Exam 3 Flashcards
CAM
CYSTIC ADENOMATOID MALFORMATION (CAM)
- Increase in terminal respiratory elements leading to development of cysts
- Involves part or all of a lung lobe
- Usually unilateral
Meningocele
MENINGOCELE - meninges only protrude
Cystic Hygromas
- BENIGN
- OF LYMPHATIC ORIGIN
- 80% ORIGINATE FROM POSTEROLATERAL PORTION OF NECK
Arnold Chiari malformation is a common type of what?
HYDROCEPHALUS
Choroid plexus cyst / Trisomy
- CYSTS IN THE CHOROID PLEXUS
- MAY BE TRANSIENT, AND RESOLVE BY END OF 2ND TRIMESTER
- 5% ARE ASSOCIATED WITH TRISOMY 18
- BILATERAL CYSTS >10 MM HAVE HIGHER ASSOCIATION WITH ABNORMAL KARYOTYPE
Neural Tube
?
Holoprosencephaly
- Failure of prosencephalon (forebrain) to divide into double lobes of cerebral hemispheres
- Thalami are fused
- Single common ventricle (horseshoe shaped)
- Caused by incomplete cleavage of prosencephalon
- Associated with facial deformities of the eyes, nose, and upper lip
Hydranencephaly
- Total or near total absence of cerebral hemispheres
- Mid-brain, basal ganglia, thalamus and cerebellum present
- Thought to be caused by bilateral blockage of the Internal Carotid Arteries
Dandy Walker
- Congenital brain malformation
- Characterized by incomplete formation of cerebellar vermis, dilation of fourth ventricle and enlargement of posterior fossa
- Thought to be result of obstruction of Foramina of Luschka and Magendie
Polyhydramnios associations
•IDIOPATHIC 60% OF TIME •MAY BE FETAL FACTOR Gastrointestinal tract abnormality •MAY BE MATERNAL FACTOR Maternal diabetes
Anencephaly
- Absence of cerebral hemispheres and overlying skull and scalp
- Only structures at base of brain present
- Can be seen on ultrasound transvaginally by 9-10 weeks
- Most common congenital anomaly of CNS
- Common in areas of world where spina bifida is common ( United Kingdom)
Causes of Pulmonary Hypoplasia
- Intrathoracic mass
- Abdominal mass
- Oligohydramnios
- Small thorax related to skeletal dysplasia
Amniotic band syndrome
Amniotic band syndrome is a rare condition caused by strands of the amniotic sac that separate and entangle digits, limbs, or other parts of the fetus.
micromelia
shortening of entire extremity
acromelia
distal extremity shortening (phalanges, metacarpals)
mesomelia
middle limb segment shortening (radius, ulna, tibia, fibula)
rhizomelia
shortening of proximal extremity (humerus, femur)
thanatophoric dysplasia
- Most common dysplasia that is lethal
* Unknown etiology
Normal AP measurement for placenta
1.5cm - 5cm anything above 6cm is abnormal
“double bubble” sign
Connection between duodenum and stomach too small causing a build up “bubble” to form on either side. Seen in ultrasound of stomach
What is the most common cause of Fetal Hydronephrosis?
