OB Notes

Heterotopic pregnancy

Heterotopic pregnancy

Multiple gestations with one in uterine cavity and the other outside of the uterus

Subchorionic Hemorrhage

Bleeding between uterine wall and chorion

Anembryonic Pregnancy

When gestational sac forms without an embryo

Abortion

Deliberate interruption of a pregnancy

Miscarriage

Spontaneous or natural loss

Complete abortion

Retained product of conception (RPOC) is expelled

Incomplete abortion

Partial expulsion of RPOC

Threatened abortion

Vaginal bleed with a closed cervix before 20 weeks

Missed abortion

Fetal death & retained dead embryo

Inevitable abortion

No chance of pregnancy survival. There is bleeding, gross rupture of the membrane & cervical dilation

Habitual Abortion

More than 3 consecutive miscarriage

Septic abortion

Spontaneous or induced that is complicated by uterine infection including endometritis

Therapeutic abortion

Elective termination

Normal placental thickness

Should be between 1.5-4cm

Placenta previa

Partially or completely covers the internal OS ( 4 grades)

False positives for placenta previa

1. Maternal bladder too full

2. Braxton hicks

3. early pregnancy

Abnormal placental attachment

Abnormal implantation of placental tissue (Chorionic villi) 3 types

Accrete

Invades < 50 % of the way through the myometrium

Increta

Invades more than 50% of the way through the myometrium

Percreta

Placenta tissue extends through uterine wall to bladder and adjacent pelvic structures

Succenturiate

AKA accessory placenta

Smaller accessory placental lobe that is separate to the main disc

Bilobed placenta

Placenta that consists of two separate disc of equal size

Circumvallate Placenta

Rolled or curled placenta edges

Placenta abruption

Placenta separates from the inner wall of the uterus before birth causing hemorrhage

Placental infarcts

AKA breus mole

large thrombus within subchorionic venous system due to obstructed venous flow

Gestational trophoblastic disease

AKA molar pregnancy

Non cancerous tumor that develops on the uterus as a result of a non viable pregnancy.

Hydatidiform (HM)

A rare mass or growth that forms Inside the womb at the beginning of a pregnancy type of GTD

Complete HM

No fetal tissue. echogenic short tissue mass containing cystic spaces of varying size (snow storm)

Partial/ incomplete HM

Some fetal tissue present. same as complete HM but with fetal tissue

HM w/ co-existing fetus

very rare when one twin transformed into a molar gestation. the other fetus is normal.

Chorioadenoma destruens

Type of cancer that grows into the muscular wall of the uterus ( invasive mole )

Choriocarcinoma

A malignant, fast growing tumor that develops from trophoblastic cells

Chorangioma

A rare tumor with frequency of about 1% which usually presents as a solitary nodule or less frequency as multiple nodules.

Normal umbilical cord length

40-60 CM

Short Umbilical cord

Less than 35CM

Normal cord width

MX From 2.6-6.0 CM

Omphalomesenteric cyst

AKA allantoic cyst

A cystic lesion of the umbilical cord

Umbilical vein thrombosis

Blockage of the umbilical cord in the umbilical cord (Lethal)

True knots of the cord

A knot in the baby’s umbilical cord can be single or multiple (rare condition can be seen as clover leaf pattern )

False knots of the cord

kinks in the umbilical cord vessels any bulge or protuberance in the baby’s umbilical cord

Nuchal cord

Cord wrapped around fetal neck

Chordal attachments

Cord usually attaches near the center of the placenta

2 kinds

battledore cordal attachment

Velamentous cord insertion

Battledore cordal attachments

AKA marginal cord insertion

Umbilical cord attached to the placenta margin

Velamentous cord insertion

When cord inserts into membranes before it enters the placenta rather than directly into the placenta

Vasa previa

When internal os is covered by the umbilical vessel

Umbilical cord prolapse

When the umbilical cord falls into the birth canal ahead of the baby head or other parts of babys body

Vessel cord

AKA bivascular cord, single umbilical artery

One umbilical artery & one umbilical vein

Umbilical vein varix

Dilation of the umbilical vein

vein diameter > 9 mm

Umbilical cord coiling

Makes umbilical cord flexible & strong provides resistance to the external force

Normal cord has 1 coil per 5 cm

Torsion or hyper coiling > 2 coils per 5cm

Non- coiled umbilical cord

At risk for poor perinatal outcome

poly hydramnios

AKA hydramnios

excessive fluid

Oliogo hydramnios

Severely decreased fluid levels

Anhydramnios

No fluid

PROM

Premature rupture of the membrane

Fetal hydros

AKA hydros fetalis

Condition where large amounts of fluid build up in the baby’s tissues and organs causing extensive swelling.

