Class 16: Fetal ABD & Thorax Abnormalities

Question 1

edema in the thorax can be ___ or ___

Answer 1

focal or diffuse

Question 2

what is edema in the thorax associated with? (2)

Answer 2

1. fetal hydrops
2. nuchal fold thickening

Question 3

the nuchal fold shouldn’t exceed ___

Answer 3

6 mm

Question 4

what is fetal hydrops?

Answer 4

fluid builds up in fetus’ tissues & organs which lead to edema

Question 5

another name for pleural effusion?

Answer 5

hydrothorax

Question 6

what is pleural effusion?

Answer 6

build up of fluid between lungs & chest cavity

Question 7

any fluid around the fetal lungs in abnormal. T/F?

Answer 7

true

Question 8

5 causes of hydrothorax?

Answer 8

1. immune/nonimmune fetal hydrops
2. CHF
3. chromosomal abnormalities
4. cardiac masses
5. intrathoracic lesions

Question 9

complications of pleural effusion? (2)

Answer 9

1. compressed lung parenchyma
2. pulmonary hypoplasia

Question 10

mortality % of pleural effusion?

Answer 10

50%

Question 11

what causes pulmonary hypoplasia?

Answer 11

decreased number of lung cells & alveoli leads to decreased organ size & weight

Question 12

what LS ratio indicates a mature lung?

Answer 12

2+

Question 13

what is the most common cause for pulmonary hypoplasia?

Answer 13

prolonged oligohydramnios

Question 14

what is cystic adenomatoid malformation?

Answer 14

condition where there is an increase in terminal respiratory elements in the lung that lead to cysts

Question 15

CAM is usually bilateral. T/F?

Answer 15

false – unilateral

Question 16

what is the most common fetal chest mass?

Answer 16

CAM

Question 17

2 effects of cystic adenomatoid malformation?

Answer 17

1. pulmonary hypoplasia
2. fetal hydrops

Question 18

what is type 1 CAM?

Answer 18

1+ large cysts replace normal lung tissue

Question 19

what size are cysts in type 1 CAM?

Answer 19

2-10cm

Question 20

which type of cystic adenomatoid malformation has favorable outcomes?

Answer 20

type 1

Question 21

what is type 2 CAM?

Answer 21

multiple small cysts in the lung that are < 2cm

Question 22

what is type 2 CAM associated with? (4)

Answer 22

1. chromosomal abnormalities
2. renal agenesis
3. diaphragmatic herniation
4. cardiac anomalies

Question 23

what is type 3 CAM?

Answer 23

microscopic cysts in lung between 0.5-5mm

Question 24

US appearance of type 3 CAM?

Answer 24

echogenic lung lobe that is affected due to many microscopic cysts causing enhancement

Question 25

what is a diaphragmatic hernia?

Answer 25

when bowel & abdominal organs herniate into the thorax

Question 26

what causes a diaphragmatic hernia?

Answer 26

improperly fused diaphragm

Question 27

mortality rate for diaphragmatic hernia?

Answer 27

50-80% due to pulmonary hypoplasia

Question 28

2 types of diaphragmatic hernia?

Answer 28

1. bochdalek 2. morgagni

Question 29

what is a bochdalek diaphragmatic hernia?

Answer 29

occurs on the posterolateral portion of the left side -- where left abdominal organs herniate into thorax

Question 30

where is morgagni diaphragmatic hernia located?

Answer 30

anterior

Question 31

AC measurement will be ___ with a diaphragmatic hernia

Answer 31

smaller than normal

Question 32

what causes polyhydramnios with a diaphragmatic hernia?

Answer 32

the esophagus may be compressed, leading to a narrow GIT & back up of fluid

Question 33

when can a cardiomediastinal shift occur?

Answer 33

heart may shift to the right with a bochdalek diaphragmatic hernia

Question 34

what is an ectopic cord?

Answer 34

when the heart protrudes through the thoracic wall through a cleft in the sternum

Question 35

what is fetal ascites?

Answer 35

fluid in the peritoneal cavity

Question 36

5 conditions associated with fetal ascites?

Answer 36

1. fetal hydrops 2. bowel perforation 3. urinary ascites 4. heart failure 5. TTTS

Question 37

what is pseudoascites?

Answer 37

muscles of the abdominal wall may mimic ascites

Question 38

another name for omphalocele?

Answer 38

exomphalos

Question 39

what is an omphalocele?

Answer 39

a herniation of abdominal contents into the base of the umbilical cord

Question 40

where does an omphalocele occur?

Answer 40

at midline

Question 41

an omphalocele is covered by ___

Answer 41

amniotic sac/peritoneal sac

Question 42

lab values for omphalocele?

Answer 42

normal or slightly elevated AFP

Question 43

omphalocele is associated with other anomalies ___%

Answer 43

29-66% of the time

Question 44

what other conditions are associated with an omphalocele? (5)

Answer 44

1. GIT 2. heart 3. chromosomal abnormalities (esp bowel herniation) 4. beckwith-wiedman syndrome 5. ascites & hydramnios

Question 45

what is gastroschisis?

Answer 45

a herniation of viscera off of midline; usually right of midline

Question 46

gastroschisis is covered by ___

Answer 46

nothing; it is exposed to amniotic fluid

Question 47

lab values of gastroschisis?

Answer 47

very high levels of AFP

Question 48

what has better prognosis? omphalocele or gastroschisis?

Answer 48

gastroschisis

Question 49

what is bladder extrophy?

Answer 49

a defect where the UB protrudes through abdominal wall

Question 50

US appearance of amniotic fluid in bladder extrophy?

Answer 50

normal

Question 51

US appearance of UB in bladder extrophy?

Answer 51

lack of visualization of urinary bladder (normal filling is every 15 min)

Question 52

what is the most common tumor in neonates?

Answer 52

sacrococcygeal teratoma

Question 53

what is sacrococcygeal teratoma made of?

Answer 53

3 germ cell layers

Question 54

is sacrococcygeal teratoma benign or malignant?

Answer 54

can be both

Question 55

US appearance of sacrococcygeal teratoma?

Answer 55

mass extending from sacrum with intact spine; solid or mixed interspersed with cystic components

Question 56

what is limb-body wall complex?

Answer 56

severe form of amniotic band syndrome that is not compatible with life -- defects are all over the body