week 5 3rd semester lab

Analyte

a chemical substance that is the subject of chemical analysis

Aneuploidy

abnormal chromosome number

Doppler

Noninvasive ultrasound test that measures blood flow

Hypoxemia

low oxygen in the blood

Idiopathic

Without known cause

Intrauterine Growth Restriction (IUGR)

Estimated fetal weight less than the 10th percentile for the gestational age

Low Birth Weight (LBW)

Birth weight below 2,500 grams (g) or 5 lbs 8 oz

Morbidity

Incidence of a specific disease in a population for a set amount of time

Mortality

the frequency of deaths in a population

Nonstress Test (NST)

Method of assessing fetal well-being by observing the fetal heart rate response to fetal movement

Oligohydramnios

low amniotic fluid

Placental Mosaicism

Condition characterized by the discrepancy between the chromosomal makeup of the fetus and placenta

Preeclampsia

Hypertension and protein in the urine, occurring during pregnancy

Sensitivity

The proportion of people who test positive for a disease who actually have the disease

Small for Gestational Age (SGA)

Diagnosis used to describe an infant that is smaller than expected for the gestational age

Specificity

The proportion of people who test negative for the disease that do not have the disease

Trisomy

Having three copies of a specific chromosome

Velocimetry

Noninvasive measurement of volume and velocity of blood flow

Polyhydramnios

High amniotic fluid levels

Macrosomic

Weight greater than 4200 - 4500 grams

Oligohydromnios

Low amniotic fluid levels

IUGR

Conditions such as poor maternal weight gain, previous IUGR infant, maternal complications, and inadequate symphysis to fundal height growth are suggestive of:

macrosomia

Select the description that does not characterize IUGR:

a.growth two SD below the mean for gestational age

b.fetal lagging abdominal circumference

c.an EFW <10th percentile

d.macrosomia

maternal hypertension

A cause of intrauterine growth restriction is:

redistributing it to the fetal brain

IUGR affects the fetal blood flow by:

anorexia

IUGR can cause poor health for the fetus into adulthood. They include all except:

a.hypertension

b.diabetes

c.anorexia

d.atherosclerosis

is a condition where elevated protein is discovered in the maternal urine

Preeclampsia:

Placental abnormalities

A common cause of IUGR is:

infectious conditions

Herpes simplex virus, cytomegalovirus, rubella, and varicella zoster are ____________, which relate to fetal growth restriction.

asymmetric

Atypical growth patterns where the fetal AC lags the BPD, HC, and FL is known as:

symmetric IUGR

Infection, congenital malformation, drugs, and chromosomal abnormalities are usually responsible for:

serum analytes

Identification of growth-restricted fetuses is done through sonographic EFW, fundal height, and:

delivery of the fetus would be considered.

BPP should be performed only when:

3

A fundal height measurement difference of more than __ centimeters less than expected after 20 weeks' gestation is cause for suspicion of IUGR.

not less than 3 weeks

If IUGR is suspected, the recommended interval between growth evaluations is:

increases

The predictive error of ultrasound _______ as the gestation increases.

nonimpact exercise

Common maternal treatments to increase growth in an IUGR fetus include all except:

two or more accelerations within 20 minutes

A normal nonstress test displays:

IUGR

Hypothermia, hematologic complications, and hypoglycemia are conditions related to:

low blood pressure

IUGR children, especially preterm, have an elevated risk of all except:

a.low blood pressure

b.behavioral problems

c.inferior school performance

d.neurologic damage

SGA

Select the correct fetal category for a fetus displaying biometric parameters below 10% without a known cause, possibly relating to parental habitus and family history, small AC/BPD/HC/FL measurements, normal AFI, normal BPD/AC ratio, and normal placenta.

a.macrosomia

b.symmetrical IUGR

c.asymmetrical IUGR

d.SGA

fivefold to tenfold increased

The fetus with poor intrauterine growth has an _________ risk for perinatal mortality compared with the fetus of normal size.

velamentous cord insertion, single umbilical artery

Cord anomalies that increase the risk of for IUGR are _________ and _________.

18 years

IUGR infants usually achieve normal growth at the age of _________.

prenatal, postnatal

Growth restriction can cause adverse effects of _________ and _________ life.

chromosomal

Poor intrauterine growth and subsequent LBW are common features of many _________ abnormalities.

Patau, Downs, Edwards

The most common chromosomal abnormalities that increase a fetus' risk for IUGR are _________ syndrome, _________ syndrome, and _________ syndrome.

Lower

Birth weight at higher altitudes is _________ than that of infants born at sea level.

multifactoral

The cause of IUGR may be idiopathic or _________.

decrease, fundal height

The accuracy of measuring all biometric parameters _________ with advancing gestational age. The measurement of _________ is least affected.

Decrease

Maternal medical conditions that affect blood circulation result in a _________ in uteroplacental blood flow and can lead to IUGR

hypertension

Maternal _________ in pregnancy is one of the leading causes of IUGR.

increase

Multiple measurements in fetal ultrasound have been used to _________ accuracy.

high, forward

In a normal fetus, the MCA is a _________ impedance circulation with continuous _________ flow.

