Leading causes of infant mortality
-Congenital malformations
-disorders related to short gestation and low birth weight
-SIDS
in that order
Placenta with Listeria Monocytogenes
Small parenchymal, yellow-white pustules that microscopically correlate with microabscesses and necrosis
Type of blood used for intrauterine transfusion
O-negative blood concentrated to a Hct between 75% to 80%
Reference range for fetoplacental blood volume is 90 - 120 cc/kg
Alpha-glutathione S-transferase (
alpha-GST)
correlate with serum bile acid level in pregnant women with intrahepatic cholestasis
Infants born to women with intrahepatic cholestasis of pregnancy
Increased risk of surfactant deficiency, bile acid pneumonia, and meconium aspiration syndrome
neonates will also often have elevated bile acid levels
Nutrient deficient in women with intrahepatic cholestasis of pregnancy
Selenium
Placentas of obese women
-hypermature with increased number of terminal villi or have accelerated villose maturation
-more acute inflammation with greater oxidative stress and increased number of cytokines
-more likely to be larger than average
-have findings of decreased perfusion with increased risk for infarctions
Findings that suggest abnormal placentation
-Absence of the echolucent clear space between uterus and placenta
-Thin hyperechoic space between the serosa of the uterus and the maternal bladder wall
-Appearance of placental lacunae with or without high-veolicty flow
-Abnormal color Doppler flow at the interface between the myometrium and the maternal bladder
Immune changes during pregnancy
-Switch from helper Tcell 1 cellular immunity to TH2 antibody-mediated immunity
-Downregulation of the maternal immune system due to enhanced regulatory T cells
-The syncytiotrophoblast lacks the MHC antigen
Progesterone receptors
PR-B is the dominant form in pregnancy. During labor, PR-A levels are higher, leading to impaired progesterone responsiveness
Gestational age for gestational diabetes testing
24 to 28 weeks
Hofbauer cells
stromal histioctyes found in placental villi of normal placenta
TTTS stages
1: oligo/poly - visibile donor bladder
2: donor bladder not visibile
3: abnormal umbilical doppler flow
4: hydrops in either donor or recipient
5: demise
MRI is better than US for fetal diagnosis when
GI obstruction and renal cysts
Most common cause of chronic infectious villositis
CMV and syphillis
Mag reduces which maternal outcomes
eclampsia and placental abruption
Hypertensive disorders
Chronic hypertension: HTN before 20 weeks, or beyond 12 weeks postpartum
Gestational hypertension: HTN after 20 weeks
Preeclampsia: HTN +proteinuria (>0.3)
severe features: systolic >160 or diastolic >110 Or severe proteinuris (>5) or severe other really bad signs
Most common ART associated with genomic imprinting disorders
Intracytoplasmic sperm injection
Most accurate method for estimating gestational age and due date
First trimester US (up to 13 6/7). Uses crown-rump length
AFP
Low <0.6 MoM
High >2.0-2.5 MoM
Estimated fetal bleed (in ml)
%fetal RBCs x 50
Amniotic fluid volume
Oligohydramnios is an abnormally low volume of amniotic fluid, typically defined as an amniotic fluid index (AFI) less than 5 cm or a single deepest pocket (SDP) < 2 cm. Polyhydramnios is an excessive amount of amniotic fluid, defined as an AFI of
24 cm or an SDP
8 cm.
Varicella mom
-Can provide EBM if no lesions on breast
-isolate from newborn until lesions crusted
-airborne and contact precuations for baby for 21-28 days
-Should receive variZIg within 10 days of birth
