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Y4R2 - Obstetrics I 🤰 > L6: Abnormalities of Amniotic Fluid > Flashcards

L6: Abnormalities of Amniotic Fluid Flashcards

1
Q

Def of Polyhydramnios

A
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2
Q

Incidence of Polyhydramnios

A

1% in all pregnancies

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3
Q

Types of Polyhydramnios

A
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4
Q

Causes of Polyhydramnios

A
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5
Q

Maternal Causes of Polyhydramnios

A
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6
Q

Maternal prolactin may play a role by increasing the …… of amniotic fluid.

A

osmotic pressure

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7
Q

Fetal causes of Polyhydramnios

A
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8
Q

Causes of Polyhydramnios

  • Multiple gestation
A

(in monochorionic twins it may be twin-to-twin transfusion syndrome)

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9
Q

Causes of Polyhydramnios

  • Anencephaly and spina bifida in most cases & the causes may be ….
A
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10
Q

Causes of Polyhydramnios

  • Congenital Heart failure
A

Congenital Heart Disease with congestive ht. failure

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11
Q

Causes of Polyhydramnios

  • Increased placental mass
A

That occurs with edema of the placenta: e.g. Hydrops
fetalis: e.g. Rh. iso-immunization, severe anemia, CMV infection

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12
Q

Causes of Polyhydramnios

  • Liver Cirrhosis
A

Causing fetal ascites “as in Syphilis”

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13
Q

Clincal Dx of Polyhydraminos

A
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14
Q

Clincal Dx of Polyhydraminos

  • Acute type
A
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15
Q

Clincal Dx of Polyhydraminos

  • Symptoms of acute type
A
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16
Q

Clincal Dx of Polyhydraminos

  • Signs of acute type
A
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17
Q

Clincal Dx of Polyhydraminos

  • General Examination of acute type
A

breathlessness, anxious, and
cyanotic

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18
Q

Clincal Dx of Polyhydraminos

  • Inspection of acute type
A
  • Over distended with glistening skin and visible dilated veins.
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19
Q

Clincal Dx of Polyhydraminos

  • Palpation of acute type
A
  1. Size of uterus > duration of amenorrhea & tense, tender
  2. Difficult to palpate fetal part.
  3. Common malpresentation & mal-position
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20
Q

Clincal Dx of Polyhydraminos

  • Percussion of acute type
A

Positive fluid thrill

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21
Q

Clincal Dx of Polyhydraminos

  • Auscultation of acute type
A

Difficult to auscultate FHS

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22
Q

Clincal Dx of Polyhydraminos

  • vaginal Examination of acute type
A

boggy fomices & cervix is pulled high up & may be dilated

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23
Q

Clincal Dx of Polyhydraminos

  • Chronic Type
A

Symptoms and Signs are slowly progressive course & after 20 weeks.

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24
Q
  • In acute polyhydramnios: Symptoms are …..
  • In chronic polyhydramnios: Symptoms are ……
A
  • severe & of sudden onset.
  • slight & of gradual onset.
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25
Q

INVx in Polyhydraminos

A
26
Q

DDx of Polyhydraminos

A
  • Causes of oversized uterus more than amenorrhea.
  • Ascites with pregnancy.
  • Ovarian cyst with pregnancy.
27
Q

Managment aspects of Polyhydraminos

A
  • Plan of ttt
  • Expectant treatment
  • Termination of pregnancy
  • Neonatal Care
28
Q

Managment aspects of Polyhydraminos

  • Plan of TTT
A
29
Q

Managment aspects of Polyhydraminos

  • Expectant Treatment
A
30
Q

Managment aspects of Polyhydraminos

  • TOP
A
31
Q

Managment aspects of Polyhydraminos

  • Neonatal Care
A
  • Diagnose & treatment of congenital anomalies, anemia, jaundice & infection.
  • Care of preterm baby & care of infant of diabetic mother.
32
Q

Complications of Polyhydraminos

A

Fetal & Maternal

33
Q

Fetal Complications in Polyhydraminos

A
  • Birth injuries
  • Cord prolapse, Placental separation and fetal asphyxia.
  • Prematurity complications when delivered early
34
Q

Maternal Complications of Polyhydraminos

A
35
Q

Maternal Complications of Polyhydraminos

  • During Pregnancy
A
36
Q

Maternal Complications of Polyhydraminos

  • During Labor
A
37
Q

Splanchic Shock Due to polyhyrdraminos

A
  • Due to pooling of blood in dilated splanchnic vessels as a result of sudden drop of intra-amniotic pressure after ROM.
38
Q

Def of Oligohydraminos

A
  • Too little amniotic fluid (oligohydramnios) is commonly defined as amniotic fluid index (AFI) less than the 5th centile for gestation.
  • It is the decreased amount of liquor amnii (< 500 cm3) OR on U/S AFI < 5cm.
39
Q

Incidence of Oligohydraminos

A

1/750

40
Q

Causes of Oligohydraminos

A
41
Q

maternal Causes of Oligohydraminos

A

Rare or absent and the commonest is severe PET.

42
Q

Fetal Causes of Oligohydraminos

A
43
Q

Fetal Causes of Oligohydraminos

  • Renal Anomalies
A

e.g. bilateral renal agenesis, complete obstruction of urinary tract, bilateral multicystic kidneys.

44
Q

Fetal Causes of Oligohydraminos

  • Multifetal Pregnancy with TITS
A

Donor fetus develops oligohydramnios

45
Q

Fetal Causes of Oligohydraminos

  • Post tem pregnancy
A

Due to placental insufficiency

46
Q

Clinical Dx of Oligohydraminos

A
47
Q

INVx in Oligohydraminos

A
48
Q

TTT of Oligohydraminos

A
49
Q

TTT of Oligohydraminos

  • In PROM
A

Treatment of PROM

50
Q

TTT of Oligohydraminos

  • In Post-term Pregnancy
A

TOP

51
Q

TTT of Oligohydraminos

  • If there is lethal fetal anomalies or IUFD
A

TOP

52
Q

TTT of Oligohydraminos

  • If there is fetal risk (cord compression or IUGR)
A

Immediate CS

53
Q

TTT of Oligohydraminos

  • If there is no fetal risk
A

Vaginal delivery is allowed with careful electronic fetal monitoring to detect any change in FHR which indicates CS

54
Q

TTT of Oligohydraminos

  • Aminoinfusion
A

Method in which physiological solution (normal saline) is infused via double lumen catheter through cervix into uterine cavity

55
Q

Complications of Oligohydraminos

A
56
Q

Matrenal Complications of Oligohydraminos

A

Malpresentation & prolonged labo

57
Q

Fetal Complications of Oligohydraminos

A
58
Q

Fetal Complications of Oligohydraminos

  • Pulmonary hypoplasia
A
59
Q

Fetal Complications of Oligohydraminos

  • Asphyxia
A

Due to cord compression

60
Q

Fetal Complications of Oligohydraminos

  • Cutaneous & skeletal abnormalities
A

Y4R2 - Obstetrics I 🤰 (10 decks)

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