foetal abnormalities Flashcards
what is polyhydramnios
too much amniotic fluid in the uterus
>95th centile for gestational age
what are the 2 main groups of causes of polyhydramnios
excess production - due to increased foetal urination
insufficient removal - due to reduced foetal swallowing
name 4 conditions that can increase in-utero foetal urination
maternal diabetes, foetal renal disorders, foetal anaemia, twin-to-twin transfusion syndrome
name 4 conditions that can reduce in-utero foetal swallowing
oesophageal/duodenal atresia
diaphragmatic hernia
anencephaly
what is duodenal atresia
blind-ending duodenum which leads to GI tract obstruction
what is the most common cause of polyhydramnios
idiopathic
name some signs that could indicate polyhydramnios
large for dates
malpresentation
tense, shiny abdo - unable to feel foetal parts
what bedside exam could indicate polyhydramnios
elevated symphysis-fundal height
how do we diagnose maternal diabetes as a cause of polyhydramnios
maternal glucose tolerance test
definitive investigation of polyhydramnios
ultrasound - either amniotic fluid index or maximum pool depth elevated
what genetic test is used to check for chromosomal abnormalities in foetus
karyotyping
what might be considered to manage severe polyhydramnios (+describe what it is)
amnioreduction - amniocentesis for intentional reduction of fluid volume
what is a serious complication of monochorionic twins
twin-to-twin transfusion syndrome
what does it mean if twins are monochorionic
they share a single placenta
what causes twin-to-twin transfusion syndrome
anastomoses of umbilical vessels between the 2 foetuses in the placenta
name a risk factors for twin-to-twin transfusion syndrome
monoamniotic twins !!
what is the consequence of twin-to-twin transfusion syndrome and how can this present clinically
hypovolaemic donor twin - high cardiac output failure due to severe anaemia
hypervolemic recipient twin - fluid overload
what is hydrops fetalis
abnormal fluid accumulation in the foetuses tissues and organs, leading to to oedema
what is the investigation for twin-to-twin transfusion syndrome
ultrasound monitoring for the signs
staging tool used for twin-to-twin transfusion syndrome and what does it evaluate
quintero (1-5)
fluid levels in sacs, size of the twins, blood flow in the umbilical cord and the placenta
management of twin-to-twin transfusion syndrome
VERY SPECIALIST
laser transection of the problematic vessels in utero
what is oligohydramnios
low level of amniotic fluid
below the 5th centile for gestational age
what are some of the main causes of oligohydramnios
premature rupture of membranes
placental insufficiency
reduced production of foetal urine
what is the main sign of oligohydramnios
small abdominal measurement
investigation for oligohydramnios
ultrasound: amniotic fluid index or maximum pool depth
conservative management of oligohydramnios
maternal rehydration
medical management of oligohydramnios
amnioinfusion - infusion of saline to increase the volume
surgical management of oligohydramnios and when its indicated
delivery - severe cases or if the foetus is in distress
what is a complication of oligohydramnios
potter syndrome
pathophysiology of potter syndrome
pressure in utero due to oligohydramnios leading to bilateral renal agenesis
