral agenesis and lack of development of the caudal spine, cord, and lower limbs.

Pregnancy Induced Hypertension (PIH)

Hypertension developing during pregnancy associated with prostaglandin abnormalities, formerly termed toxemia.

Preeclampsia

High blood pressure accompanied by proteinuria during pregnancy, which may lead to maternal seizures if untreated.

Eclampsia

The occurrence of seizures or coma in a patient diagnosed with preeclampsia.

Chronic Hypertension

High blood pressure present before pregnancy or diagnosed before $20\text{ wks}$ of gestation.

Systemic Lupus Erythematosus (SLE)

An autoimmune disorder affecting almost all organ systems, associated with an increased incidence of spontaneous AB, stillbirths, IUGR, and immune complex deposits in placental vessels.

Hyperemesis

Excessive vomiting during pregnancy leading to dehydration and electrolyte imbalance, requiring evaluation for maternal gallstones or ulcers and ruling out trophoblastic disease.

Pyelonephritis

A urinary tract infection presenting with flank pain, fever, and white blood cells (WBC) in the urine.

Uterine Fibroids

Benign uterine tumors stimulated by estrogen during pregnancy that may outgrow their blood supply, undergo necrosis, cause pain, and trigger premature labor.

Tocolysis

The pharmacological or therapeutic inhibition of labor.

Cerclage

A surgical procedure involving stitching the cervix closed to prevent premature delivery in cases of incompetent cervix.

PROM

Premature rupture of membranes, a potential cause of preterm labor.

Spaulding Sign

Overlapping of fetal skull bones seen on ultrasound, serving as an indicator of fetal death.