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What is the optimal time to perform amniocentesis for chromosomes?
15-20 weeks
Indigo Carmine dye is injected into the amniotic sac of one twin during amniocentesis. This is performed on the (1st / 2nd) twin being sampled?
first
AFP levels are measured in amniotic fluid. T/F
True
False
true
Amniocentesis results take up to 3 weeks before the final analysis is available. Why?
Cell culturing
icubate
grow
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.
The amound of fluid acquired during amniocentesis is approx ________ per week of gestation.
1 cc
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
List 2 indications for therapeutic amniocentesis
polyhydramnios
Management of Oligohydramnios (fluid insertion)
Name 4 potential complications of amniocentesis
miscarriage
cramping
fluid leak PROM
preterm labor
bleeding (post procedure)
amnio chorio separation
infection (chorioamnioitis)
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
Amniocentesis is exclusively performed (transabdominally / transcervically)?
transabdominal
What is the purpose of fluid instillation into the amniotic cavity?
Create acoustic window to vis fetal ext&int anatomy and allow fetal movement.
Fluid instilled into uterus is?
saline
What is the optimal time to perform CVS?
10-14wks
CVS is never performed prior to ?
9.5 weeks
Limb reduction is extremely rare with CVS? T/F
True
False
True
AFP levels are measured using CVS. T/F
True
False
False
The tissue being sampled is ?
trophoblastic (placenta)
chorionic vendosum
What are the 2 main advantages of chorionic villus sampling in comparison to amniocentesis?
Early Dx
Faster results
Name the 2 CVS techniques used to acquire chorionic villus samples. Note: Method used is usually related to radiologist/perinatologist preference.
TA
Transcervical
The karyotype of the placenta is the karyotype of the fetus. T/F
True
False
True
The 20-30 mg of trophoblastic tissue withdrawn is then transferred to _________________________.
a sterile petri dish containing culture medium.
List 4 post procedure maternal complications.
1. fluid leak
2. vaginal spotting
3. bleeding
4. cramping
5. infection
6. spontaneous abortion
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
CVS results are available within?
7-10 days
TC-CVS or TA-CVS can be performed until term?
TA-CVS
Cordocentesis is aka?
PUBS
percutaneous umbilical blood sampling
PUBS is initially performed as early as ______ but usually _________.
17 weeks
26+
The spinal needle (20G) may be guided through the placenta. T/F
True
False
True
The PUBS needle is inserted (proximal/distal) to the cord insertion into the placenta. Why?
Proximal
sways less
PUBS needle is guided into the umbilical (artery/vein)?
Vein
Name the 2 complications that may occur when the umbilical artery is punctured.
Bradychardia <120
post process bleeding
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
Describe hysterosonography.
Infusion of saline into endometrium canal to see if tubes patent / endo path and image transvag sonography
Hysterosonography is valuable for differentiating an endometrial polyp from a __________________ or _______________.
fibroid
endometrial hyperplasia
Which of the following procedures may be indicated when a
rapid karyotyping is desirable
?
A. amniocentesis
B. PUBS
C. cordocentesis
B. PUBS
Elevated MS AFP occurs when the value obtained is > ___________ of the mean for the GA.
2.5
List 4 conditions associated with elevated MS AFP
GTD
NTD (open spina bifida)
multiples
omphalocele
fetal demise
The fetal heart is confirmed both prior to and after an interventional procedure? T/F
True
False
True
Define: Percutaneous
Passage through skin with a needle puncture
Late maternal age?
>35
CVS, Amniocentesis and PUBS require aseptic techniques (T/F)
True
False
True
The risk of fetal loss is slightly higher with CVS/Amnio?
CVS
A higher Dx accuracy (99%) occurs with CVS/Amnio?
amnio
Define: Diagnostic Fetoscopy
An endoscopic methos for view of fetus in 2nd trimester and used to sample fetal blood , skin liver for prenatal Dx.
What is the MC indication for operative fetoscopy?
larger ablation
common vessels TTTS
NTD's may be Dx by only one of the following procedures. This procedure would be?
a. amnio
b. CVS
amnio
Author
lstaal1
ID
22538
Card Set
OB 510
Description
Interventional Procedures
Updated
2010-06-08T02:25:08Z
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