1 AMNIOTIC FLUID Flashcards
WHAT DOES AMNIOTIC FLUID PROVIDE FOR FETUS? (6)
1) PROTECTION FROM PHYSICAL TRAUMA
2) GROWTH
3) STABLE TEMPERATURE FOR FETUS
4) NORMAL DEVELOPMENT OF BONES AND MUSCLES
5) AIDS IN MATURATION OF LUNGS AND GI TRACT
6) NUTRIENTS
IN THE FIRST TRIMESTER WHAT PRODUCES THE AMNIOTIC FLUID? (5)
1) CHORION FRONDOSUM
2) MEMBRANES
3) SKIN
4) GU TRACT
5) LUNGS
IN EARLY PREGNANCY FLUID IS MOSTLY PRODUCED BY THE ?
CHORIOAMNIOTIC MEMBRANES
IN THE 2ND AND 3RD TRIMESTER THE AMNIOTIC FLUID IS MOSTLY PRODUCED BY THE?
KIDNEYS *
IN THE 2ND AND 3RD TRIMESTER A SMALL AMOUNT OF AMNIOTIC FLUID IS PRODUCED BY THE?
LUNGS
HOW IS THE AMNIOTIC FLUID REMOVED?
FETUS DRINKING THE FLUID
FLUID GOES THROUGH FETAL GI TRAT AND IS ABSORBED BY THE?
BOWEL
WHAT EXCRETES URINE?
KIDNEYS
WHERE DOES THE URNIE GET EXCRETED?
AMNIOTIC CAVITY
WHAT CAUSES POLYHYDRAMNIOS? (EXCESS)
GI
OR
SWALLOWING DEFECTS
WHAT CAUSES OLIGOHYDRAMNIOS? (REDUCED)
BILATERAL GU OBSTRUCTION
OR
RENAL AGNESIS
ESTIMATING AMNIOTIC FLUID VOLUME IS?
SUBJECTIVE OR OBJECTIVE?
SUBJECTIVE
HOW DO YOU MEAURE THE AMNIOTIC FLUID VOLUME?
MAXIMUM VERTICLE POCKET
DEEPEST FREE OF THE UMBILICAL CORD OR FETAL PARTS
WHA IS CONSIDERED POLYHYDRAMNIOS?
> 8CM*
HOW IS PROBE SITUATIED?
PERPINDICULAR TO FETAL ABDOMEN
WHAT IS AFI?
AMNIOTIC FLUID INDEX
LARGEST POCKET IN EACH QUADRANT ADDED TOGETHER
WHAT IS NORMAL AFI (SUM OF 4 QUADRANTS)
BETWEEN 5-25 CM
WHEN IS MAX AMNIOTIC FUID REACHED?
22 WEEKS
WHEN IS AMNIOTIC FLUID MAINTAINED UNTIL?
34 WEEKS
THEN SLOWLY DEMINISHES
AT 34 WEEKS WHAT SIZE POCKET IS REQUIRED FOR FETAL BREATHING?
1 CM
WHAT ARE THE 4 QUADRANTS WE MEASURE?
SAG RUQ
SAG RLQ
SAG LLQ
SAG LUQ
WHAT IS POLYHYDRAMNIOS?
AN EXCESS OF AMNIOTIC FLUID FOR A GIVEN GESTATION OF PREGNANCY
THE FETUS FLOATS FREELY IN AMNIOTIC FLUID AT ALL TIMES SHOLUD BE TOUCHING UTERUS ON AT LEAST _____ OF THE UTERUS
2 SIDES
WHAT AFI IS SUGGESTIVE OF POLYHYDRAMNIOS?
> 25 CM AFI *
WHAT IS THE MOST COMMON CAUSE OF POLYHYDRAMNIOS?
DIABETES MELLITUS
WHAT ARE THE OTHER CAUSES OF POLYHYDRAMNIOS?
CNS HIGH GI OBSTRUCTION ***. (DECREASING IN FETUS SWALLOWING IE ESOPHAGEAL ATRESIA OR DUODENAL ATRESIA, DIAPHRAGMATIC HERNIA) HYDROPS TWIN TO TWIN TRANSFUSION SYNDROME MUSCULOSKELETAL DYSPLASION IDOPATHIC
POLYHYDRAMNIOS MAY CAUSE… (4)
1) MATERNAL ABDOMINAL PAIN
2) MATERNAL SOB
3) PROM
4) PRETERM DELIVERY
WHAT IS PERFORMED TO REDUCED THE FLUID UNTIL THE LARGEST POKET IS < 8CM ?
AMNIOCENTESIS
COMPLICATIONS OF AMNIOCENTESIS (3)
1) PROM
2) PRETERM DELIVERY
3) INFECTION (AMNIONITIS)
WHAT IS THE DRUG THAT DECREASES FETAL URINE OUTPUT
INDOMETHACIN *
PROSTAGLANDIN INHIBITOR
COMPLICATION OF INDOMETHACIN?
PREMATURE CLOSURE OF DUCTUS ARTERIOSUS
only in early pregnancy
WHAT PERCENT OF CASES OF POLY ARE ASSOCIATED WITH FETAL ABNORMALITY ?
20%
WHAT IS OLIGOHYDRAMNIOS?
REDUCED OR ABSENT AMNIOTIC FLUID VOLUME FOR A GIVEN GESTATIONAL AGE
< 5CM
OLIGO IS WHEN LARGEST POCKET IS LESS THAN ?
2 X 2 CM
WHEN IS OLIGOHYDRAMNIOS CALCULATED ?
5.5 - 9 WEEKS
FORMULA FOR CALCULATING OLIGO IN FIRST TRIMESTER?
MSD (mm) - CRL (mm) = < 5cm
CAUSES OF OLIGOHYDRAMNIOS? (7)
1) PROM (amniotic membrane rupture)
2) IUGR
3) RENAL ANOMALY (polycystic kidneys, bilat agenesis, or bladder outflow obstruction)
4) POST DATES
5) ABRUPTION
6) TWIN TO TWIN TRANSFUSION (DONOR TWIN)
7) I DIOPATHIC
OLIGOHYDRAMNIOS MAY CAUSE (3)
1) LIMB ANOMALIES (club feet)
2) PULMONARY HYPOPLASIA
3) RESTRICTED GROWTH
