Amniotic Fluid Related Complications Flashcards
a clear yellowish liquid that sorrounds the unborn baby (fetus)
Amniotic Fluid
2 membranes
chorion and amnion
normal afi
600-800
Functions of amniotic fluid
- growth & development
- cushions & protects
- baby’s muscles & bones develop
- keeps umbilical cord from compressed
- lubricates fetus body parts
- constant temperature
excessive fluid sorrounding the fetus more than 2000 ml
Hydramnios
type of amniotic fluid that gradually increases
chronic
type of amniotic fluid that increases rapidly over a period of days
diagnosed in 20 & 24 weeks gestation
acute
assessment of amniotic fluid (hydramnios)
- DM
- Rh Sensitization
- multiple-gestation pregnancies
How will you assess the levels of amniotic fluid (hydramnios)
- FH increases
- difficulty palpating/auscultating FHR
- sonograhy large spaces
- abdomen & tight on inspection
If the amount of amniotic fluid is 3000 ml or more the woman experiences: (hydramnios)
- SOB
- Edema in the lower extremities
fetal neonatal implications (hydramnios)
- fetal malformations
- preterm birth
- prolapse cord
- incidence of malpresentations
as the nurse how will he/she plan for this? (hydramnios)
the mother will:
- verbalize decrease in SOB
- decrease in degree of pedal edema
If the accumulation of amniotic fluid is severe enough to cause maternal dyspnea & pain, what is required
- hospitalization & removal of the excessive fluid are required.
- amniocentesis should be done in guidance with ultrasound to prevent damage with fetus and placenta.
the amount of amniotic fluid is severely reduced & concentrated (less than 500 ml)
oligohydramnios
etiology for oligohydramnios?
uknown,
but found in cases of postmaturity
assosciated with
- major renal malformations
- renal aplasia
- dysplastic kidneys
assessment for polyhydramnios
- labor is dysfunctional
- progress is slow
in antepartum period
- uterus does not increase in size
- fetus is easily palpated
- fetus is not ballotable (feeling of rebound in the fetus followed by a quick digital tap on the wall of the uterus)
fetus is assessed by (polyhydramnios)
- biophysical profile
- non stress test
- serial ultrasound
fetal-neonatal implications (polyhydramnios)
- during gestational period (fetal skin & skeletal abnornalities)
- pulmonary hypoplasia
- during labor and birth (cord and head compression)
If oligohydramnios occurs in the first part of pregnancy, what would happen?
there is danger of fetal adhesions
during labor: to detect cord compression of variable decelerations (what is implemented)
EFM: Electronic Fetal Monitoring
it is administered after membranes have ruptured to decrease the frequency & severity of variable decelerations in the FHR during labor
Amnioinfusion
EFM evaluates the following:
- increasing or decreasing baseline
- decreased variability
- presence of late decelerations
if variable decelerations are noted, for EFM, what to do?
Woman’s position can be changed to releieve pressure on the umbilical cord & have physician notified.
a small amount of amniotic fluid leaks into the chorionic plate & enter the maternal system
amniotic fluid embolism
amniotic fluid embolism occurs:
during labor, birth or within 30 minutes after birth.
What inflammatory reaction occurs in AFE?
DIC: activates abnormal clotting in the mother’s lungs and blood vessels.
Assessment: maternal (AFE)
- onset of respiratory distress
> chest pain
> dyspnea
> frothy sputum - circulatory collapse
> cyanosis
> tachycardia
> hypotension - acute hemorrhage
- cor pulmonale
