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36 Cards in this Set

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  • Back
Amniotic fluid is primarily produced from _______in the first trimester and ____in the second and third trimester.
1. Chorioamnion perfusion
2. Fetal Kidneys
Name the seven functions of amniotic fluid.
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
In the first and second trimester amniotic fluid will vary depending on
Gestational weeks or age
The normal range of amniotic fluid in the third trimester is______
8-22 cm (AFI)
A visual survey of the entire uterine cavity should be performed for a __________ __________ of amniotic fluid.
SUBJECTIVE ASSESSMENT
What are the sonographic visual limitations in the presence of decreased fluid?
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
Sonographic findings of Polyhydramnios
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
Describe the procedure used to obtain AFI
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
Some of the associated conditions with Polyhydramnios?
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%)
Some of the associated conditions with Oligohydramnios?
1. PROM
2. IUGR
3. Post Dates
4. Fetal Demise
5. Renal Abnormalities/Agenesis
6. Fetal Posterior Urethral Valve Syndrome
7. Chromosomal Abnormalities
What fetal conditions can be caused by Oligohydramnios?
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.
Increased maternal hydration can _____amniotic fluid volume.
Increases
Sonographic findings of amniotic band syndrome?
***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.
How do amniotic sheets and/or synechia appear on ultrasound?
***Echo dense line in uterine cavity separated from uterine wall by an echolucent space

****Appears as thick membrane, projecting into the amniotic fluid.
An umbilical cord that is considered a long cord measures ____cm?
80 cm
The fetus is encapsulated by what structure in utero?
AMNION
Thrombosis of the umbilical vessels occurs most often in which vessel?
UMBILICAL VEIN
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 __________.
OMPHALOMESENTRIC CYST or ALLANTOIC CYST
An umbilical cord consists of (4) things
2 arteries (deoxygenated blood)
1 vein (oxygenated blood)
Wharton's Jelly
Amnion
An important fact of umbilical cord abnormalities is the __________umbilical artery is absent a higher percentage of time than the _____.
1. LEFT UMBILICAL ARTERY is ABSENT
2. RIGHT UMBILICAL ARTERY
Associated Abnormalities of a 2 Vessel Cord
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
When scanning the umbilical cord, the use of color flow can be helpful in identifying....
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
Define and Sonographically describe an ALLANTOIC CYST.
Allantoic cyst is a dilation of the remnant embryonic allatonic duct.

Ultrasonic Appearance: usually small, located within cord away from fetal abdomen.
Define and Sonographically describe OMPHALOMESENTERIC DUCT CYST.
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
How does an umbilical vein thrombosis appear sonographically?
1. ANEURYSMAL DILATION
2. Increased Echogencity of Vessel Luman
3. Absence of Doppler signal/Color Flow
4. Presence of Non-immune fetal hydrops
What maternal associated conditions are seen with Umbilical vein thrombosis?
Maternal Diabetes
Maternal Phlebitis
Maternal Arteritis
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 _______, _____, _____.
1. Short Umbilical Cord
2. Limb-body
3. Wall complex
Limb-body wall complex is a _________condition for/to the fetus.
LETHAL
What is a false knot?
The folding of vessels which are longer than the covering membrane/simple dilation of vessels.
Define Nuchal Cord
Umbilical cord wrapped around fetal neck
What can cause a true knot in the umbilical cord?
1. Excessive fetal movement
2. Long cord
3. Presence of polyhydramnios
An umbilical cord knot may become ____and _____the umbilical vessels.
1. Tightened
2. Occluded
Describe and draw a battledore or marginal placenta cord insertion.
Occurs when cord inserts into the edge or margin of the placenta.

See pg 11
Describe and draw a membranous (velamentous) cord insertion.
Cord inserts in membrane before entering placenta.

See pg 12
List associated fetal conditions and associated risks of a velementous cord insertion.
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
What do these structures become after
baby is delivered.?

1. Umbilical Vein
2. Umbilical Arteries
3. Ductus Venous
4. Foramen Ovale
5. Ductus Arteriosis
1. Ligamentum Teres
2. Medial Umbilical Ligament
3. Ligamentum Venosum
4. Closes
5. Ligamentum Arterosis