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MIDS 187 - OB2 + OB3 > The Fetal Abdomen (lesson 19) > Flashcards

The Fetal Abdomen (lesson 19) Flashcards

1
Q

What is pseudoascites?

A

Hypoechoic muscles in the abdomen

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2
Q

What organs and structures develop from the embryonic foregut? (4)

A

Liver, gallblader, ducts, and pancreas

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3
Q

At what week does an outgrowth develop on the caudal portion of the foregut?

A

4th wk

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4
Q

When does gut herniation resolve?

A

By 13 wks

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5
Q

When does bile secretion begin?

A

12th wk

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6
Q

Does the gallbladder reach the anterior abdominal wall?

A

No, it does not

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7
Q

The spleen is similar in echogenicity to what? And slightly less than what?

A

Similar to kidneys, less than liver

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8
Q

What can echogenicity in the stomach indicate?

A

Can be seen in third-trimester placental abruption, and can represent swallowed blood or vernix

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9
Q

What is meconium?

A

It is composed of materials the fetus ingests during gestation, and it is less echogenic than the bowel walls

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10
Q

What are the two most common abdominal wall defects?

A

Omphalocele and gastroschisis

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11
Q

What is the distinguishing feature of an umbilical hernia vs an omphalocele?

A

The position of cord insertion

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12
Q

What can cause elevated AFP levels in the amniotic fluid or maternal serum?

A

Abdominal wall malformations

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13
Q

Abdominal wall malformations DECREASE or INCREASE AFP?

A

Increase

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14
Q

What are the two types of omphalocele? Describe each type.

A

These are when the bowel does not migrate back into the abdomen and remains in the umbilical cord. Big OOMPH.

Type I - owing to a fusion failure of the lateral ectomesodermal folds

Type II - failure of the muscle, fascia, and skin to fuse

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15
Q

What is the size range for an omphalocele?

A

2-10cm

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16
Q

When there is an omphalocele present, where is it and what is it covered by?

A

Located centrally, and always covered by a membrane

17
Q

When can a sonographer definitively diagnose Omphalocele in the first tri-mester?

A

When the omphalocele is larger than the abdomen

18
Q

The presence of what two organs in the omphalocele is bad news?

A

Spleen or heart

19
Q

How large is gastrochisis?

A

2-4cm

20
Q

What substances can mum use to put baby at risk for gastrochisis?

A

Nicotine or cocaine

21
Q

Does gastrochisis cause a raise in AFP?

A

Yes, due to bowel direct contact with the amniotic fluid, doubles in comparison to omphalocele

22
Q

Does an omphalocele cause a rise in AFP?

A

Yes, but not as high as gastrochisis

23
Q

Diabetic mothers and macrosomic fetuses have what size of liver?

A

Large

24
Q

How do liver calcifications occur in the fetsuses?

A

Intrauterine infections, especially TORCH infections, and toxoplasmosis and herpes

25
Q

If the sonographer thinks a fetus has gallstones, what else could it be?

A

Tumefactive sludge or thickened bile

26
Q

Is esophageal atresia male or female predominant?

A

Male

27
Q

What can cause an absence of stomach fluid?

A

Oligiohydramnios and stress of nonimmune hydrops

28
Q

At what weeks should you be concerned for a consistently empty or small stomach?

A

18 wks

29
Q

What artery does the bowel twist around in midgut volvulus?

A

SMA

30
Q

What side does gastrochisis usually occur on?

A

Right side

31
Q

What is a symptom of midgut volvulus?

A

Bilious vomiting

32
Q

What sign is associated with midgut volvulus? (think dishwasher)

A

Whirlpool sign

33
Q

What is duodenal atresia?

A

The failure of the duodenum to change from a solid cord of tissue to a tube

34
Q

What are the 3 duodenal recanalization anomalies?

A

Duodenal diaphragm or web, results in stenosis
Solid cord with atresia
Segmental or partial absence of the duodenum

35
Q

Duodenal atresia is most commonly associated with what?

A

Trisomy 21

36
Q

When is echogenic bowel a concern?

A

When it is greater than the echogenicity of nearby fetal bones

37
Q

What is the most common echogenic mass in the fetal abdomen?

A

Echogenic bowel

38
Q

What are five differential diagnoses with increased bowel echogenicity?

A
  • Congenital fetal infections (cytomegalovirus)
  • Chromosomal abnormalities such as triploidy and trisomy 21, 18, 13
  • Mesenteric ischemia
  • Meconium ileus
  • Swallowed blood from intra-amniotic bleeding
39
Q

What is the membrane that omphaloceles are covered by?

A

Peritoneum/amnion

MIDS 187 - OB2 + OB3 (8 decks)

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