OB first trimester pathology

Gestational age

the way in which a pregnancy can be dated on the first day of the last menstrual cycle; also referred to as menstrual age

Infundibulum

The distal segment of the fallopian tube

Decidua Basalis

The endometrial tissue at the implantation site, and the maternal contribution of the placenta

Vitelline duct

What structure connects the embryo to the yolk sac?

Yolk sac

What structures lies within the extra embryonic coelom?

Hyperemesis gravidarum

Excessive vomiting during pregnancy

Blighted ovum

(anembryonic gestation) - an abnormal pregnancy in which there is no evidence of a fetal pole or yolk sac within the gestational sac

Uterine leiomyoma

A bengin, smooth muscle tumor of the uterus; may also be referred to as a fibroid or uterine myoma

Subchorionic hemorrhage

A bleed between the endometrium and the gestational sac at the edge of the placenta

Implantation bleeding

A bleed that occurs at the time in which the conceptus implants into the decimalized endometrium

Methotrexate

A chemotherapy drug used to attack rapidly dividing cells used to attack rapidly dividing cells like those seen in an early pregnancy; this drug is often used to manage ectopic pregnancies

Turner syndrome

A chromosomal aberration where one sex chromosome is absent; may also be referred to as monosomy X

Aneuploid

A condition of having an abnormal number of chromosomes

Falx cerebri

A double fold of dura mater located within midline of the brain

Bradycardia

A low heart rate

Choriocarcinoma

A malignant form of GTD is:

Human chorionic gonadotropin

Hormone produced by the trophoblastic cells of the early placenta; may also be used as a tumor marker in non gravid patients and males

Trophoblastic cells

The cells that surround the gestation that produce human chorionic conadotropin

Abortion

The complete expulsion or partial expulsion of the conceptus

Double decidual sign

The normal sonographic appearance of the decider capsular and decide parietals, separated by the anechoic fluid-filled uterine cavity

Chorion

The outer membrane of a gestation that surrounds the amnion and the developing embryo

Heterotopic pregnancy

coexisting ectopic and intrauterine pregnancies

Corpus luteum cyst

physiologic ovarian cyst that develops after ovulation has occurred

Preeclampsia

pregnancy-induced maternal high blood pressure and excess protein in the urine after 20 weeks gestation

Intrauterine contraceptive device

A reversible form of contraception that is manually placed in the uterine cavity to prevent pregnancy; also referred to as an intrauterine device

Eclampsia

A sequela of preeclampsia in which uncontrollable maternal hypertension and proteinuria lead to maternal convulsions and possibly fetal and maternal death

Anembryonic gestation

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 single live IUP. What is the most likely diagnosis?

Invasive mole

A type of gestational trophoblastic disease in which a molar pregnancy invades into the myometrium and may also invade through the uterine wall and into the peritoneum

Trisomy 16

All of the following are associated with an abnormal NT except: Trisomy 21 Trisomy 16 Trisomy 18 Turner syndrome

Adnexal ring

All of the following are clinical features of an ectopic pregnancy except: pain Vaginal bleeding Shoulder pain Adnexal ring

Small for dates

All of the following are clinical findings consistent with a complete molar pregnancy except: Vaginal bleeding Hypertension Uterine enlargement Small for dates

low hCG

All of the following are consistent with a complete hydatidiform mole except: Heterogeneous mass within the endometrium Bilateral theca lutein cysts Hyperemesis gravidarum Low hCG

IUCD

All of the following are contributing factors for an ectopic pregnancy except: Pelvic inflammatory disease assisted reproductive therapy IUCD Advanced paternal age

Bilateral, multiloculated ovarian cysts

All of the following are sonographic findings consistent with ectopic pregnancy except: Decidual thickening Complex free fluid within the pelvis Bilateral, multiloculated ovarian cysts Complex adnexal mass separate from the ipsilateral ovary

Low beta-hCG

All of the following may be sonographic findings in the presence of an ectopic pregnancy except: Pseudogestational sac Corpus luteum cyst Adnexal ring Low beta-hCG

Molar pregnancy

All of the following would be associated with a lower-than-normal hCG level except: Ectopic pregnancy Molar pregnancy Blighted ovum Spontaneous abortion

Anembryonic gestation

An abnormal pregnancy in which there is no evidence of a fetal pole or yolk sac within the gestational sac; also referred to as a blighted ovum

Gestational sac

Another name for the chorionic sac is the:

Trisomy 18

Chromosomal aberration in which there is a third chromosome 18; also referred to as Edwards syndrome

Trisomy 21

Chromosomal aberration in which there is a third chromosome 21; also referred to as Down syndrome

Low hCG

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

Choroid plexus

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

Rhombencephalon

During a first-trimester sonogram, you note a round, cystic structure within the fetal head. This most likely represents the:

Limb buds

Early embryonic structures that will eventually give rise to the extremities

24 hours

Fertilization typically occurs within ________ after ovulation

Missed abortion

Fetal demise with a retained fetus

Chorionic villi

Fingerlike projections of gestational tissue that attach to the decimalized endometrium and allow transfer of nutrients from the other to the fetus

Idiopathic

From an unknown origin

Multiparity

Having had several pregnancies

Multiloculated

Having more than one internal cavity

Triploid

Having three sets of each chromosome or 69 total

Chorionic cavity

In the early gestation, where is the secondary yolk sac located?

