Module 14 : Amniotic Fluid Flashcards Preview

Ob/Gyne 2 > Module 14 : Amniotic Fluid > Flashcards

Flashcards in Module 14 : Amniotic Fluid Deck (25)
Loading flashcards...
1
Q

what are 6 things that amniotic fluid provides

A
  • protection from physical trauma
  • allows for growth
  • provides a stable temperature for the fetus
  • enables normal development of bones and muscle
  • aids in maturation of lungs and GI tract
  • may provide some nutrients
2
Q

what produces amniotic fluid in the first trimester

A
  • chorion frondosum
  • membranes
  • skin
  • GU tract and lungs
    MOSTLY FROM CHORIOAMNIONIC MEMBRANES
3
Q

what produces amniotic fluid in the first trimester

A
  • produced primarily by kidneys

- small amount by lungs

4
Q

how is the fluid removed

A
  • fetus drinks it
5
Q

how does the fluid move through the fetus

A
  • fetus swallows it
  • fluid goes through fetal GI tract and absorbed by the small bowel
  • kidneys excrete urine back into the amniotic cavity
6
Q

what abnormality in fetus will cause polyhydramnious

A
  • any high GI obstruction

- swallowing deficits

7
Q

what abnormality in fetus will cause oligohydramnious

A
  • bilateral GU obstruction

- renal agenisis

8
Q

is evaluating amniotic fluid subjective ?

A
  • yes
9
Q

what are the 2 measurements of amniotic fluid

A
  • maximum vertical pocket

- AFI

10
Q

how is the maximum vertical pocket measured and what measurement indicated poly

A
  • deepest pocket that is free of umbilical cord or fetal parts
  • 8 cm
11
Q

how is the AFI done

A
  • largest pocket in each quadrant is measured anterior to posterior then added together
12
Q

what the normal range for AFI

A

5-25cm

< 5 = oligo
> 25 = poly

13
Q

when is the maximum level of amniotic fluid and when does it start to diminish

A
  • may reached at 22 weeks and maintain until 32 weeks

- at 34 weeks begins to diminish

14
Q

what is the minimum amount of fluid required fro fetal breathing

A

1cm

15
Q

how would one determine if there was poly subjectively

A
  • fetus floats freely in amniotic fluid
    (should be touching uterus on at least 2 sides of uterus)
  • > 8cm pocket
  • > 25cm AFI
16
Q

what are 7 causes of poly

A
  • diabetes mellitus
  • CNS
  • high GI obstruction
  • hydrops
  • TTTS
  • musculoskeletal dysplasias
  • idiopathic
17
Q

what is the most common cause of poly

A
  • diabetes mellitus

- can effect kidneys of baby causing increased urine production

18
Q

what 4 things can result from poly

A
  • maternal abdominal pain
  • maternal SOB
  • PROM
  • preterm delivery
19
Q

what are two methods of treating poly maternally

A
  • amniocentesis

- drugs like INDOMETHACIN

20
Q

why is amniocentesis performed and what are the 3 complications

A
  • reduce fluid until largest pocket is less than 8 cm

- PROM, preterm delivery, infection

21
Q

what does indomethacin do and what is a complication from it when are they administered

A
  • prostaglandin inhibitor which decreases the fetal urine output
  • premature closure of ductus arteriosis
  • only used early in pregnancy not near term
22
Q

what are two things proving oligo

A
  • AFI < 5cm

- largest pocket < 2x2cm

23
Q

how do we calculate first trimester oligohydramnious

A

5 1/2 - 9 weeks

MSD(mm) - CRL(mm) < 5mm

24
Q

7 causes of oligo

A
  • PROM
  • IUGR
  • renal anomaly
  • post dates
  • abruption
  • TTTS (donor twin)
  • idiopathic
25
Q

what three things may result from oligo

A
  • limb anomalies (club feet)
  • pulmonary hypoplasia
  • restricted growth