OB 510

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OB 510
2010-06-07 22:25:08

Interventional Procedures
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  1. What is the optimal time to perform amniocentesis for chromosomes?
    15-20 weeks
  2. Indigo Carmine dye is injected into the amniotic sac of one twin during amniocentesis. This is performed on the (1st / 2nd) twin being sampled?
  3. AFP levels are measured in amniotic fluid. T/F
  4. Amniocentesis results take up to 3 weeks before the final analysis is available. Why?
    • Cell culturing
    • icubate
    • grow
  5. The small amount of amniotic fluid that initially enters the syringe is discarded. Why?
    Mothers genetic information is in the first little bit, not the baby's. Maternal specific.
  6. The amound of fluid acquired during amniocentesis is approx ________ per week of gestation.
    1 cc
  7. List 2 advantages of early (before 13 weeks) amniocentesis. (4)
    • increased risk of tenting
    • more cultural failure
    • poorly def fet anatomy
    • increased risk of pregnancy loss
  8. List 2 indications for therapeutic amniocentesis
    • polyhydramnios
    • Management of Oligohydramnios (fluid insertion)
  9. Name 4 potential complications of amniocentesis
    • miscarriage
    • cramping
    • fluid leak PROM
    • preterm labor
    • bleeding (post procedure)
    • amnio chorio separation
    • infection (chorioamnioitis)
  10. List 4 indications for amniocentesis in obstetrical management
    • advanced maternal age
    • fetal reduction
    • chromosomes (family hx aneuploidy)
    • abnormal quadruple screen
    • lung maturity
    • abnormal us prenatal findings
    • 3 or more spontaneous abortions
  11. Amniocentesis is exclusively performed (transabdominally / transcervically)?
  12. What is the purpose of fluid instillation into the amniotic cavity?
    Create acoustic window to vis fetal ext&int anatomy and allow fetal movement.
  13. Fluid instilled into uterus is?
  14. What is the optimal time to perform CVS?
  15. CVS is never performed prior to ?
    9.5 weeks
  16. Limb reduction is extremely rare with CVS? T/F
  17. AFP levels are measured using CVS. T/F
  18. The tissue being sampled is ?
    trophoblastic (placenta)

    chorionic vendosum
  19. What are the 2 main advantages of chorionic villus sampling in comparison to amniocentesis?
    • Early Dx
    • Faster results
  20. Name the 2 CVS techniques used to acquire chorionic villus samples. Note: Method used is usually related to radiologist/perinatologist preference.
    • TA
    • Transcervical
  21. The karyotype of the placenta is the karyotype of the fetus. T/F
  22. The 20-30 mg of trophoblastic tissue withdrawn is then transferred to _________________________.
    a sterile petri dish containing culture medium.
  23. List 4 post procedure maternal complications.
    • 1. fluid leak
    • 2. vaginal spotting
    • 3. bleeding
    • 4. cramping
    • 5. infection
    • 6. spontaneous abortion
  24. List 4 indications for CVS.
    • 1. late maternal age
    • 2. previous trisomy
    • 3. parent with chromosomal rearrangement
    • 4. X-linked (dom boy recessive girl) hemophelia
    • 5. mendelian disorder
  25. CVS results are available within?
    7-10 days
  26. TC-CVS or TA-CVS can be performed until term?
  27. Cordocentesis is aka?
    • PUBS
    • percutaneous umbilical blood sampling
  28. PUBS is initially performed as early as ______ but usually _________.
    • 17 weeks
    • 26+
  29. The spinal needle (20G) may be guided through the placenta. T/F
  30. The PUBS needle is inserted (proximal/distal) to the cord insertion into the placenta. Why?
    • Proximal
    • sways less
  31. PUBS needle is guided into the umbilical (artery/vein)?
  32. Name the 2 complications that may occur when the umbilical artery is punctured.
    • Bradychardia <120
    • post process bleeding
  33. List 6 indications for PUBS?
    • 1. Rapid karyotyping (48-72 hrs)
    • 2. Infections TOXOPLASMOSIS
    • 3. Assess anemia, erythroblastosis, Rh+ baby
    • 4. Method blood transfusion
    • 5. Platelet disorders
    • 6. Fetal Arrhythmias
  34. Describe hysterosonography.
    Infusion of saline into endometrium canal to see if tubes patent / endo path and image transvag sonography
  35. Hysterosonography is valuable for differentiating an endometrial polyp from a __________________ or _______________.
    • fibroid
    • endometrial hyperplasia
  36. Which of the following procedures may be indicated when a rapid karyotyping is desirable?

    A. amniocentesis
    B. PUBS
    C. cordocentesis
    B. PUBS
    (this multiple choice question has been scrambled)
  37. Elevated MS AFP occurs when the value obtained is > ___________ of the mean for the GA.
  38. List 4 conditions associated with elevated MS AFP
    • GTD
    • NTD (open spina bifida)
    • multiples
    • omphalocele
    • fetal demise
  39. The fetal heart is confirmed both prior to and after an interventional procedure? T/F
  40. Define: Percutaneous
    Passage through skin with a needle puncture
  41. Late maternal age?
  42. CVS, Amniocentesis and PUBS require aseptic techniques (T/F)
  43. The risk of fetal loss is slightly higher with CVS/Amnio?
  44. A higher Dx accuracy (99%) occurs with CVS/Amnio?
  45. Define: Diagnostic Fetoscopy
    An endoscopic methos for view of fetus in 2nd trimester and used to sample fetal blood , skin liver for prenatal Dx.
  46. What is the MC indication for operative fetoscopy?
    • larger ablation
    • common vessels TTTS
  47. NTD's may be Dx by only one of the following procedures. This procedure would be?

    a. amnio
    b. CVS