Double every 48 hours

In the first trimester, normal hCG levels will:

Pelvic inflammatory disease

Infection of the female genital tract that may involve the ovaries, uterus, and/or the fallopian tubes

Focal myometrial contraction

Localized, painless contractions of the myometrium in the gravid uterus that should resolve within 20 to 30 minutes

11 and 14 weeks

NT measures are typically obtained between:

Double sac sign

See term double decidual sign

Ectopic pregnancy

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

Choroid plexus

Specialized cells within the ventricular system responsible for cerebrospinal fluid production

Embryo

Term given to the developing fetus before 10 weeks gestation

Nuchal translucency

The anechoic space along the posterior aspect of the fetal neck

Intradecidual sign

The appearance of a small gestational sac in the uterine cavity surrounded by the thickened echogenic endometrium

Pseudogestational Sac

The appearance of an abnormally shaped false gestational sac within the uterine cavity as a result of an ectopic pregnancy; this often corresponds with the accumulation of blood and secretions within the uterine cavity

Amniotic cavity

The cavity that contains simple-appearance amniotic fluid and the developing embryo

Zygote

The cell formed by the union of two gametes; the first stage of a fertilized ovum

Conception

The combination of a female ovum with a male sperm to produce a zygote; also referred to as fertilization

Corpus luteum of pregnancy

The corpus luteum that is maintained during an early pregnancy for the purpose of producing estrogen and primarily progesterone

Embryonic demise

The death of an embryo before 10 weeks gestation

Hematopoiesis

The development of blood cells

Morula

The developmental stage of the conceptus following the zygote

Chorionic sac

The gestational sac; also see key term chorion

Hematocrit

The laboratory value that indicates the amount of red blood cells in blood

Ampulla (fallopian tube)

The longest and most tortuous segment of the fallopian tube; area of the tube in which fertilization takes place and a common location for ectopic pregnancies to implant

Crown rump length

The measurement of the embryo/fetus from the top of the head to the rump

Mean sac diameter

The measurement of the gestational sac to obtain a gestational age; achieved by adding the measurements of the length, width, and height of the gestational sac and dividing by 3

Physiologic bowel herniation

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

Ectopic pregnancy

The most common cause of pelvic pain with pregnancy is:

Hydatidiform mole

The most common form of gestational trophoblastic disease in which there is excessive growth of the placenta and high levels of human chorionic gonadotropin; typically benign

Ampullary portion of the uterine tube

The most common location of an ectopic pregnancy is the:

Corpus luteum cyst

The most common pelvic mass associated with pregnancy is the:

Ampulla of the uterine tube

The most common site of fertilization is within the:

Choriocarcinoma

The most malignant form of gestational trophoblastic disease with possible metastasis to the liver, lungs, and vagina

Graafian follicle

The name for the dominant follicle prior to ovulation

physiologic bowel herniation

The normal developmental stage when the midgut migrates into the base of the umbilical cord

1mm per day

The normal gestational sac will grow:

Chorion frondosum

The part of the chorion, covered by chorionic villi, that is the fetal contribution of the placenta

Decidual reaction

The physiologic effect on the endometrium in the presence of a pregnancy

Adnexal ring sign

The sonographic sign that describes the appearance of an ectopic pregnancy within the fallopian tube

Extraembryonic coelom

The space between the chorionic sac and the amniotic sac that contains he secondary yolk sac; also referred to as the chorionic cavity

Chorionic cavity

The space between the chorionic sac and the amniotic sac that contains the secondary yolk sac; also referred to as the extra embryonic coelom

Miscarriage

The spontaneous end of a pregnancy before viability

Blastocyst

The stage of the conceptus that implants within the decimalized endometrium

Zygote

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

Secondary yolk sac

The structure responsible for early nutrient transfer to the embryo, the yolk sac seen during a sonographic examination of the early gestation

Vitelline duct

The structure that connects the developing embryo to the secondary yolk sac

hCG

The trophoblastic cells produce:

Amnion

The wall of the inner sac (amniotic cavity) that contains the embryo and amniotic fluid; echogenic curvilinear structure that may be seen during the first trimester within the gestational sac

hCG

What hormone maintains the corpus luteum during pregnancy?

Progesterone

What hormone, produced by the corpus luteum, maintains the thickened endometrium?

Methotrexate

What is often used to medically treat an ectopic pregnancy?

Complete molar pregnancy

What is the most common form of GTD?

Graafian

What is the name fo the dominant follicle prior to ovulation

Blastocyst

What is the stage of the conceptus that implants within the decidualized endometrium

Lungs

Which of the following is the most likely metastatic location for GTD? Rectum Pancreas Spleen Lungs

Ovary

Which of the following locations for an ectopic pregnancy would be least likely?

Chorionic sac

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

Gestational trophoblastic disease

a disease associated with an abnormal proliferation of the trophoblastic cells during pregnancy; may also be referred to as a molar pregnancy

Ectopic pregnancy

A pregnancy located outside the endometrial cavity of the uterus

Fimbria

the fingerlike extension of the fallopian tube located on the infundibulum

Discriminatory zone

the level of human chorionic gonadotropin beyond which an intrauterine pregnancy is consistently visible

rhombencephalon

the primary brain vesicle also referred to as the hindbrain, becomes the cerebellum, pons, medulla oblongata, and fourth ventricle

Decidual reaction

The first monographically identifiable sign of pregnancy is the:

Yolk sac

The first structure noted within the gestational sac is the: