Test Review Vi Fetal Circulation\, Umbilical Cord And Amniotic Fluid

Front 1

Amniotic fluid is primarily produced from _______in the first trimester and ____in the second and third trimester.

Back 1

1. Chorioamnion perfusion
2. Fetal Kidneys

Front 2

Name the seven functions of amniotic fluid.

Back 2

1. Cushions to protect fetus
2. Allows free movement of fetus
3. Prevents adherence of amnion to the embryo or fetus
4. Maintains fetal temperature
5. Allows symmetric growth
6. Source of fetal nutrition
7. Essential for lung development

Front 3

In the first and second trimester amniotic fluid will vary depending on

Back 3

Gestational weeks or age

Front 4

The normal range of amniotic fluid in the third trimester is______

Back 4

8-22 cm (AFI)

Front 5

A visual survey of the entire uterine cavity should be performed for a __________ __________ of amniotic fluid.

Back 5

SUBJECTIVE ASSESSMENT

Front 6

What are the sonographic visual limitations in the presence of decreased fluid?

Back 6

1. Fetus is difficult to visualize
2. Fetus appears crowded
3. No clear visible pocket of fluid
4. Pocket of fluid is less than 2 cm

Front 7

Sonographic findings of Polyhydramnios

Back 7

1. Fetus limbs and trunk is surrounded by fluid
2. Fetus anatomy is easily seen and scanned
3. Overall all fluid appearance is increased
4. AFI is greater than 8 cm

Front 8

Describe the procedure used to obtain AFI

Back 8

1. The maternal cavity is divided into 4 quadrants,
2. Starting at midline horizontal and vertical at the umbilicus.
3. Each section a pocket of fluid is identified by holding the transducer in the sagittal plane (perpendicular) toward table or floor.
4. Measurement of the fluid is vertical without having any limbs or cord
5. Add each pocket of fluid together to get the sum index

Front 9

Some of the associated conditions with Polyhydramnios?

Back 9

1. Fetal Upper Gastrointestinal Obstructions
2. Fetal Hydrops
3. Renal Disorders
4. Maternal Diabetes
5. Skeletal Anomalies
6. CNS Disorders
7. Cystichygroma
8. Placenta Abnormalities
9. Maternal Infections
10. Idiopathic (60%)

Front 10

Some of the associated conditions with Oligohydramnios?

Back 10

1. PROM
2. IUGR
3. Post Dates
4. Fetal Demise
5. Renal Abnormalities/Agenesis
6. Fetal Posterior Urethral Valve Syndrome
7. Chromosomal Abnormalities

Front 11

What fetal conditions can be caused by Oligohydramnios?

Back 11

1. Clubbing of hands and feet
2. Dolichocephaly
3. Pulmonary Hypoplasia
4. Hip Displacement

****Umbilical Doppler- Restricted blood flow due to increased pressure on umbilical cord from lack of fluid.

Front 12

Increased maternal hydration can _____amniotic fluid volume.

Back 12

Increases

Front 13

Sonographic findings of amniotic band syndrome?

Back 13

***Strand like structures free floating or extending through uterine cavity and attached uterine wall.

****Various fetal malformations involving the limbs, cranio-facial region, fetal trunk by entanglements and subsequent compression of fetus.

Front 14

How do amniotic sheets and/or synechia appear on ultrasound?

Back 14

***Echo dense line in uterine cavity separated from uterine wall by an echolucent space

****Appears as thick membrane, projecting into the amniotic fluid.

Front 15

An umbilical cord that is considered a long cord measures ____cm?

Back 15

80 cm

Front 16

The fetus is encapsulated by what structure in utero?

Back 16

AMNION

Front 17

Thrombosis of the umbilical vessels occurs most often in which vessel?

Back 17

UMBILICAL VEIN

Front 18

Smooth enlargement, Anechoic Mass arises from the umbilical cord near the site of fetal insertion.

Doppler evaluation fails to demonstrate blood flow within the mass.

Most likely diagnosis is ____________or __________.

