OB- hydrops Flashcards
Fetal ascites is diagnosed when fluid is seen where? (4)
- between bowel loops
- along the abdominal flanks
- around the liver
- outlining potential spaces
what is isolated ascites caused by?
obstructive urinary or gastrointestinal obstruction
what does early or small amounts of ascites appear as?
- difficult to visualize and appears as an anachouc rim of fluid at the edge of abdominal viscera
in male fetuses, ascites may be seen in what?
in the scrotum (hydrocele)
advanced stages of ascities and easier to diagnose and appear as what? outlining what (5)?
- anachoic fluid
outlining:
- liver
- spleen
- small bowel
- umbilical vein
- falciform ligament
Hypoechoic band In normal fetuses?
In normal fetuses, there is a small hypoechoic band (< 2 cm in thickness) extending along the anterior and lateral fetal abdomen
What is psedoascites?
Pseudoascites does NOT surround the liver, and is always a subcutaneous finding, whereas the true ascites will extend around bowel loops
what is hydrops fetalis?
- Rhesus (Rh) blood group isoimmunization of the fetus
what is nonimmune hydrops caused by?
caused by factors other than isoimmunization
hydrops fetalis symptoms? (4)
- placental thickening
- abnormal fluid in abdominal cavity, heart, or lungs
- excess amniotic fluid
- general edema
what does fetal hydrops refer to?
- a fetus with pathological accumulation of fluid in 2 or more body cavities of tissue
what are the potential body cavities that may conatin fetal hydrops? (5)
- Subcutaneous edema (thick skin)
- Peritoneal cavity (ascites)
- Pericardial effusion (heart)
- Pleural effusion (lungs)
- Associated with Polyhydramnios and Placental Edema
What is immune hydrops?
- decreased since the advent Rh(D) immunoglobuin (prophylaxis given to mother’s at risk for Rh isoimmunization)
What does immune hydrops occur?
when a mother develops (Rh-) antibodies (IgG) to antigen-positive fetal
what kind of disease is immune hydrops?
fetal hemolytic disease
imune hydrops: fetal hemolytic disease includes? (5)
- anemia
- extramedullary erythropoisesis
- hepatosplenomegaly
- hypoalbuminemia
- congestive heart failure
prevention of immune hydrops?
300mg of RhoGam is given at 28 weeks gestation in sensitized individuals, or within 48 h after invasive fetal procedure (amniocentesis, chronic villus sampling)
Maternal non-immune hydrops causes and associations? (9)
- uncontrolled diabetes
- severe anemia
- severe hypoproteinemia
- Indomethacin
(premature closure of ductus arteriosus) - Maternal syphilis
- Maternal hyperthyroidism
- Cytomegalovirus
- Parvovirus B19 (Fifth Disease)
Placenta/ cord non-immune hydrops causes and associations?
- large chorioangioma
- umbilical artery aneurysm
- cord torsion, knot or tumor
What is indomethacin (indocin)?
- prescription drug used to treat moderate to severe pain, swelling, and stiffness from arthritis
why is Indomethacin (Indocin) not safe to take during pregnancy?
because it may cause heart defects and other problems to a developing fetus
What can Syphilis cause?
- can cause miscarriage, still birth, or fetal death after birth
Babies born with congenital syphilis can have what S/S? (7)
- bone damage
- severe anemia
- enlarged liver and spleen
- jaundice
- nerve problems causing blindness or deafness
- meningitis
- skin rashes
what does CMV stand for?
cyto- megalo- virus
what is the leading non-genetic cause of childhood hearing loss?
- CMV
What does CMV cause?
- vision loss
- microcephally
- behaviour issues
- mental disability
- cerebral palsy
- seizures
Non- immune fetal hydrops causes and associations? (13)
Congenital Infection Monochorionic twins (TTTS) Skeletal dysplasia Fetal hypokinesis Tumours and other syndromes Chest: Congenital diaphragmatic hernia Lymphatic neck (cystic hygroma) Gastrointestinal Urinary tract cardiovascular chromosomal hematologic
cardiovascular non- immune fetal hydrops causes and associations? (2)
- supraventricular tachycardia
- vein of galen malformation
chromosomal non- immune fetal hydrops causes and associations? (5)
- turners syndromes
- trisomy 21, 18, 13
- triplody
What is fetal akinesia deformation sequence characterized by (6)?
- decreased fetal movement (fetal akinesia)
- IUGR
- multiple joint contractures (arthrogryposis)
- facial anomalies
- pulmonary hypoplasia
- developmental abnormalities
Fetal akinesia deformation sequence prognosis?
- 30% of affected individuals are stillborn
- many liveborn infants survive only a short time due to complications of pulmonary hypoplasia
FADS (Fetal akinesia deformation sequence) inheritence?
- may be inherited in an autosomal recessive manner
- may be caused by matations in the RAPSN or DOK7 genes
