ultrasound anomalies Flashcards
non-immune hydrops
-any causes of fetal hydrous not caused by RBC alloimmunization
-1/1500-1/3800 births
+up to 35% discovered incidentally on ultrasound
hydrops
refers to abnormal fluid buildup in 2 or more locations
ascites
fluid buildup in the abdomen
cardiovascular hydrops
- most common mechanism (17-35%)
- due to increased central venous pressure
chromosomal abnormality associated hydrops
- 7-16% of cases
- can be due to cardiac anomalies, lymphatic dysplasia abnormal myelopoeisis, etc
infection associated hydrops
- 5-7%
- can be due to anemia, anoxia, endothelial cell damage, and increased capillary permeability
- CMV, too, parvo, syphilis, herpes, rubella, coxsackie virus, leptospirosis, trypanosome cruzi
twin-twin transfusion associated hydrops
- 3-10%
- due to hyper___emia and increased central venous pressure
aneuploidy and hydrops
- monosomy X (42-67% cases)
- Trisomy 21 (23-30%)
- Trisomy 13, 18, 12
syndromic hydrops
- Noonan
- Pena-Shokeir syndrome
- myotonic dystrophy
- multiple pterygium syndrome
- skeletal dysplasias
pena-shokeir syndrome
- caused by mutations of the DOK7 and RAPSN genes
- can cause IUGR, joint contractures, pulmonary hypoplasia, and facial anomalies
- also called fetal akinesia deformation sequence
metabolic conditions and hydrops
- galactosialidosis
- GM1 gangliosidosis
- sialidosis
- MPS IVA
- Farber disease
- most of these not evaluated prenatally, as they aren’t what we worry about most with hydrops
parvo pathogenesis
affects bone marrow by preferentially infecting and replicating inside erythroid cells
-see hand and neck depression
-incredibly anemic baby with hydrops starting 2-4w post-maternal infection
+usually starts with ascites
*10% risk of fetal hydrous after maternal infection (which is usually mild)
parvo treatment
transfusion at 19-22w usually helps the fetal bone marrow recover and baby will be okay
MCA doppler
looks at blood vessel in fetal brain to show how fast blood is being shunted and therefore how anemic the fetus is
+higher doppler values indicate more significant anemia
PUBS
-used to be used to study hematocrit levels and find out if baby is anemic
-now used to transfuse following MCA
+use dense pellet of high crit irradiated O negative blood to transfuse