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DMS 400 OB/GYN > Class 16: Fetal ABD & Thorax Abnormalities > Flashcards

Class 16: Fetal ABD & Thorax Abnormalities Flashcards

1
Q

edema in the thorax can be ___ or ___

A

focal or diffuse

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2
Q

what is edema in the thorax associated with? (2)

A
  1. fetal hydrops
  2. nuchal fold thickening
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3
Q

the nuchal fold shouldn’t exceed ___

A

6 mm

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4
Q

what is fetal hydrops?

A

fluid builds up in fetus’ tissues & organs which lead to edema

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5
Q

another name for pleural effusion?

A

hydrothorax

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6
Q

what is pleural effusion?

A

build up of fluid between lungs & chest cavity

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7
Q

any fluid around the fetal lungs in abnormal. T/F?

A

true

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8
Q

5 causes of hydrothorax?

A
  1. immune/nonimmune fetal hydrops
  2. CHF
  3. chromosomal abnormalities
  4. cardiac masses
  5. intrathoracic lesions
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9
Q

complications of pleural effusion? (2)

A
  1. compressed lung parenchyma
  2. pulmonary hypoplasia
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10
Q

mortality % of pleural effusion?

A

50%

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11
Q

what causes pulmonary hypoplasia?

A

decreased number of lung cells & alveoli leads to decreased organ size & weight

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12
Q

what LS ratio indicates a mature lung?

A

2+

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13
Q

what is the most common cause for pulmonary hypoplasia?

A

prolonged oligohydramnios

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14
Q

what is cystic adenomatoid malformation?

A

condition where there is an increase in terminal respiratory elements in the lung that lead to cysts

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15
Q

CAM is usually bilateral. T/F?

A

false – unilateral

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16
Q

what is the most common fetal chest mass?

A

CAM

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17
Q

2 effects of cystic adenomatoid malformation?

A
  1. pulmonary hypoplasia
  2. fetal hydrops
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18
Q

what is type 1 CAM?

A

1+ large cysts replace normal lung tissue

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19
Q

what size are cysts in type 1 CAM?

A

2-10cm

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20
Q

which type of cystic adenomatoid malformation has favorable outcomes?

A

type 1

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21
Q

what is type 2 CAM?

A

multiple small cysts in the lung that are < 2cm

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22
Q

what is type 2 CAM associated with? (4)

A
  1. chromosomal abnormalities
  2. renal agenesis
  3. diaphragmatic herniation
  4. cardiac anomalies
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23
Q

what is type 3 CAM?

A

microscopic cysts in lung between 0.5-5mm

24
Q

US appearance of type 3 CAM?

A

echogenic lung lobe that is affected due to many microscopic cysts causing enhancement

25
Q

what is a diaphragmatic hernia?

A

when bowel & abdominal organs herniate into the thorax

26
Q

what causes a diaphragmatic hernia?

A

improperly fused diaphragm

27
Q

mortality rate for diaphragmatic hernia?

A

50-80% due to pulmonary hypoplasia

28
Q

2 types of diaphragmatic hernia?

A
  1. bochdalek
  2. morgagni
29
Q

what is a bochdalek diaphragmatic hernia?

A

occurs on the posterolateral portion of the left side – where left abdominal organs herniate into thorax

30
Q

where is morgagni diaphragmatic hernia located?

A

anterior

31
Q

AC measurement will be ___ with a diaphragmatic hernia

A

smaller than normal

32
Q

what causes polyhydramnios with a diaphragmatic hernia?

A

the esophagus may be compressed, leading to a narrow GIT & back up of fluid

33
Q

when can a cardiomediastinal shift occur?

A

heart may shift to the right with a bochdalek diaphragmatic hernia

34
Q

what is an ectopic cord?

A

when the heart protrudes through the thoracic wall through a cleft in the sternum

35
Q

what is fetal ascites?

A

fluid in the peritoneal cavity

36
Q

5 conditions associated with fetal ascites?

A
  1. fetal hydrops
  2. bowel perforation
  3. urinary ascites
  4. heart failure
  5. TTTS
37
Q

what is pseudoascites?

A

muscles of the abdominal wall may mimic ascites

38
Q

another name for omphalocele?

A

exomphalos

39
Q

what is an omphalocele?

A

a herniation of abdominal contents into the base of the umbilical cord

40
Q

where does an omphalocele occur?

A

at midline

41
Q

an omphalocele is covered by ___

A

amniotic sac/peritoneal sac

42
Q

lab values for omphalocele?

A

normal or slightly elevated AFP

43
Q

omphalocele is associated with other anomalies ___%

A

29-66% of the time

44
Q

what other conditions are associated with an omphalocele? (5)

A
  1. GIT
  2. heart
  3. chromosomal abnormalities (esp bowel herniation)
  4. beckwith-wiedman syndrome
  5. ascites & hydramnios
45
Q

what is gastroschisis?

A

a herniation of viscera off of midline; usually right of midline

46
Q

gastroschisis is covered by ___

A

nothing; it is exposed to amniotic fluid

47
Q

lab values of gastroschisis?

A

very high levels of AFP

48
Q

what has better prognosis? omphalocele or gastroschisis?

A

gastroschisis

49
Q

what is bladder extrophy?

A

a defect where the UB protrudes through abdominal wall

50
Q

US appearance of amniotic fluid in bladder extrophy?

A

normal

51
Q

US appearance of UB in bladder extrophy?

A

lack of visualization of urinary bladder (normal filling is every 15 min)

52
Q

what is the most common tumor in neonates?

A

sacrococcygeal teratoma

53
Q

what is sacrococcygeal teratoma made of?

A

3 germ cell layers

54
Q

is sacrococcygeal teratoma benign or malignant?

A

can be both

55
Q

US appearance of sacrococcygeal teratoma?

A

mass extending from sacrum with intact spine; solid or mixed interspersed with cystic components

56
Q

what is limb-body wall complex?

A

severe form of amniotic band syndrome that is not compatible with life – defects are all over the body

DMS 400 OB/GYN (21 decks)

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