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Diagnostic Sonography Hagen--OB/GYN > Chpt 58 Amniotic Fluid...membranes > Flashcards

Chpt 58 Amniotic Fluid...membranes Flashcards

1
Q

Amniotic fluid is produced by:

A 
Umbilical cord
Kidneys
Lungs
Skin
Amniotic membranes
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2
Q

In early gestation, the main source of amniotic fluid is the

A

Amniotic membrane

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3
Q

In second half of pregnancy, what accounts for nearly all of amniotic fluid

A

Fetal kidneys and urination

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4
Q

Fetal lung development depends critically on….

A

The exchange of amniotic fluid within the lungs

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5
Q

Severely low amniotic fluid(lungs) =

A

Pulmonary hypoplasia

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6
Q

1st trimester fluid can be seen surrounding the fetus…what weeks contain more amounts of fluid?

A

20-30

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7
Q

Fluid particles within amnion may represent:

A 
Normal variant 
Particulate matter
Vernix(fatty material on fetal skin)
Intraamniotic blood
Intrauterine meconium(snowstorm)
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8
Q

Intrauterine meconium produces what appearance

A

Snowstorm

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9
Q

Amniotic sludge Is a dense collection of echogenic particles within the fluid at the level of the

A

Cervix

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10
Q

Amniotic sludge is associated with

A

Premature rupture of membranes, chorioamnionitis, preterm delivery

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11
Q

Most common ways to determine level of amniotic fluid

A

Subjective assessment
Amniotic fluid index—AFI
Single pocket assessment

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12
Q

Performed as the sonographer initially scans through the entire uterus to visually assess the fluid present, fetal position, placental position. Most successful with experienced sonographers(eyeball)

A

Subjective assessment

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13
Q

Uterine cavity is divided into four quadrants

Largest vertical pocket of amniotic fluid in each quadrant is measured

A

Amniotic fluid index

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14
Q

For amniotic fluid index the image must be in the ___ plane

A

Longitudinal

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15
Q

Concerning amniotic fluid index the probe should be in what position when determining fluid pockets

A

Perpendicular to the table

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16
Q

T/f It is important to apply a lot of pressure when measuring the amniotic fluid index

A

False it is important to not apply to much pressure causing fluid pockets to appear smaller

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17
Q

Criteria for amniotic fluid index

A

Image should be in longitudinal plane, probe should be perpendicular to table, measure each pocket in a vertical fashion, do not include thickness of maternal uterine wall, do not apply to much pressure, use color Doppler

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18
Q

A.k.a. maximum vertical pocket

A

Single pocket assessment

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19
Q

Concerning single pocket assessment fluid should measure greater than

A

1 cm

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20
Q

Normal values correlate with a total AFI of

A

10 to 20 cm

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21
Q

AFI less than 5 cm with largest vertical pocket measuring less than 2 cm

A

Oligohydramnios

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22
Q

AFI measures greater than 24 cm and largest vertical pocket measures more than 8 cm

A

Polyhydramnios

23
Q

Horizontal and vertical dimensions of the maximum vertical pocket are multiplied together to obtain a single area

Rarely used, sometimes used with multiple gestation

A

2 diameter pocket assessment

24
Q

Twin pregnancies have a ____ median AFI value than singleton pregnancies

A

Slightly Lower

25
Q

Polyhydramnios is defined as amniotic fluid volume of

A

> 2000 ml

26
Q

Polyhydramnios may be painful, compress other organs, cause __________ or produce shortness of breath from compression on the diaphragm

A

Hydro nephrosis

27
Q

Fetal conditions associated with polyhydramnios

A

Central nervous system disorders (caused depressed swallowing), G.I. problems(ineffective swallowing)

28
Q

Maternal conditions associated with polyhydramnios

A

Congestive heart failure, obesity, anemia, Blood incompatibility, diabetes, syphilis

29
Q

The most common maternal cause of elevated AFI

A

Diabetes

30
Q

Fetal causes of polyhydramnios

A

Meningomyelocele, omphalocele(abdominal wall defect), twin transfusion, hydrocephaly, blood incompatible, skeletal anomalies/sacrococxygeal teratoma, urethra stenosis, spina bifida, esophageal atresia

31
Q

With polyhydramnios the mother has an increased risk of

A

Developing pregnancy induced hypertension, preterm labor, postpartum hemorrhage

32
Q

Oligohydramnios results in fetal crowding and

A

Decreased fetal movement

33
Q

Causes of oligohydramnios

A

Demise, renal anomalies, IUGR, PROM, post dates(42 weeks), pre eclampsia

34
Q

Most common cause of oligohydramnios

A

Premature rupture of membranes

35
Q

Growth delay is increased by how much when oligohydramnios is present

A

x4

36
Q

Persistent oligo hydramnios in the ____ has a poor prognosis

A

Second trimester

37
Q

Single pocket measurement less than _____ lasting ______ after a spontaneous premature rupture of membranes at ____ gestation is associated with an extremely high mortality rate

A

<1cm
14 days
<25 weeks

38
Q

If membranes are not ruptured and oligo is present before 28 weeks gestation careful evaluation of what should be made

A

Kidneys

39
Q

When will the fetal membranes normally rupture

A

After onset of labor

40
Q

PROM

A

Premature rupture of membranes

41
Q

PPROM

A

Preterm premature rupture of membranes

42
Q

SPROM

A

Spontaneous rupture of membranes

43
Q

Risk factors for rupture of fetal membranes

A

Smoking, vaginal bleeding, history of STD, PID, pregnancy related invasive procedures, African-American descent

44
Q

PROM is associated with

A

Preterm delivery (common)

45
Q

If PROM occurs at 24 to 33 weeks gestation, follow up procedures include

A

Administration of corticosteroids, antibiotics, delivery at approximately 34 weeks

46
Q

An _____ may be performed to verify fetal lung maturity in cases where the fetus needs to be delivered before 34 weeks

A

Amniocentesis

47
Q

Term patients who experience rupture of membranes commonly move into active labor within

A

24 hours

48
Q

Associated with abnormality in fetal membranes

Common, non-recurrent cause of various fetal malformations involving the limbs, craniofacial region, and trunk

A

Amniotic band syndrome

49
Q

Caused by rupture of amnion during early pregnancy development, leading to subsequent entanglement of various fetal parts by fibrous bands, entrapment of fetal parts by the bands may cause lymphedema, amputations, or/defects. with this amnion disruption the fetus may also adhere to and fuse with chorion, causing maldevelopment of fetal tissues

A

Amniotic band syndrome

50
Q

Common findings with amniotic band syndrome are

A

Facial cloths, asymmetric encephaloceles, amputations, club foot deformities

51
Q

Identified as non-floating bands crossing through the amniotic cavity

A

Amniotic sheets

52
Q

Thicker than amniotic bands, Do not cause fetal malformations

A

Amniotic sheets

53
Q

Patients with uterine synechia and infertility are diagnosed with

A

Asherman syndrome

54
Q

Amniotic sheets are believed to be caused by

A

Uterine scars(from previous d&c)C-sections, episodes of endometritis

Diagnostic Sonography Hagen--OB/GYN (6 decks)

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