ureteropelvic junction obstruction (UPJ)
omphalocele vs gastroschisis
Gastroschisis less serious than omphalocele
limb/body wall complex
SEVERE FORM OF AMNIOTIC BAND SYNDROME
OR
EARLY VASCULAR ACCIDENT CAUSING DISRUPTIVE BODY WALL EVENTS
Anomalies may involve lateral body wall defects, thorax, abdomen, face, limbs and spine
Not compatible with life
Bochdalek hernia
the herniation of abdominal contents into the chest cavity because of an opening in the left posterolateral portion of the diaphragm
Prune Belly Triad
- Deficient abdominal musculature
- Cryptorchidism
- GU tract anomaly (PUV)
- DISTENDS FETAL ABDOMEN WITH WRINKLED APPEARANCE
Diaphragmatic hernias: Causes
CAUSE: improperly fused or formed diaphragm
Pseudoascites in the fetus
- Hypoechoic ring around abdominal wall may simulate ascites
* It represents the muscles of the abdominal wall
Posterior urethral valve obstruction
- Occurs in male fetuses
- Results when thin leaflets obstruct fetal urethra
L/S ratio
Lecithin sphingomyelin ration
Measures Lung Maturity
Microcephaly
- SMALL HEAD
- HC MEASURES > 3 STANDARD •DEVIATIONS BELOW NORMAL
- MENTAL RETARDATION
erythroblastosis fetalis
Erythroblastosis fetalis (non-immune fetal hydrops): •Erythroblastosis fetalis is hemolytic anemia in the fetus
Condition found specifically with Rh incompatibility
sacrococcygeal teratoma
- MOST COMMON TUMOR IN NEONATES
- MADE UP OF ALL 3 GERM LAYERS
- SEEN AS MASS EXTENDING FROM SACRUM
- MAY BE BENIGN OR MALIGNANT
- MAY BE SOLID, MIXED OR INTERSPERSED WITH CYSTIC COMPONENTS
abnormalities associated with non immune fetal hydrops
- Cardiovascular abnormality (most common)
- Chromosomal abnormalities (2nd most common)
- Fetal structural abnormalities
- Anemia
- Infections
- Genetic disorders
- Idiopathic causes
- Maternal disorders
- Placental disorders
hydrocephalus and ventricular enlargement
Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain
The CSF tends to build within the ventricles of the brain resulting in enlargement
cleft lip
- CLEFT LIP
- CLEFT PALATE
- FAILURE OF LIP FUSION •PRIOR TO 35 DAYS FROM CONCEPTION
- MAY BE AN ISOLATED FINDING
- MAY BE ASSOCIATED WITH BRAIN ANOMALIES OR TRISOMIES
osteogenesis imperfecta
- INHERITED DISORDER
- DISORDER OF PRODUCTION OR SECRETION OF COLLAGEN
- ABNORMAL FRAGILITY OF THE BONES DUE TO HYPOMINERALIZATION OF ENTIRE SKELETON
- BONES CAN BE FRACTURED OR DEFORMED EASILY
- STILLBIRTH POSSIBLE DUE TO CRANIAL FRACTURE
nonimmune fetal hydrops
CAN BE CAUSED BY OVER 40 CONDITIONS •Cardiovascular abnormality (most common) •Chromosomal abnormalities (2nd most common) •Fetal structural abnormalities •Anemia •Infections •Genetic disorders •Idiopathic causes •Maternal disorders •Placental disorders
polydactyly
- Having more than 5 fingers or toes
- On lateral or medial side
- May be an isolated finding
- May be a dominant inherited trait
polyhydramnios
Polyhydramnios •IDIOPATHIC 60% OF TIME •MAY BE FETAL FACTOR -Gastrointestinal tract abnormality •MAY BE MATERNAL FACTOR -Maternal diabetes
amniotic band syndrome
Amniotic band syndrome is a rare condition caused by strands of the amniotic sac that separate and entangle digits, limbs, or other parts of the fetus.
duodenal atresia
Lack of adequate communication between duodenum and stomach
campomelic dysplasia
- LETHAL
- AUTOSOMAL RECESSIVE OR SPORADIC
- RARE (1 IN 200,000)
Arnold Chiari Malformation: Ultrasound Appearance
- “BANANA SIGN” - refers to shape of cerebellum; banana shape instead of apple
- “LEMON SIGN” - narrower portion of anterior portion of head
- DILATION OF LATERAL VENTRICLES - bilateral and severe “bat wing sign”
- PARTIAL ABSENCE OF CAVUM SEPTUM PELLUCIDUM
- DILATION OF THIRD VENTRICLE
Types of holoprosencephaly
-Alobar (most severe) •Single horseshoe shaped ventricle •Fused thalami •Associated with craniofacial abnormalities -Semilobar •More cerebral tissue present •Occipital lobe present •Associated with cleft palate and lip -Lobar •Nearly complete separation of cerebral hemispheres
Ultrasound Appearance of Hydranencephaly
Ultrasound appearance:
•No cerebral parenchyma
•Large anechoic areas surrounding midbrain
Dandy Walker Malformation: Other names
AKA: Dandy Walker Syndrome, Dandy Walker Cyst, Dandy Walker Variant
Dandy Walker: Ultrasound Appearance
- Cystic enlargement of fourth ventricle
- Dilated third ventricle
- Variable dilation of lateral ventricles
- Cerebellar lobes split apart and abnormal in shape
Anencephaly: Ultrasound Appearance
- Cranial vault absent
- Intracranial contents absent
- Orbits and face present
- Bulging eyes
- Short neck
- Polyhydramnios present in half the cases
Adequate dose of Rh immunoglobulin (RhoGAM) is to be given when?
