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Obs Gynae > Amniotic Fluid > Flashcards

Amniotic Fluid Flashcards

1
Q

Source of amniotic fluid during pregnancy

A

1 to 12 weeks source is ultrafiltrate of maternal plasma
12 to 20 weeks transudate across fetal skin
>20 weeks fetal urine(main)

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2
Q

Osmolality of amniotic fluid

A

Approx 260mosm/L

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3
Q

Which substance is replaced in amniotic fluid

And replaced after how many hours

A

Water in amniotic fluid is replaced once in every three hours that is eight times a day

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4
Q

PH of amniotic fluid

A

7-7.5

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5
Q

First structure to be stained with meconium is

A

Umblical cord

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6
Q

Last structure to be stained with meconium is

A

Placenta

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7
Q

Colour of amniotic fluid

A

Straw coloured

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8
Q 
What does the following colour of the amniotic fluid tell you
Green
Golden
Dark
dark brown
Greenish yellow
A

Green – meconium stained
Golden – Rh incompatibility
Dark – abruption (blood stained)
Dark brown (tobacco juice) – intra uterine death
Greenish yellow – post term baby (40 weeks - EDD)

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9
Q

Turn over rate of amniotic fluid at term

Fetal urine production rate at term

A

500-800ml/24hrs

27ml/hr (650ml/day)

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10
Q 
Range of weeks on the following
Early term
Term
Late term
Post term
A

Early Term- 37wk-38wk + 6
Term- 39wk-40wk + 6
Late term- 41wk-41+6
Post term- >42wk

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11
Q

At How many weeks does a non-medically indicated Csection done

A

39 weeks

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12
Q 
Amount of amniotic fluid at the following time
12wks
16wks
20wks
28wks
36wks
40wks
42wks
A 
12wks-50ml
16wks-250ml
20wks-400ml
28wks-1L
36wks-900ml
40wks-800ml (EDD)(Term)
42wks-200ml
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13
Q

When is the Amniotic fluid maximum during pregnancy

A

32weeks

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14
Q

What are the methods to measure poly/oligohydroamnios
Which is MC used
Which is more sensitive

A

A F I (amniotic fluid index)
DVP (Deep vertical pocket)
-A F I
-DVP

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15
Q 
AFI and DVP for the following 
Normal 
Oligo
Poly 
volume
A

Condition AFI DVP
Normal 5-24 2-8cm
Oligo =5 =2
Poly >/=24 >8
Volume >/=2L =200ml

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16
Q

The following problems will need to what poly or oligo hydroamnio
Any problems swallowing
Any problem in urinating

A

Polyhydroamnios

Oligohydroamnios

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17
Q

M.c.c of mild polyhydroamnios
M.c.c of mild oligohydroamnios
M.c.c of severe polyhydroamnios
M.c.c of severe oligohydroamnios

A

Idiopathic
Idiopathic
Gross congenital anomalies (GCA)
Gross congenital anomalies (GCA)

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18
Q

Which GCA Is associated with Severe polyhydramnios

A

GIT>NTD

Most common in GIT:Cleft Palate

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19
Q

Which d/s is ass. With severe oligohydroamnios

Other causes

A

Renal agenesis

PUV (Post. Urethral valve)- shows KEY HOLE SIGN on USG

20
Q

Conditions caused by polyhydroamnios

A
  1. Severe respiratory distress
  2. Abruption
  3. PTL
  4. Cord prolapse
  5. PROM(when membrane rupture before onset of labour)
  6. Malpresentation
  7. PPH
  8. Amniotic fluid embolisation
21
Q

Conditions caused by oligohydroamnios

A
  1. Pulmonary hypoplasia (early onset oligo)
  2. Limb deformities (limb amputatation)
  3. Fetal distress(compression of umbilical cord)
  4. Malpresentation
  5. Long standing oligo-abruption
  6. IUGR (uteroplacental insufficiency causes oligo - they exist together)
22
Q

