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OB GYN RESIDENCY > Chapter 11: Disorders of Amnionic Fluid > Flashcards

Chapter 11: Disorders of Amnionic Fluid Flashcards

1
Q

Amniotic fluid volume increase

A

30 mL at 10 weeks
200 mL by 16 weeks
800 mL by the mid-third trimester

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2
Q

Amniotic fluid composition

A

98% water

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3
Q

Abnormally decreased fluid volume

A

Oligohydrmanios

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4
Q

Abnormally increased fluid volume

A

hydramnios or polyhydramnios

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5
Q

(First half of pregnancy) Transfer of water and other small molecules

across amnion

A

transmembranous flow

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6
Q

(First half of pregnancy) Transfer of water and other small molecules

across the fetal vessels on placental surface

A

intramembranous flow

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7
Q

(First half of pregnancy) Transfer of water and other small molecules

across fetal skin

A

transcutaneous flow

until keratinisation at 22 to 25 weeks

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8
Q

Fetal urine produc­tion begin

A

8 and 1 1 weeks’ gestation

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9
Q

when does lethal renal abnormalities manifests

A

after 1 8 weeks

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10
Q

Fetal urine osmolality

A

equal to amniotic fluid

hypotonic to maternal and fetal plasma

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11
Q

Amniotic fluid volume regulation late pregnancy

Fetal urination

A

production

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12
Q

Amniotic fluid volume regulation late pregnancy

Fetal swallowing

A

Resorption

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13
Q

Amniotic fluid volume regulation late pregnancy

Fetal lung fluid secretion

A

Production

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14
Q

Amniotic fluid volume regulation late pregnancy

intramembranous flow across the fetal vessels on placental surface

A

Resorption

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15
Q

Amniotic fluid volume regulation late pregnancy

transmembranous flow across amniotic membrane

A

Resorption

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16
Q

Measurement: dye dilution

A

aminohippurate

17
Q

Mean value (22-39 wks)

A

750ml

18
Q

Normal Single deepest pocket

A

> 2cm

<8cm

19
Q

Normal AFI

A

> 5cm

<25 cm

20
Q

Mild Hydramnios

A

AFI 25 to 29.9 cm

SDP 8 to 9.9 cm

21
Q

Moderate Hydramnios

A

AFI 30 to 34.9 cm

SDP 10 to 11.9 cm

22
Q

Severe

A

AFI 35 cm or more

SDP 12 cm or more

23
Q

Etiology of hydramnios

A
  • fetal anomalies:
    structural abnormalities or genetic syndromes , and diabetes
  • Con­genital infection: cytomegalovirus, toxoplas­mosis, syphilis, and parvovirus
  • red blood cell alloimmunization
  • placental chorioangioma
    -hydrops fetalies
24
Q

Pathophysiology: hydramnios with diabetes

A

maternal hyperglycemia causes fetal hypergly­cemia, with resulting fetal osmotic diuresis into the amniotic fluid compartment

25
Q

Diagnostic criteria for twin-twin transfusion syn­drome (TTTS)

A

Monochorionic ges­tations, hydramnios of one sac and oligohydramnios of the other

26
Q

Hydramnios complication

A

Maternal
-uterine Distention
- Dyspnea and orthopne
- Edema - lower extremities, vulva, and abdominal wall
- placental abruption, uterine dysfunction during labor, and postpartum hemorrhage
fetal
-membrane rupture or therapeutic amnioreduction

27
Q

Oligohydramnios ethology

A
  • fetal abnormality
  • placental abnormality su􏰀ciently severe —> impair perfusion
  • Rule out ruptured membrane
28
Q

Oligohydramnios Congenital anomalies (renal)

A

bilateral renal agenesis
bilateral multicystic dysplastic kidney
unilateral renal agenesis with contralateral multicystic dysplastic kidney
infantile form of autosomal recessive poycystic kidney dis­ease

29
Q

Oligohydramnios Congenital anomalies (genitourinary)

A

persistent cloaca and sireno­ melia

30
Q

Drugs causing oligohydramnios

A

ACEi
ARBs

Effects:
fetal hypotension
renal hypoperfusion
renal ischemia
anuric renal failure

NSAIDs

Effects:
acute and chronic renal insu􏰀ciency
Fetal skull bone hypoplasia and limb contrac­tures

31
Q

Oligohydramnious outcome

A

stillbirth
preterm birth
heart rate pattern abnormalities
growth restriction

32
Q

Oligohydramnios management

A

close fetal surveillance

maternal hydration

OB GYN RESIDENCY (17 decks)

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