Non- Immune Hydrops

Most common excessive accumulation of fetal fluid within the fetal extravascular compartments and baby cavities.

Immune hydrops

AKA Erythroblastosis details/ isoimmunization

Mothers immune system causes babies red blood cells to break down.

Amniotic band sequence/ syndrome

Pieces of the amnion membrane attached to the fetus causing defects

Neural tube defects

Occurs when the embryonic neural tube fails to close

Anencephaly

Baby is born without parts of the brain or skull (lethal)

frog like appearance

Enencephaly

AKA Acrania

Partial or complete absence of the cranial vault. fetal cranium absent but fetal brain tissue os always present

Cephalocele

Infant is born with gap in the skull

Meningocele

Herniation of only membranes

Encephalocele

Herniation of brain tissue and membranes

Meningoencephalocele

Herniation of brain tissue, meninges & CSF ( cerebrospinal fluid)

Spina bifida

Incomplete development of the spinal cord or coverings. cleft or opening in the spine.

Most common location for spina bifida

Lumbosacral area

2nd most common location for spina bifida

Cervical area

Rachischisis

( Most serious for of SB)

Posterior neuropore of the neural tube fails to close resulting in a cleft through the spine.

Spina bifida occulta

Mildest

Malformation of one or more of the vertebrae without apparent damage to the spinal cord

Meningocele

A sac that pushes through the gap in the spine

Myelomeningocele

( Most severe from of SB )

Part of the spinal cord itself protrudes through the back

Arnold - Chiari Malfromation

Condition in which brain tissue extends into the spinal canal.

Dandy - walker malformation DMW

Development deviation in the roof of the 4th ventricle and cerebellum.

Holoprosencephally

Disorder caused by the failure of the prosencephalon ( the embryonic forebrain) to sufficiently divide into double lobes of the cerebral hemispheres

Alobar Holoprosencephally

Most serious form where the brain has No tendency to separate is usually associated with facial abnormalities

Semilobar holoprosencephaly

Brains hemispheres have a slight tendency to separate

Lobar Holoprosencephaly

Nearly complete separation of the cerebral hemispheres

( Least severe)

Aqueductal stenosis

Result from an obstruction atresia or stenosis of the aqueduct of Sylvius ( connects to the 3rd & 4th ventricles)

Vein of Galen malformation (VGM)

Abnormal connections between arteries & the deep draining veins of the brain which develop before birth (Rare)

Choroid plexus cyst

Often located in the atria of the lateral ventricles. Often seen 15-24 weeks & often resolves by 22-26 weeks

Porencephaly

Extremely rare condition of the central nervous system involving a cyst or cavity in the cerebral hemisphere

Schizencephaly

Cleft in the cerebral cortex

Hydrancephaly

RARE Where the brains cerebral hemispheres are absent and replaced by sacs filled with cerebral spinal fluid

Hydrocephalus

Build up of fluid in the cavities ( ventricles) deep with in the brain

Lissencephaly

Smooth brain

condition where there is no gyro/sulci within the cerebral cortex

Microcephaly

Small head

Meckel - syndrome

Characterized by multiple cyst in the kidney, protrusion of a portion of the brain through an opening in the skull and extra fingers & or toes

Scoliosis

S shaped spine abnormal lateral curvature

kyphosis

Abnormal posterior curvature of the spine

TORCH

Toxoplasmosis, rubellacytomggalovirus, herpes simplex & HIV

sometimes with an s- syphilis

Fetal intracranial tumers

MOST COMMON

Teratoma that will distort the normal brain appearance

Choroid plexus papillomas

Found with in the choroid plexus produces an increased production of CSF ( Cerebra spinal fluid ) can lead to venreicilomegaly

Skeletal dysplasia

Term used to describe abnormal growth and density of the cartilage and bone

Rhizomelia

Shortening of the proximal extremity

Humerus & Femur

Mesomelia

Middle limb segment shortening ( radius, ulna, tibia, fibula)

Acromelia

Distal extremity shortening ( phalanges and metacarpals )

Phocomelia

Absent middle portion of the limb ( hand & feet attached to trunk )

Thanatophoric displasia

one of the more common forms of lethal short limbed dwarfism seen

Achondrogenesis

Rare type of growth hormone deficiency in which there is a defect in the development of bone & cartilage