Amniotic Fluid

Question 1

Amniotic fluid is produced by the ___ of fluid across the placenta prior to 19 weeks.

Answer 1

transudation

Question 2

After 19 weeks, ____ ____ is produced by the fetal kidneys, tissues, skin, and fetal membranes.

Answer 2

amniotic fluid

Question 3

Amniotic fluid is introduced to the GI tract by _____.

Answer 3

swallowing

Question 4

Name the 4 functions of amniotic fluid.

Answer 4

• Protective cushion for fetus
• Equalization of pressure and temperature
• Reservoir for fetal metabolites
• Essential for the development of fetal lungs

Question 5

Sonographically, amniotic fluid should be ___.

Answer 5

anechoic

Question 6

Sonographically in the third trimester you might see ___ or ___ ___ floating in the amniotic fluid.

Answer 6

vernix, cellular debris

Question 7

Prior to 19 weeks, the ___ ___ ___ of fluid is measured.

Answer 7

largest vertical pocket

Question 8

Make sure there is no ___ ___ or ___ ___ in your measurement of any fluid pocket. Largest vertical pocket normal range is ____ cm of fluid.

Answer 8

fetal cord, fetal parts

2-10

Question 9

After 19 weeks the amniotic fluid index (AFI) is measured in ___ quadrants, which are added together and should range from ___ cm of fluid.

Answer 9

four; 5-25

Question 10

Amniotic fluid increases until the ___ week and then slowly decreases.

Answer 10

28th

Question 11

Define oligohydramnios.

Answer 11

abnormally decreased amount of amniotic fluid

Question 12

Name the DRIPPP causes of oligohydramnios.

Answer 12

D- Demise
R- Renal abnormalities
I-IUGR
P- Post dates >40 weeks
P- Premature rupture of membranes (PROM)
P- Preeclampsia/eclampsia

Question 13

Define ahydramnios.

Answer 13

absence of any amniotic fluid

Question 14

Define polyhydramnios.

Answer 14

abnormally increased amount of amniotic fluid which can be acute or chronic

Question 15

What are the three degrees of polyhydramnios?

Answer 15

Mild- vertical pocket 8-12 cm
Moderate- vertical pocket 12-16 cm
Severe- vertical pocket >16cm

Question 16

What is eclampsia? What is preeclampsia? Explain the difference.

Answer 16

Preeclampsia is a condition in which the mother develops hypertension during pregnancy. Eclampsia is diagnosed after the hypertensive mother experiences a seizure.

Question 17

What is an amniocentesis?

Answer 17

a method of retrieving amniotic fluid to send to the lab for analysis- a needle is placed into the uterine cavity under US guidance

Question 18

The rate of complications for an amniocentesis is ___ and complications can include ___, ____, and ___.

Answer 18

.5%

pregnancy loss, infection, complete loss of fluid

Question 19

There are two tests performed with amniotic fluid in the lab. What are they called and what do they test for?

Answer 19

LS Ratio (lethecin to sphingomyelin ratio)-- a ratio of greater than 2 to 1 indicates respiratory distress syndrome will be unlikely. This means that the fetal lungs are mature enough for delivery.
PG (Phosphatidylglycerol)-- this appears within the amniotic fluid at the time of fetal lung maturity (around 35 weeks) so it is indicative of lung maturity.

Question 20

There are many causes of maternal polyhydramnios. Name two.

Answer 20

gestational diabetes

Rh incompatibility

Question 21

There are many causes of fetal polyhydramnios. Be familiar with these —->

Answer 21

CNS anomalies, GI anomalies such as duodenal or intestinal atresia, facial clefts or masses, fetal hydrops, twin twin transfusion, sacrococcygeal teratoma, skeletal dysplasia