Prenatal care
Mechanism by which the TDaP vaccine given to the pregnant patient confers neonatal protection
What is passive transport of IgG across the placenta?
Two first trimester ultrasound findings associated with Down syndrome
What are cystic hygroma and absent or hypoplastic nasal bone?
Name 6 risk factors for stillbirth in developed countries
What are non-Hispanic black race, nulliparity, AMA, obesity, cigarette smoking and alcohol?
Name 6 risk factors for cholestasis of pregnancy
What are multifetal gestation, personal or family history of cholestasis, IVF, cholelithiasis, AMA, and hepatitis C?
Definition of late term pregnancy
Pregnancies from 41-0/7 to 41-6/7 weeks
Recommended test for first trimester pregnant patient with history of GDM and BMI 41
What is glucose tolerance testing?
Most powerful (by likelihood ratio) second trimester ultrasound marker for Down syndrome
What is increased nuchal fold?
Two most useful tests in evaluation of stillbirth
What are autopsy and placental pathology?
Classic symptom of cholestasis
What is third trimester pruritis, generally of the palms and soles, often worse at night? Patients may have excoriations, but typically do not have a rash.
Name 4 of 8 perinatal morbidities that increase in late term pregnancies
What are oligohydramnios, meconium aspiration syndrome, macrosomia, shoulder dystocia, neonatal seizures, neonatal intensive care unit admission, perinatal mortality, and decreased Apgar scores?
Name four second trimester ultrasound markers for Down syndrome with a likelihood ratio less than 2
What are intracardiac echogenic focus, isolated choroid plexus cyst, pyelectasis and short femur?
Preferred cytogenetic specimen in evaluation of stillbirth
What is amniotic fluid from amniocentesis at the time of prenatal diagnosis of the demise?
Bile acid level where serial bile acids and delivery at 37 weeks is warranted
What is 40?
Name 4 of 6 maternal morbidities that increase with late term pregnancy.
What are cesarean delivery, operative vaginal delivery, postpartum hemorrhage, infection, severe perineal laceration, and hypertensive disorders of pregnancy?
Percentage of patients with a normal ultrasound and karyotype that will have a pathogenic variant on chromosomal microarray
What is 1.7%?
Name two second trimester ultrasound markers for Down syndrome with likelihood ratios greater than 5
What are echogenic bowel and ventriculomegaly?
Name two maternal blood tests for evaluation of cause of stillbirth
What are antiphospholipid antibodies and the Kleihaeur-Betke?
Bile acid level where serial bile acids are warranted, and delivery should be considered prior to 37 weeks gestation.
What is 100?
Performed in the setting of a dilated cervix, this procedure involves digitally separating the membranes from the lower uterine segment and may be associated with discomfort and vaginal bleeding.
What is membrane sweeping?
Percentage of patients with a structural finding on ultrasound and a normal karyotype that will have a pathogenic variant on chromosomal microarray
What is 6%?
Detection rate on NIPS for Down syndrome
What is 99%?
Preferred cytogenetic test for evaluation of cause of stillbirth
What is chromosomal microarray?
Risk of recurrence of cholestasis in pregnancy in subsequent pregnancies and with estrogen containing birth control
What is up to 90%?
Timing for initiation of antenatal surveillance if induction is declined
What is 41 weeks?