Term | Importance |
Risk for Amniocentesis for pregnancy complication | 1/300 |
Risk for PUBS for pregnancy complication | 3-5% |
Risk for CVS and Early Amniocentesis for pregnancy complication | 1% |
Rhogam administered 3 times and they are | Time of Amniocentesis/CVS, 28 weeks and Delivery |
IgM | First responder antibodies - Rhogam destroys IgM |
IgG | Memory antibodies |
Initital Office Visit (Prenatal Care) | Medical history, Obstetrical history, Surgical history, Family history, Physical exam, Lab tests. |
Symptoms of Pregnancy | Amenorrhea, Nausea and vomiting, Breast tenderness, Bladder irritability and frequent urination, Linea nigra, Chloasma |
Prenatal Care Maternal Assessment | Current Medication, Alcohol, tobacco, over-the-counter medication, Pets, Physical abust, Nutrition, Environmental exposure |
TORCH | Toxoplasmosis / Toxoplasma gondii, Other infections, Rubella, Cytomegalovirus,Herpes simplex virus |
Quad Screen | AFP, HCG, UE3, Inhibin-A. 14(some) 15-22 weeks |
When is CVS performed? | 10-13.6 weeks. |
When is NT performed? | 11-13.6 weeks |
When is Amniocentesis performed? | 16-22 weeks |
When is PUBS performed? | No earlier than week 17. |
Maternal history conditions predisposing to fetal demise | Prior stillbirth, prior abruption |
Maternal disease, which predispose to fetal demise | Insulin dependent diabetes, Hypertension, Renal disease, Autoimmune disease - Lupus, rheumatoid arthritis. |
OB complications, which predispose to fetal demise | PROM, Preeclampsia, Post Date, Decreased fetal movement, Decrease amniotic fluid volume. |
HELLP | Hemolysis, Elevated liver enzymes, Lowered platelets. |
Prenatal diagnosis is advantageous for who? | The immediate family |
Tay Sachs | Eastern European Jewish descent |
Sickle Cell | Black descent |
Thalassemia | Mediterranean or Asian |
Cystic Fibrosis | Caucasian |
First Trimester Ultrasound evaluates for: | Heart Beat, Nuchal Translucency, and Gestational Age by CRL |
First Trimester Serum Screen | d |
First Trimester Screening | PAPP-A, hCG and Nuchal translucency |
Combined First Trimester Screening | hCG, PAPP-A, NT and Maternal Age |
Integrated Testing | 1st and 2nd trimester ultrasound and biochemistry. NT, PAPP-A, AFP, uE3, hCG and inhibin A. |
Sequential Screening | Combined 1st trimester screening and 2nd trimester Quad Screen. |
Second trimester uses what 4 biochemical markers: | AFP, uE3, hCG and DIA. |
Non-Invasive Methods | Biochemical Marker Screening, Ultrasound, MRI, Fetal Echocardiogram, Fetal cells in mother's blood. |
Minimally Invasive | CVS, Amnio |
Moderately Invasive | PUBS, Embryoscopy/Fetoscopy, Fetal skin/muscle Biopsy, PGD. |
Soft Markers for DS | Nasal Bone, Nuchal Fold, Pyelectasis, Clinodactyly, Sandal gap, Echogenic cardiac foci, Choroid plexus cyst, Flattened midface |
Ashkenazi Jewish are high risk for: | Tay Sachs, Gaucher, Canavan, Cystic fibrosis |
African Americans are high risk for: | Sickle cell, Hemoglobin C, Alpha-thalassemia, Beta-thalassemia. |
AMA defined as: | 35 years of age at the time of delivery. |
Factors that affect AFP values | Gestational Age, Number of Fetuses, Maternal Age, Maternal weight, Maternal Race, Insulin. |
Causes of ELEVATED AFP | Normal variant, Underestimation of gestational age, Multiple gestation, Overestimation of maternal weight, Poor placental function, ONTD, VWD, Renal anomalies, Oligo, Bleeding, IUFD, Skin disorders. |
hCG levels for T21, T18, NT | Up, Down, NC |
uE3 levels for T21, T18, NT | Down, Down, NC |
DIA levels for T21, T18, NT | High, NC, NC |
MSAFP Elevated at: | 3.0 MoM |
Causes of low MSAFP | Overestimation of dates, Underestimation of maternal weight, Normal variant, IUFD, Maternal diabetes, SGA, DS. |
Fetal Echocardiogram used to: | Identify cardiac defects, cardiac arrhythmias, situs inversus, cardiac tumors, cardiomyopathy. |
Amniotic Fluid | Cushions, allows for movement, Lung development, Digestive Development, Renal Development. |
Infertility | Physical, Chromosomal, Genetic, Autoimmune, Hormonal. |
ICSI | Intracytoplasmic sperm injection One sperm directly into egg. |
PGD | Preimplantation Genetic Diagnosis |