UWorld USMLE

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• Signs of uteroplacental insufficiency include late decelerations on nonstress test and/or oligohydramnios on ultrasound (ie, single deepest pocket <2 cm).

• Preeclampsia is most likely caused by abnormal placentation and narrowed spiral artery formation

• placental hypoperfusion, hypoxia, and ischemia trigger the release of antiangiogenic factors causing maternal endothelial cell damage. This damage may manifest in multiple organ systems, including the liver (eg, referred epigastric pain from stretching of the hepatic capsule) and kidneys (eg, proteinuria from acute kidney injury).  In the brain, endothelial cell damage can precipitate an acute stroke

• Noninvasive cffDNA testing can be performed at ≥10 weeks gestation and has a high sensitivity and specificity for detecting trisomy 21 (Down syndrome), trisomy 18 (Edward syndrome), and trisomy 13 (Patau syndrome).

• Abnormal results are confirmed by fetal karyotyping via first-trimester chorionic villus sampling or second-trimester amniocentesis

• Duodenal atresia impairs fetal swallowing of amniotic fluid and, therefore, may cause polyhydramnios (single deepest pocket of amniotic fluid ≥8 cm), as in this patient.

• trisomy 18 (Edward syndrome), which can present on fetal ultrasound as rocker-bottom feet or clenched hands with overlapping fingers