1st definitive sign of pregnancy

A

USG showing
gestational sac-yolk sac-cardiac activity
Can be seen in TVS/TAS

23
Q

Probes used in doing TVS / TAS

A

One with higher frequency is used to do TVS (usually >/=5)

TAS - 3

24
Q

Which of the following is done empty bladder
TAS
TVS

A

TVS is done empty bladder

TAS is done with full bladder

25
Q

Gestational sac is seen earliest on

A

TVS
4wk 1D-3D to 4.5wks
TVS here is operator dependent

26
Q

Earliest time g.sac can be identified on TVS from LMP

  1. 20D
  2. 25D
  3. 30D
  4. 35D
A

30D

Earliest time g.sac can be identified on TVS is 4wks 1D-3Dto 4.5 wks from LMP

27
Q

Earliest time g.sac can be identified on TVS from fertilisation

  1. 20D
  2. 25D
  3. 30D
  4. 35D
A

This would be LMP-15days
So earliest time g.sac can be identified on TVS from LMP would be 4wks 1D-3D to 4.5wks i.e 30D
Now earliest time g.sac can be identified on TVS from fertilisation will be 30D-15D=15D
Therefore in options earliest time would be 20D

28
Q

Earliest time g.sac can be identified on TAS will be

A

5 wks

29
Q

When is G.sac seen on USG

  1. 4wks
  2. 5wks
  3. 6wks
  4. 7wks
A
  1. 5wks
30
Q

Is the statement true or false

Whatever seen on TVS can be seen on TAS

A

False

Whatever seen on TAS can be seen on TVS but the vice versa is not true

31
Q

True g.sac is lateral in uterus true or false

A

True

32
Q

Name the intrauterine Px sign of g.sac

A

double ring sign
Aka double decidual sac sign
(1 g.sac + 1 decidua)

33
Q

What does pseudo sac during Px means

A

During normal Px the g.sac shows double decidual sac sign or double ring sign (1 g.sac + 1 decidua)
In ectopic Px single ring in uterus is seen it is present at the centre
This is known as pseudo sac

34
Q

When is yolk sac detected on TVS

A

5wks ; earliest

35
Q

Name the sign together formed by yolk sac and amniotic sac

Name the sign together formed by decidua and g.sac

A

Double bleb sign

Double decidual sac sign / double ring sign

36
Q

When can cardiac activity detected on USG

At what time it can be detected earliest

A

TVS- 5-6 wks
TAS- 6-7 wks

Earliest -5 wks
If TVS/TAS not mentioned then 6 wks

37
Q

Best marker for gestational age assessment

And what is ideal time to measure

A

Crown rump length

7-10 weeks

38
Q

Can CRL be used to calculate g.sac age

A

Yes until 14 wks i.e 1st trimester CRL can be used to calculate g.sac age

39
Q

What do you use in 2nd trimester to calculate the CRL

A

In 2nd trimester we use USG to see the BPD (biparietal diameter)
At 14-20 weeks

40
Q

How do you calculate the CRL in 3rd trimester

A

Femur length

41
Q

Which of the following is best marker for gestation age

  1. CRL
  2. BPD
  3. Femur length ‘
  4. Abdominal circumference
A

CRL

42
Q

Which of the following is best marker for gestational age

  1. CRL@ 16wks
  2. BPD@ 16wks
  3. Femur length@ 32wks
  4. Abdominal length@ 20wks
A

BPD @16wks

43
Q

The earliest we do Gestational Age assessment the more better results
True or false

A

True

44
Q

USG markers of macrosomia/ IUGR

A

Abdominal circumference

45
Q

IUGR Criteria

A

Expected birth wt. <10th percentile

46
Q

On USG what is the significance of abdominal circumference with reference to macrosomia

A

If AC is > 35cm is suggestive of macrosomia

Obs Gynae (7 decks)

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