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36 Cards in this Set
- Front
- Back
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Causes of high maternal alpha fetoprotein |
Open neural tube defects(eg anencephaly) Ventral wall defects(eg omphalocele) Multiple gestation |
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Causes of low maternal alpha fetoprotein |
Aneuploidies(Trisomy 18 and 21) In addition there's compensatory release of bhcg and inhibin A( high) |
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Hypertension in pregnancy value |
Systolic >140 and diastolic >90 |
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Patients with pre-eclampsia are at risk for fetal growth restriction and oligohydramnios due to |
Abnormal placental spiral artery development which leads to increased placental vascular resistance, decreased uteroplacental perfusion and decreased umbilical vein oxygen delivery. |
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How does pre-eclampsia affect vessels? |
Chronic placental ischemia leads to increased release of antiangiogenic factors leads to decreased proangiogenic factors like vegf which then leads to decreased angiogenesis and vascular problems. |
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Physiologic renal adaptation during pregnancy |
Increased glomerular filtration rate and increased basement membrane permeability leads to decreased tubular resorption of filtered protein leading to trace amount of urinary protein <300mg. Which is a normal finding |
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What kind of congenital anomaly is club foot? |
Deformation. |
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The hyperventilation of pregnancy creates a |
Respiratory alkalosis with metabolic compensating(increased renal bicarbonate excretion. It's caused by elevated progesterone level stimulating an increased in central respiratory drive |
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What's the cause of gestational thrombocytopenia |
Hemodilution and increased platelet sequestration. There's approximately 30% increase in plasma volume during pregnancy that helps with fetal nutrient and bleeding during delivery but platelet production does not typically increase. Hence the hemodilution. Then the placenta is a major site of normal platelet sequestration. |
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Bhcg is secreted by |
Syncytiothrophoblast |
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The important direct role of bhcg |
It's to maintain the corpus luteum which produces progesterone in early pregnancy |
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Etiology of polyhydramnios |
Decreased fetal swallowing(gi obstruction and anencephaly or increased fetal urination |
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Treatment for early unruptured ectopic pregnancy |
Methotrexate |
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What increases insulin resistance during the second and third trimester |
Human placenta Lactogen (hpl) |
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Hpl |
Increased maternal insulin resistance in the second and third trimester. Making glucose easily available to the growing fetus. |
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How does gestational diabetes Occur |
It occurs when the compensatory rise in maternal insulin secretion is adequate to prevent serum glucose level from reaching excessively high levels. |
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What can increase the risk of placenta abruptio |
Pre-eclampsia |
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Most adult patient with rubella develop |
Polyarthralgia while congenital develops sensorineural deafness,cataract and cardiac malformation (pda) |
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In ectopic pregnancy what would curettage reveal |
Desidual changes in the endometrium due to progesterone secretion.Dilated coiled endometrial gland and vascularized edematous stroma |
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Mechanism of action of Mifepristone and misoprostol in termination of pregnancy |
Mifepristone is a progesterone antagonist for necrosis of the decidua while misoprostol is a prostaglandin E1 analog causes cervical softening and uterine contraction causing the expulsion of the pregnancy. |
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Phase of female gametogenesis from childhood to puberty |
Arrested in Prophase of meiosis 1 |
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Phase of female gametogenesis in ovulation |
Arrested in Metaphase of meiosis 2 |
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In pre-eclampsia specific gravity is |
Increased due to concentrated urine. Kidney tries to retain sodium in oliguric state. |
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What to always check out for in a pregnant patient |
Blood pressure with gestational age Above or below 20 weeks. Always rule out pre-eclampsia |
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Placenta invasion into the myometrium through defect in the desidua basalis |
Placenta accreta-attachment to the myometrium Placenta increta-invasion of the myometrium Placenta percreta- invasion into the myometrium and serosa |
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Transgenic adverse effect of valproate |
Neural tube defect |
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Cause of cholelithiasis in pregnancy |
Estrogen induced cholesterol hypersecretion and progesterone induced gall bladder hypomobility. |
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Subgaleal hemorrhage |
When emissary vein between dural sinuses and scalp is sheared. Accumulation of blood between periosteum and galea aponeurosis. |
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Dizygotic twin |
Two oocyte and two sperms |
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The later the division of zygote(8 to 12 days) |
More likely identical twins. Monochorionic monoamniotic. After 13 days can result in conjoined twins. |
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Mother develops masculine features during pregnancy |
Aromatase defficiency. Aromatase converts androstenedione to Estrone and testosterone to Estradiol. |
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Partial mole have |
Triploid karyotype 69xxx or xxy containing paternal and maternal DNA with an extra set of paternal origin |
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Complete mole have |
Only paternal DNA 46xx or xy rarely |
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Drug associated with ebstein anomaly |
Lithium |
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Intracranial hemorrhage in newborn born at full term |
Vitamin k defficiency |
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Alternative drug for doxycycline |
Amoxicillin |