Back 18

OMPHALOMESENTRIC CYST or ALLANTOIC CYST

Front 19

An umbilical cord consists of (4) things

Back 19

2 arteries (deoxygenated blood)
1 vein (oxygenated blood)
Wharton's Jelly
Amnion

Front 20

An important fact of umbilical cord abnormalities is the __________umbilical artery is absent a higher percentage of time than the _____.

Back 20

1. LEFT UMBILICAL ARTERY is ABSENT
2. RIGHT UMBILICAL ARTERY

Front 21

Associated Abnormalities of a 2 Vessel Cord

Back 21

Congential 20-50%

1. Cardiac Defects
2. Genitourinary Anomalies
3. Skeletal Anomalies
4. Abdominal Wall Defects
5. Diaphragmatic Hernia
6. CNS Disorders

CHROMOSOMAL ABNORMAILITIES

****Trisomy 13, 18, 21
****Triploidy

INCREASED IUGR

Front 22

When scanning the umbilical cord, the use of color flow can be helpful in identifying....

Back 22

1. No of vessels in a cord
2. Knot in the cord
3. Umbilical vessel THROMBOSIS
4. Umbilical Cord Cyst
5. Nuchal Cord
6. Umbilical Vein Varix
7. Placental Cord Insertion

Front 23

Define and Sonographically describe an ALLANTOIC CYST.

Back 23

Allantoic cyst is a dilation of the remnant embryonic allatonic duct.

Ultrasonic Appearance: usually small, located within cord away from fetal abdomen.

Front 24

Define and Sonographically describe OMPHALOMESENTERIC DUCT CYST.

Back 24

1. Dilation of the remnant embryonic omphalomesenteric ducts.
2. Seen after 16 weeks
3. Located close to fetus
4, Can measure up to 6 cm
5. Seen females more than males 5:3 ratio

Front 25

How does an umbilical vein thrombosis appear sonographically?

Back 25

1. ANEURYSMAL DILATION
2. Increased Echogencity of Vessel Luman
3. Absence of Doppler signal/Color Flow
4. Presence of Non-immune fetal hydrops

Front 26

What maternal associated conditions are seen with Umbilical vein thrombosis?

Back 26

Maternal Diabetes
Maternal Phlebitis
Maternal Arteritis

Front 27

An anomaly that is associated with a _______umbilical cord and sonographically the fetus appears stuck to the placenta with a visible abdominal wall defect is _______, _____, _____.

Back 27

1. Short Umbilical Cord
2. Limb-body
3. Wall complex

Front 28

Limb-body wall complex is a _________condition for/to the fetus.

Back 28

LETHAL

Front 29

What is a false knot?

Back 29

The folding of vessels which are longer than the covering membrane/simple dilation of vessels.

Front 30

Define Nuchal Cord

Back 30

Umbilical cord wrapped around fetal neck

Front 31

What can cause a true knot in the umbilical cord?

Back 31

1. Excessive fetal movement
2. Long cord
3. Presence of polyhydramnios

Front 32

An umbilical cord knot may become ____and _____the umbilical vessels.

Back 32

1. Tightened
2. Occluded

Front 33

Describe and draw a battledore or marginal placenta cord insertion.

Back 33

Occurs when cord inserts into the edge or margin of the placenta.

See pg 11

Front 34

Describe and draw a membranous (velamentous) cord insertion.

Back 34

Cord inserts in membrane before entering placenta.

See pg 12

Front 35

List associated fetal conditions and associated risks of a velementous cord insertion.

Back 35

Associated fetal conditions

1. cord prolapse if cord insertion is near internal os
2. Thrombosis
3. Cord rupture during delivery
4. Vasa Previa

Associated Fetal Condition

1. IUGR
2 Premature Birth

Front 36

What do these structures become after
baby is delivered.?

1. Umbilical Vein
2. Umbilical Arteries
3. Ductus Venous
4. Foramen Ovale
5. Ductus Arteriosis

Back 36

1. Ligamentum Teres
2. Medial Umbilical Ligament
3. Ligamentum Venosum
4. Closes
5. Ligamentum Arterosis