amniotic fluid

Question 1

what is it secreted by

Answer 1

amniotic cells (which lie over the placenta) into the amniotic sac

Question 2

what happens to the amniotic fluid

Answer 2

99% water. swallowed by fetus, enters fetal circulation absorbed by intestinal villi or transudation through skin. in last 1/4 pregnancy- fetal urinary adds to it

Question 3

what is polyhydramnios

Answer 3

increased secretion amniotic fluid because of a large placenta or fetal malformation preventing the fetus from swallowing the fluid or being absorbed

Question 4

causes of polyhydramnios

Answer 4

diabetes, multiple pregnancy (large placenta); anencephaly, spina bifida, atresia of the upper GI tract (abnormalities of the fetus)

Question 5

what happens in acute polyhydramnios

Answer 5

fluid accumulates quickly. distress to mother

Question 6

signs acute polyhydramnios

Answer 6

dyspnoea, tachycardia, abdominal pain, vomiting

Question 7

what is acute most freq associated with

Answer 7

monochorionic twins

Question 8

treat acute polyhydramnios

Answer 8

remove fluid by amniocentesis

Question 9

what is chronic polyhydramnios

Answer 9

slow accumulation. symptoms similar to acute. distended uterus- feel a fluid thrill

Question 10

test in polyhydramnios

Answer 10

ultrasound

Question 11

treatment polyhydramnios

Answer 11

minor- relieved by sedation at night. amniocentesis- 500ml removed at one time. after 35 weeks- induce vaginal amniocentesis

Question 12

what is the risk of amniocentesis in poly

Answer 12

pre term labour, abruption

Question 13

why should the liquor be released slowly in treatment poly

Answer 13

prevent cord prolapse

Question 14

what is likely after treatment poly

Answer 14

PPH

Question 15

what is oligohydramnios

Answer 15

defective liquor secreting cells or in late pregnancy- renal tract malformation preventing fetal urination

Question 16

associations oligohydramnios

Answer 16

post date, renal tract malformation, following rupture of membranes

Question 17

if oligohydramnios occurs early in pregnancy what is the management

Answer 17

abortion

Question 18

if pregnancy continues in oligohydramnios what may happen

Answer 18

amniotic bands form which can damage the fetus

Question 19

test oligohydramnios

Answer 19

ultrasound

Question 20

what can oligohydramnios cause later in pregnancy

Answer 20

pulmonary hypoplasia pressure deformities- wry neck, club foot, altered shape of the skull

Question 21

what can oligohydramnios cause in labour

Answer 21

lack of amniotic fluid can lead to umbilical cord compression and fetal distress- transcervical infusion of saline into the amniotic sac