Within 72 hours of delivery of Rh + Baby
RhoGAM is given when during pregnancy?
28th Week of Pregnancy
RhoGAM Treatment must be done with which of the following: •Pregnancy •Miscarriage •Abortion •Amniocentesis •Chorionic Villi Sampling
RhoGAM treatment must be repeated with each of the listed
Characteristics of Thanatophoric Dysplasia?
- Severely flattened vertebral bodies
- Extreme rhizomelia
- Extreme micromelia
- Bowed long bones
- Narrow thorax with protruding abdomen (champagne cork appearance)
Causes of Micro Cephaly
CAUSES:
- Trisomies
- Exposure to environmental teratogens
- Uterine infections
Rh Incompatibility
CAUSED BY AN INCOMPATIBILITY BETWEEN THE BLOOD OF MOTHER AND FETUS
Fetal Effects of Rh Disease:
FETAL EFFECTS: Jaundice Anemia Brain damage Heart failure Death
Causes of Rh Disease:
- MOST PEOPLE HAVE Rh POSITIVE BLOOD (85-95% of population)
- IF YOU HAVE THE Rh ANTIGEN YOU ARE Rh + positive
- IF YOU DO NOT HAVE THE Rh ANTIGEN YOU ARE Rh - negative
- AN Rh - MOTHER AND Rh + FATHER ARE NEEDED FOR IMMUNE RELATED HYDROPS TO DEVELOP
Polydactyly may be linked with what genetic diseases?
- Trisomy 13, 18, 21
- Ellis-van Creveld syndrome
- Rubinstein-Taybi syndrome
Duodenal Atresia: 1/2 of the cases are associated with what other anomalies?
- VACTERL (vertebral, anorectal, cardiac, tracheoesophageal, renal, & limb)
- Bowel malrotation
- Trisomy 21
Campomelic Dysplasia
Shortening and bowing of long bones of legs (tibia and fibula most affected)
Narrow chest
Large calvarium with small face
Hypoplastic scapulae
MENINGOMYELOCELE
MENINGOMYELOCELE - meninges and spinal cord protrude
Cystic Hygromas: US appearance
APPEAR AS UNILOCULAR OR MULTILOCULAR CYSTIC MASS
Cystic Hygromas can be associated with what other condition?
MAY BE ASSOCIATED WITH TURNER’S SYNDROME
Besides the posterior lateral portion of the neck, what other locations can Cystic Hygromas be located?
-OTHER LOCATIONS INCLUDE AXILLA, GROIN, MEDIASTINUM, THORAX
What is the most common mass in fetal chest?
CYSTIC ADENOMATOID MALFORMATION (CAM)
WHAT IS THE MOST COMMON TUMOR IN NEONATES?
Sacrococcygeal Teratoma
Sacrococcygeal teratoma is made up of what?
MADE UP OF ALL 3 GERM LAYERS
Is a Sacrococcygeal Teratoma benign or malignant?
MAY BE BENIGN OR MALIGNANT
What state is Sacrococcygeal Teratoma usually in?
MAY BE SOLID, MIXED OR INTERSPERSED WITH CYSTIC COMPONENTS
Where is Sacrococcygeal Teratoma usually located?
SEEN AS MASS EXTENDING FROM SACRUM
Arnold Chiari malformation is associated with what condition?
ASSOCIATED WITH SPINA BIFIDA
How does Arnold Chiari malformation affect the spinal cord?
PORTION OF SPINAL CORD IS TETHERED AND ENDS BELOW L2
How does Arnold Chiari malformation affect the cerebellum?
CEREBELLUM IS PULLED THROUGH CISTERNA MAGNA
Posterior urethral valve obstruction: Ultrasound appearance
US features: •Enlarged bladder •Thickened bladder wall •Dilated ureters •“Keyhole appearance” due to dilated urethra •Oligohydramnios
Situs inversus in relation to the fetal heart?
congenital condition in which the major visceral organs are reversed or mirrored from their normal positions. The normal arrangement of internal organs
Diaphragmatic Hernia: incidence?
1 in every 2000-4000 live births
Diaphragmatic Hernia: Mortality rate?
MORTALITY: 50-80% due to pulmonary hypoplasia
Types of Diaphragmatic Hernias?
Bochdalek - posterolateral on the left
Morgagni - anterior
Ultrasound Findings of Diaphragmatic Hernia?
- Stomach, bowel, or other organs located in thorax
- An AC that is smaller than normal
- May be associated with polyhydramnios
