Chapter 23-The First Trimester

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Malignant form of GTD

Choriocarcinoma

With a normal pregnancy, the first structure noted within the decidualized endometrium is the

Chorionic sac

During a 12-week sonogram, bilateral echogenic structures are noted within the lateral ventricles of the fetal cranium. These structures most likely respresent

Choroid Plexus

Sonographically, a normal-appearing 7 week IUP is identified. Within the adnexa, an ovarian cystic structure with a thick, hyperechoic rim is also discovered. This ovarian mass most likely respresents

Corpus Luteum Cyst

The most common pelvic mass associated with pregnancy is the

Corpus luteum cyst

The most common cause of Pelvic pain with pregnancy

Ectopic Pregnancy

Other name for the Chorionic Sac

Gestational sac

Dominant follicle prior to ovulation

Graafian Follicle

Most likely locations for an Ectopic Pregnancy

Isthmus of the tube, Ampulla of the tube, and Interstitial of the tube

Compared with a normal IUP, the ectopic pregnancy will have a

Low hCG

Most likely Metastatic location for GTD

Lungs

Used often to medically treat an ectopic pregnancy

Methotrexate

Clinical Features of Ectopic Pregnancy

Pain, vaginal bleeding, shoulder pain

Contributing factors for an ectopic pregnancy

Pelvic Inflammatory Disease, assisted reproductive therapy, and IUCD

The migration of the embryonic bowel into the base of the umbilical cord at 9 weeks is referred to as

Physiologic bowel herniation

Hormone produced by the corpus luteum that maintains the thickened endometrium

Progesterone

A sonographic examination was performed on a pregnancy patient who complained of vaginal bleeding. Sonographically, a crescent-shaped anechoic area is noted adjacent to the gestational sac. The gestational sac contained a 6 week live IUP. The most likely diagnosis is

Subchorionic Hemorrhage

Associated with an abnormal NT

Trisomy 18, Trisomy 21, and Turner Syndrome

Structure that connects the embryo to the Yolk Sac

Vitelline Duct

Structure that lies within the extraembryonic coelom

Yolk sac

The structure created by the union of sperm and egg is the

Zygote

Trisomy 16 is not associated with

an abnormal NT

The stage of the conceptus that impants within the decidualized

blastocyst

The secondary yolk sac location in the early gestation

chorionic cavity

The most common form of GTD(Gestational Trophoblastic Disease)

complete molar pregnancy

Sonographic findings consistent with ectopic pregnancy

decidual thickening, complex free-fluid within the pelvis, and complex adnexal mass seperate from the ipsilateral ovary

In the First trimester, normal hCG levels will

double every 48 hours

Associated with a lower-than-normal hCG level

ectopic pregnancy, blighted ovum, and spontaneous abortion

Hormone that maintains the corpus luteum during pregnancy

hCG

The trophoblastic cells produce

hCG

Consistent with a complete hydatidiform mole

heterogenous mass within the endometrium, bilateral theca lutein cysts, and hyperemesis gravidarum

Sonographic findings in the presence of an ectopic pregnancy

psuedogestational sac, corpus luteum cyst, and an adnexal ring

The first sonographically identifiable sign of pregnancy

the Decidual reaction

During a First trimester songoram, you note a round, cystic structure within the fetal head. This Most Likely represents

the Rhombencephalon

First structure noted within the Gestational Sac

the Yolk sac

Clnical Findings consistent with a Complete Molar Pregnancy

vaginal bleeding, hypertension, and uterine enlargement

NT measures are typically obtained between

11-14 weeks

The normal gestational sac will grow

1mm per day

Fertilization typically occurs within

24 hours after ovulation

The most Common site of fertilization is in the

Ampulla of the uterine tube


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