Class 16: Fetal ABD & Thorax Abnormalities Flashcards
edema in the thorax can be ___ or ___
focal or diffuse
what is edema in the thorax associated with? (2)
- fetal hydrops
- nuchal fold thickening
the nuchal fold shouldn’t exceed ___
6 mm
what is fetal hydrops?
fluid builds up in fetus’ tissues & organs which lead to edema
another name for pleural effusion?
hydrothorax
what is pleural effusion?
build up of fluid between lungs & chest cavity
any fluid around the fetal lungs in abnormal. T/F?
true
5 causes of hydrothorax?
- immune/nonimmune fetal hydrops
- CHF
- chromosomal abnormalities
- cardiac masses
- intrathoracic lesions
complications of pleural effusion? (2)
- compressed lung parenchyma
- pulmonary hypoplasia
mortality % of pleural effusion?
50%
what causes pulmonary hypoplasia?
decreased number of lung cells & alveoli leads to decreased organ size & weight
what LS ratio indicates a mature lung?
2+
what is the most common cause for pulmonary hypoplasia?
prolonged oligohydramnios
what is cystic adenomatoid malformation?
condition where there is an increase in terminal respiratory elements in the lung that lead to cysts
CAM is usually bilateral. T/F?
false – unilateral
what is the most common fetal chest mass?
CAM
2 effects of cystic adenomatoid malformation?
- pulmonary hypoplasia
- fetal hydrops
what is type 1 CAM?
1+ large cysts replace normal lung tissue
what size are cysts in type 1 CAM?
2-10cm
which type of cystic adenomatoid malformation has favorable outcomes?
type 1
what is type 2 CAM?
multiple small cysts in the lung that are < 2cm
what is type 2 CAM associated with? (4)
- chromosomal abnormalities
- renal agenesis
- diaphragmatic herniation
- cardiac anomalies
what is type 3 CAM?
microscopic cysts in lung between 0.5-5mm
US appearance of type 3 CAM?
echogenic lung lobe that is affected due to many microscopic cysts causing enhancement
what is a diaphragmatic hernia?
when bowel & abdominal organs herniate into the thorax
what causes a diaphragmatic hernia?
improperly fused diaphragm
mortality rate for diaphragmatic hernia?
50-80% due to pulmonary hypoplasia
2 types of diaphragmatic hernia?
- bochdalek
- morgagni
what is a bochdalek diaphragmatic hernia?
occurs on the posterolateral portion of the left side – where left abdominal organs herniate into thorax
where is morgagni diaphragmatic hernia located?
anterior
AC measurement will be ___ with a diaphragmatic hernia
smaller than normal
what causes polyhydramnios with a diaphragmatic hernia?
the esophagus may be compressed, leading to a narrow GIT & back up of fluid
when can a cardiomediastinal shift occur?
heart may shift to the right with a bochdalek diaphragmatic hernia
what is an ectopic cord?
when the heart protrudes through the thoracic wall through a cleft in the sternum
what is fetal ascites?
fluid in the peritoneal cavity
5 conditions associated with fetal ascites?
- fetal hydrops
- bowel perforation
- urinary ascites
- heart failure
- TTTS
what is pseudoascites?
muscles of the abdominal wall may mimic ascites
another name for omphalocele?
exomphalos
what is an omphalocele?
a herniation of abdominal contents into the base of the umbilical cord
where does an omphalocele occur?
at midline
an omphalocele is covered by ___
amniotic sac/peritoneal sac
lab values for omphalocele?
normal or slightly elevated AFP
omphalocele is associated with other anomalies ___%
29-66% of the time
what other conditions are associated with an omphalocele? (5)
- GIT
- heart
- chromosomal abnormalities (esp bowel herniation)
- beckwith-wiedman syndrome
- ascites & hydramnios
what is gastroschisis?
a herniation of viscera off of midline; usually right of midline
gastroschisis is covered by ___
nothing; it is exposed to amniotic fluid
lab values of gastroschisis?
very high levels of AFP
what has better prognosis? omphalocele or gastroschisis?
gastroschisis
what is bladder extrophy?
a defect where the UB protrudes through abdominal wall
US appearance of amniotic fluid in bladder extrophy?
normal
US appearance of UB in bladder extrophy?
lack of visualization of urinary bladder (normal filling is every 15 min)
what is the most common tumor in neonates?
sacrococcygeal teratoma
what is sacrococcygeal teratoma made of?
3 germ cell layers
is sacrococcygeal teratoma benign or malignant?
can be both
US appearance of sacrococcygeal teratoma?
mass extending from sacrum with intact spine; solid or mixed interspersed with cystic components
what is limb-body wall complex?
severe form of amniotic band syndrome that is not compatible with life – defects are all over the body