Umbilical Artery

_________ Doppler may help differentiate a constitutionally small fetus and a pathologic IUGR fetus.

Maternal, fetal, placental

Risk factors or etiologies of IUGR can be divided into three groups: _________, _________, and _________.

weight, amniotic

Estimated fetal _________, sonographic biometry, Doppler flow, and _________ fluid changes assist in identification of growth restricted fetuses.

weight

Avoidance and cessation of smoking during pregnancy can increase fetal _________.

20

BPP observations are made within a _________ -minute time frame

heart rate, movement

Advanced acidemia, hypoxemia, and hypercapnia affect fetal _________ and _________, two of the four biophysical features of a BPP.

NST, BPP, Doppler, AFV

Antenatal surveillance is done with four fetal growth assessments: _________, _________, _________, and _________.

otherwise healthy and grows at a constant rate

A fetus that is constitutionally small falls below the 10th percentile for gestational age, but is

sonographic EFW, serum analytes, and funal height

Identification of growth-restricted fetuses is done through:

Fundal height

Commonly used to screen for IUGR

early ultrasound or last known menstrual period

Diagnosis of IUGR is centered on ultrasound biometry and is dependent on accurate dating by an

doppler evaluation

the cornerstone for the management of an IUGR fetus.

UA, MCA, UTA, DV, and UV.

Doppler parameters to aid in IUGR diagnosis include flow changes to the:

poor outcome

Absent or reversed end-diastolic flow in an UA is indicative of:

fetal brain sparing

A CPR below 1.08 is an indication of

omnious finding

A reversal of a-wave in the DV is abnormal and is an

oligohydramnios

a complication of IUGR.

gestational age, doppler values, growth, and BPP

Management of IUGR is limited and timing of delivery for a fetus with IUGR should be individualized on the basis of:

asymmetric IUGR

Large head size relativeto small abdomen

Symmetric IUGR

Small head and abdominal size

Extrinsic:

Placental factors

Maternal vascular factors

Etiology for Asymmetric IUGR:

Instrinsic:

Chromosomal abnormalities

Congenital malformations

Drugs

Infections

Pre-eclampsia (early onset)

Etiology for Symmetric IUGR:

umbilical vein flow, and cardiac output

IUGR causes decreased:

mortality, cerebral circulation

IUGR causes increased:

short and long-term morbidity

learning disabilities

short stature

reduced cognitive function

high blood pressure

diabetes

stroke

Increased postnatal effects of IUGR:

Echogenic bowel- 25 weeks gestation

Uterine Artery Doppler

Umbilical Artery

Middle Cerebral Artery (MCA)

Ductus Venosus (DV)

Doppler uses:

Ductus Venosus

Middle Cerebral Artery

Spectral Doppler Waveform- MCA

Normal Waveform- Uterine Artery

Normal Waveform- Ductus Venosus

Abnormal Waveform- Ductus Venosus

Severely compromised fetus

Abnormal Waveform- Umbilical Vein

Fetus with IUGR- pulsations in the umbilical vein

State the name of the virus that may cause fetal micropthalmia and brain calcifications.

Varicella zoster (chickenpox)

(microphtalmia-small orbits)

Provide the name of the virus that causes mononucleosis.

Epstein-barr virus

List the name of 2 common parasitic diseases associated pregnancy.

Toxoplasmosis, malaria

List what the acronym TORCH stands for.

Toxoplasmosis, other, rubella, cytomegalovirus, herpes

Includes common maternal infections assoc. with congenital anomalies

State the 3 ways that toxoplasmosis is transmitted.

Undercooked/raw meat, contact w/ cat feces, food/contaminated water

Provide the name of the sexually transmitted disease that may cause cataracts, deafness, and/or seizures.

syphillis

Provide the alternative name for German measles.

rubella/3 day measles

One of the first recognized mat. Inf. that resulted in fetal anomalies

State the name of the virus that affects 33% of children by the age of 5.

Cytomegalovirus (CMV) - one of the TORCH viruses

State the most common metabolic disorder of pregnancy.

gestational diabetes metillus

Describe the 2 types of diabetes.

type 1 - insulin dependent (former-juvenile-onset)type 2 - noninsulin dependent (former-adult-onset diabetes, diet can help)

-gestational diabetes - only during pregnancy)

-impaired glucose tolerance

-other/secondary-caused by panc. dz, pancreatectomy, hormones, drugs, chemicals, certain genetic syndromes

increased incidence of fetal anomalies seen w all

Explain the glucose tolerance test.

Between 24-28 weeks, drink glucose solution, wait 1 hour have glucose level checked

Normal < 140 mg/dl140 or above: fail (will have 3 hour glucose tolerance test/double of first one)

If 3 hour test fails, diagnose with gestational diabetes

Provide the alternative name for Rh isoimmunization.

Erythroblastosis fetalis (fetal blood cells will die/RBC be attacked)