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DMST 285 OBGYN 2 > Amniotic Fluid > Flashcards

Amniotic Fluid Flashcards

1
Q

What does amniotic fluid allow for baby? 6

A
  1. Provides protection from physical trauma
  2. Allows for growth
  3. Provides a stable temperature for the fetus
  4. Enables normal development of bones and muscles by facilitating room for movement
  5. AIDS in the maturation of lungs and GI tract
  6. Provides some nutrients, hormones and antibodies
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2
Q

What is amniotic fluid produced by in the first trimester? 5

A
  1. Chorion frondosum
  2. Membranes
  3. Skin
  4. GU tract
  5. Lungs

In early pregnancy main from chorioamniotic membranes

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3
Q

In the 2nd and 3rd trimester Production of amniotic fluid is produced by what? 2

A
  1. Kidneys
  2. Small amount from lungs
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4
Q

Removal of amniotic fluid is done how?

A

Fetus drinking the fluid

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5
Q

What is the process of amniotic fluids in gestation? 3

A
  1. The fetus drinks the amniotic fluid
  2. Fluid foes through the fetal GI tract, and is absorbed by the bowel
  3. The fetal kidneys excrete urine back into the amniotic cavity
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6
Q

During the amniotic fluid process, any high GI obstructions or Swallowing deficits cause what?

A

Polyhydramnios

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7
Q

In terms of amniotic fluid process, any bilateral GU obstructions or renal agenesis causes what?

A

Oligiohydramnios

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8
Q

When looking at amniotic fluid volume, what is the most important point?

A

Experienced observer

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9
Q

How do we measure amniotic fluid volume?

A

Maximum vertical pocket

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10
Q

What is the maximum vertical pocket?

A

Deepest pocket that is free of the umbilical cord or fetal

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11
Q

Amniotic fluid index (AFI) is what?

A

Largest pocket in quadrant is added together

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12
Q

What is the normal level for AFI?

A

5-25cm

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13
Q

What is the depth of the largest visible pocket for a normal vessel?

A

2 < X < 8 cm

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14
Q

Maximum amniotic fluid is reached when? And when is it maintained?

A

At 22 weeks and maintained at 34 weeks

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15
Q

After which week does AFI start to diminish slowly?

A

34 weeks

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16
Q

How much of a pocket is needed/ required for fetal breathing?

A

1cm

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17
Q

What does this image demonstrate?

A

AFI measurements in the four quadrants

18
Q

What does polyhydramnios look like subjectively? 2

A
  1. The fetus floats freely in the amniotic fluid
  2. Fetus should be touching the uterus on at least 2 sides normally
19
Q

How deep is the Polydramnios pocket?

A

> 8 cm pocket

20
Q

What is the AFI for Polyhydramnios?

A

> 25 cm AFI

21
Q

What does this image demonstrate?

A

Polyhydramnios, the deepest amniotic pocket is >8cm

22
Q

What does this image demonstrate?

A

Polyhydramnios, AFI is >25cm

23
Q

What are some causes of polyhydramnios? 7

A
  1. Diabetes mellitus
  2. CNS - NTD
  3. High GI obstruction
  4. Hydrops
  5. Twin to twin transfusion syndrome
  6. MSK Dysplasia
  7. Idiopathic
24
Q

What is the most common cause of polyhydramnios?

A

Diabetes mellitus

25
Q

What might polyhydramnios cause? 4

A
  1. Maternal abdominal pain
  2. Maternal SOB
  3. PROM
  4. Preterm delivery
26
Q

How does polyhydramnios cause PROM?

A

Due to the uterus expanding so quickly

27
Q

How does polyhydramnios cause preterm labour? 2

A
  1. The uterus expanding quickly
  2. LGA
28
Q

What are two ways to lower polyhydramnios?

A
  1. Amniocentesis
  2. Indomethacin
29
Q

Amniocentesis is performed until the fluid is at what level?

A

<8

30
Q

Complications from amniocentesis is what? 3

A
  1. PROM
  2. Preterm delivery
  3. Infection
31
Q

What does indomethacin do?

A
  1. Prostaglandin inhibitor that decreases fetal urine output
  2. Administered to mother
32
Q

What are complications of indomethacin?

A

Complications = premature closure of ductus arteriosus

33
Q

When can indomethacin be used?

A

Early pregnancy

34
Q

When would we have oligiohydramnios? (measurements)

A
  1. AFI is <5cm
  2. When the largest pocket is <2x2cm
35
Q

When do we calculate oligohydramnios?

A
  1. 5 1/2 - 9 weeks
  2. MSD(mm) - CRL(mm) < 5mm
36
Q

MSD - CRL is what diameter in early olgiohydramnios?

A

<5mm

37
Q

What are some causes of oligiohydramnios? 7

A
  1. PROM
  2. IUGR
  3. Renal anomaly
  4. Post dates
  5. Abruption
  6. Twin to twin transfusion
  7. Idiopathic
38
Q

What does this demonstrate?

A

Olgiohydramnios

39
Q

What might oligiohydramnios cause? 3

A
  1. Limb anomalies (club feet(
  2. Pulmonary hypoplasia
  3. Restricted growth
40
Q

What are some major difference between Poly and Oli hydramnios? 2

A
  1. Poly has some. Therapies that can assist, Oli only has one therapy that might help (bed rest)
  2. Oli- The early it is identified the more severe the affect is on the fetal lungs. Limb and muscle development is also impaired

DMST 285 OBGYN 2 (15 decks)

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