Deck 22: High-Risk Obstetric Sonography

Question 1

Increases in the pulsatility of the inferior vena cava are associated with

A) macrosomia.
B) fetal hypoxia.
C) twin gestations.
D) intrauterine growth restriction.

Answer 1

B
Abnormal flow velocity waveform of the inferior vena cava (IVC) is another key sign of fetal compromise. In fetal hypoxia, the pulsatility of the blood flow in the IVC increases.

Question 2

Fetal intravascular transfusion is recommended in fetuses with

A) severe hydrops.
B) polyhydramnios.
C) oligohydramnios.
D) chromosomal abnormalities.

Answer 2

A
Therapy by intrauterine transfusion of red cells into the umbilical vein is recommended in fetuses with severe hydrops and anemia. A transfusion of thrombocytes may be considered in fetuses with severe thrombocytopenia.

Question 3

The interfetal membrane is

A) a congenital malformation found with multifetal gestations.
B) identifiable in a diamniotic twin gestation.
C) only associated with same-gender twin gestations.
D) predominantly part of the cord.

Answer 3

B
The interfetal membrane is identified in a diamniotic pregnancy, which includes fraternal and maternal twin gestations.

Question 4

Which procedure is done earliest in a pregnancy?

A) Chorionic villus sampling
B) Amniocentesis for the L-S ratio
C) Amniocentesis for genetic analysis
D) Umbilical cord transfusions

Question 5

Ultrasound is used during in utero procedures to confirm that the needle is in the correct position and that ___________________________.

Question 6

The lecithin-sphingomyelin (L-S) ratio is used to

A) determine lung maturity.
B) rule out uterine infections.
C) determine cardiac activity.
D) determine fetal abnormalities.

Question 7

In severe cases of intrauterine growth restriction, which fetal artery usually can be detected?

A) Renal artery
B) Hepatic artery
C) Splenic artery
D) Superior mesenteric artery

Question 8

If twin fetuses are of opposite gender, they are always

A) monochorionic and monoamniotic.
B) monochorionic and diamniotic.
C) dichorionic and monoamniotic.
D) dichorionic and diamniotic.

Question 9

Which component of amniotic fluid increases beyond normal limits when certain fetal defects are present?

A) Progesterone
B) Human chorionic gonadotropin (hCG)
C) Alpha-fetoprotein (AFP)
D) Luteinizing hormone (LH)

Question 10

________________was developed as a 2nd trimester means of collecting a sample of amniotic fluid, which is used for a variety of metabolic assays or for DNA extraction.

A) Amniocentesis
B) Ultrasound exam
C) Chorionic villus sampling
D) Biophysical profile

Question 11

If division occurs in the embryonic disk more than 13 days after fertilization, the result is

A) the demise of one twin.
B) a dichorionic-monoamniotic gestation.
C) conjoined twins.
D) a dichorionic-diamniotic gestation.

Question 12

Scores lower than 8 on a biophysical profile are

A) usually followed up with additional testing or induced labor.
B) associated with a good perinatal outcome.
C) followed up with a fetal intravascular transfusion.
D) considered questionable and followed up with another profile in 6 weeks.

Question 13

When it must be determined whether a fetus is in distress, a(an) _________ may be performed.

A) amniocentesis
B) ultrasound exam
C) chorionic villus sampling
D) biophysical profile

Question 14

__________________________ measures the degree of fetal lung development.

Question 15

In a twin gestation, division of the zygote before day 4 postfertilization results in a

A) monochorionic-monoamniotic gestation.
B) monochorionic-diamniotic gestation.
C) dichorionic-monoamniotic gestation.
D) dichorionic-diamniotic gestation.

Question 16

In multifetal gestations, identifying chorionicity (placentae) is most accurate

A) during the 3rd trimester.
B) at exactly 12 gestational weeks.
C) from gestational weeks 6 through 10.
D) from gestational week 14 through gestational week 16.

Question 17

Which of the following is NOT a variable observed during a biophysical profile examination?

A) Fetal breathing
B) Fetal heart rate
C) Fetal urination
D) Amniotic fluid volume

Question 18

________________was developed as an early 1st trimester means of collecting tissue for genetic analysis using placental tissue buds.

A) Amniocentesis
B) Ultrasound exam
C) Chorionic villus sampling
D) Biophysical profile

Question 19

Amniocentesis is associated with which risk(s)?

A) Infection
B) Injury to the fetus
C) Premature delivery
D) All of the above

Question 20

Abnormal fetal aortic flow velocity waveforms have been associated with

A) musculoskeletal abnormalities.
B) genitourinary dysfunctions.
C) neurologic dysfunctions.
D) cardiac dysfunctions.

Question 21

The most common indications for the sampling of fetal blood are the _________________________ and ______________________.

Question 22

Twin gestations result from fertilization of either _______ or a _______.

Question 23

When certain defects are found during a pregnancy, high concentrations of _____________________ are found in amniotic fluid samples.