ABOG Maternal-Fetal Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Superimposed preeclampsia

New proteinuria or end-organ dysfunction after 20 weeks in a patient with chronic hypertension; delivery is definitive and timing depends on severity and gestational age.

Low-dose aspirin prophylaxis

81 mg daily started before 16 weeks reduces early-onset preeclampsia in high-risk patients, including prior preeclampsia, chronic hypertension, diabetes, and multifetal gestation.

Carpenter-Coustan criteria

Three-hour 100-g oral glucose tolerance test thresholds for gestational diabetes: fasting 95, 1-hour 180, 2-hour 155, 3-hour 140 mg/dL; two or more abnormal values establish diagnosis.

Perimortem cesarean timing

In maternal cardiac arrest, left uterine displacement and continuous compressions precede perimortem cesarean, ideally within 4-5 minutes of arrest to improve maternal and fetal survival.

Amniotic fluid embolism

Sudden hypoxia, hypotension, and coagulopathy during labor or delivery; diagnosis is clinical and treatment is supportive with aggressive transfusion and cardiopulmonary support.

Acute fatty liver of pregnancy

Third-trimester nausea, jaundice, hypoglycemia, and coagulopathy from microvesicular hepatic steatosis; urgent delivery is definitive and maternal ICU support is often required.

Magnesium sulfate toxicity

Progression from loss of deep tendon reflexes to respiratory depression and cardiac arrest; calcium gluconate 1 g IV is the antidote and infusion should be stopped.

Postpartum hemorrhage definition

Cumulative quantified blood loss greater than 1000 mL or bleeding with hemodynamic instability; uterotonics, tranexamic acid, and escalation follow in sequence.

Shoulder dystocia sequence

McRoberts maneuver and suprapubic pressure first, then internal rotation, posterior arm delivery, and finally cephalic replacement or cleidotomy if needed.

Uterine tachysystole

More than five contractions in ten minutes averaged over thirty minutes; reduce or stop oxytocin and consider tocolysis while monitoring the fetal heart tracing.

Category III fetal tracing

Absent baseline variability with recurrent decelerations or bradycardia; requires prompt evaluation and often expedited delivery given risk of fetal acidemia.

Placenta accreta spectrum

Abnormal trophoblast invasion into myometrium or beyond; planned cesarean hysterectomy at 34-36 weeks by a multidisciplinary team reduces hemorrhage morbidity.

TTTS diagnostic criteria

Donor twin with deepest vertical pocket under 2 cm and stuck twin, recipient with pocket over 8 cm; Quintero staging guides fetoscopic laser therapy.

Twin reversed arterial perfusion

Acardiac twin perfused by the pump twin through placental anastomoses; intrafetal radiofrequency ablation or cord occlusion is used when cardiac failure develops.

Middle cerebral artery Doppler

Peak systolic velocity greater than 1.5 multiples of the median suggests fetal anemia and is the trigger for intrauterine transfusion in alloimmunization.

RhD immune globulin

300 mcg anti-D given at 28 weeks and within 72 hours postpartum to RhD-negative unsensitized patients prevents alloimmunization and hemolytic disease.

FETO for diaphragmatic hernia

Fetoscopic tracheal occlusion for severe left congenital diaphragmatic hernia improves survival but increases preterm premature rupture of membranes and preterm birth.

Cell-free DNA screening

Maternal plasma screening with sensitivity above 99% for trisomy 21; it remains a screening test and diagnostic confirmation requires amniocentesis or chorionic villus sampling.

Fragile X premutation

55-200 CGG repeats; maternal premutation can expand to full mutation above 200 repeats in offspring, causing intellectual disability and behavioral features.

Chromosomal microarray

Detects submicroscopic deletions and duplications and is preferred over karyotype for fetuses with structural anomalies or unexplained developmental delay.

Folic acid recurrence prevention

4 mg daily started before conception reduces neural tube defect recurrence risk by about 70% in women with a previously affected pregnancy.

Nuchal translucency threshold

Measurement above 3.5 mm warrants anatomic survey, fetal echocardiography, and genetic evaluation even when karyotype is normal.

Oligohydramnios definition

Deepest vertical pocket under 2 cm; polyhydramnios is a pocket over 8 cm, and amniotic fluid index thresholds are 5 cm and 24 cm respectively.

Ductus venosus a-wave

Absent or reversed a-wave indicates severe placental insufficiency and elevated stillbirth risk, often prompting intensified surveillance or delivery.

Short cervical length

Cervical length under 25 mm at 16-24 weeks in a singleton predicts preterm birth; cerclage or vaginal progesterone may be offered based on history.

Group B Streptococcus prophylaxis

Universal rectovaginal screening at 36 0/7-37 6/7 weeks; intrapartum penicillin G is first-line prophylaxis for colonized patients.

Congenital cytomegalovirus

Most common congenital viral infection; primary maternal infection carries the highest transmission and sequelae risk including hearing loss and neurodevelopmental delay.

Maternal syphilis treatment

Penicillin G is the only proven regimen; penicillin-allergic pregnant patients should undergo desensitization rather than receive alternative antibiotics.

Neuraxial timing with heparin

Hold low-molecular-weight heparin at least 12 hours (prophylactic) or 24 hours (therapeutic) before neuraxial placement to reduce epidural hematoma risk.

Postdural puncture headache

Positional headache after dural puncture; conservative therapy and caffeine first, with epidural blood patch for persistent symptoms.

Lipid emulsion rescue

For local anesthetic systemic toxicity, stop injection, support the airway, and give 20% lipid emulsion 1.5 mL/kg bolus followed by infusion.

Number needed to treat

One divided by the absolute risk reduction; number needed to harm is one divided by the absolute risk increase, both expressing clinical effect magnitude.