Normal Pregnancy and Common Complications Review

Comprehensive flashcards covering maternal anatomy, pregnancy physiology, screening tests, fetal anomalies, and major obstetric complications including hypertension, diabetes, and infections.

What three bones constitute the symmetrical innominate bones of the female pelvis?

The ilium, ischium, and the pubis.

How do the female and male pelvic brims differ in shape?

The female pelvic brim is oval-shaped transversely and widest further forward, while the male pelvic brim is heart-shaped and widest towards the back.

Which pelvic floor muscles constitute the posterior wall and the pelvic floor itself?

The pyriformis covers the posterior wall, while the levator ani and coccygeus constitute the pelvic floor.

What is the role of progesterone synthesized by the placenta after $35$ days of gestation?

Progesterone promotes smooth muscle relaxation in the gut, ureters, and uterus, raises body temperature, and is a principal hormone for preventing preterm labour.

Which hormone modifies maternal metabolism to increase energy supply to the fetus and increases insulin secretion?

Human placental lactogen ($hPL$).

What is the primary cause of 'physiological anaemia' in pregnancy?

A discrepancy between the increase in plasma volume ($30-50$ percent) and the slower increase in red cell mass ($18-30$ percent with supplements).

By how much does the cardiac output increase by the end of the first $12$ weeks of pregnancy?

It increases from $5$ to $6.5\,L/min$ through a $10\%$ increase in stroke volume and a pulse rate increase of approximately $15$ beats/min.

Define 'supine hypotension syndrome' in the context of late pregnancy.

A profound drop in cardiac output and venous return that occurs when lying supine, caused by the enlarged uterus compressing the inferior vena cava.

What effect does progesterone have on the respiratory system during pregnancy?

It increases tidal volume by approximately $40\%$ ($500-700\,mL$), causing the woman to breathe more deeply rather than more frequently.

How much does the uterus increase in weight by term?

It undergoes a $10$-fold increase in weight to $1000\,g$.

What is the 'operculum' in the cervix?

A thick mucus plug formed by the hypertrophy of cervical glands that acts as a barrier to infection.

In the first trimester, how much do renal blood flow and glomerular filtration rate ($GFR$) typically increase?

They increase by $30-50\%$.

What are the timing and method for Chorionic Villus Sampling ($CVS$)?

It is performed between $10$ and $13$ weeks and involves the aspiration of trophoblastic cells for karyotyping or DNA analysis.

What markers are measured in the 'Combined test' for Down's syndrome screening, and when is it performed?

Performed at $11-13^{+6}$ weeks, it measures ultrasound nuchal translucency ($NT$), $PAPP-A$, and $\beta$-human chorionic gonadotrophin ($hCG$).

Distinguish between exomphalos and gastroschisis.

Exomphalos is a midline defect where bowel/viscera are contained within a sac at the umbilical cord apex; Gastroschisis involves the protrusion of bowel through a defect (usually to the right of the cord) without a covering sac.

What is the worldwide rate for monozygotic twinning?

Approximately $3.5$ per $1000$.

Describe the clinical definition of pre-eclampsia.

A blood pressure of $\ge 140/90\,mmHg$ and $\ge 300\,mg$ of proteinuria in a $24$-hour collection after $20$ weeks of gestation.

What are the three components of HELLP syndrome?

Haemolysis ($H$), Elevated Liver enzymes ($EL$), and Low Platelets ($LP$).

What are the maternal blood glucose targets for optimal control in diabetic pregnancies?

Fasting blood glucose between $3.5$ and $5.9\,mmol/L$ and 1-hour post-prandial levels $< 7.8\,mmol/L$.

What fetal risks are associated with Parvovirus $B19$ infection?

Suppression of erythropoiesis, cardiac toxicity, and severe anaemia which can lead to hydrops fetalis and death in $10\%$ of cases infected below $20$ weeks.

What characterizes the 'blueberry muffin' rash in newborns?

Generalized, non-blanching, purpuric macules and nodules caused by extramedullary hematopoiesis, associated with Congenital Rubella Syndrome or $CMV$.

Define the three levels of the Placenta Accreta Spectrum.

Accreta: villi attach to the superficial myometrium; Increta: villi invade the myometrium; Percreta: villi extend through the myometrium and serosa.

What is the defining clinical presentation of vasa praevia?

Fetal vessels running in membranes below the presenting part, which can cause rapid fetal exsanguination upon rupture of membranes.