ch 57 amniotic fluid membranes and hydrops

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rbeacr
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139529
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ch 57 amniotic fluid membranes and hydrops
Updated:
2012-03-04 14:00:42
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57 amnioic fluid membranes hydrops
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amniotic fluid, membranes, and hydrops
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  1. keritinization occurs
    • 24-26 weeks
    • water can go through fetal skin after
  2. urine production startes
    • 8-11 weeks (9weeks)
    • doesnt contribute to amniotic fluid until 18-20wks- most of amn volume in second half of preg
  3. amniotic fluid functions
    • cushion to protect fetus
    • embyonic movements
    • prevents adherence of amnion
    • symmetrical growth
    • constant temp
    • resoviour for metabolites before excretion by maternal system
  4. lung development
    • depends on amniotic fluid
    • bathe lungs in horomone to mature
    • litte fluid- hypoplastic lungs
  5. amn fluid increases until
    33 weeks
  6. subjective af asessment
    • eye-ball it
    • experienced sonographer
  7. AFI
    • amniotic fluid index
    • 4 quadrants- measure vertical legnth
    • normal 10-20 cm
    • low below 5 oligo
    • high above 20 poly
  8. single pocket
    • maximum vertical pocket
    • greater than 1cm
    • less than 2 is oligo
    • 2-8cm normal
    • 8+ poly
  9. two diameter pocket
    • largest pocket
    • horizontal and vertical
    • multiplied together for single volume
    • 15-50cm
  10. twin preg afi
    • lower median than single
    • 2 diameter pocket is better indicator of oligo than largest single
    • largest vertical bets for find poly
  11. polyhydraminos
    • 25%maternal 25%fetal 25%idiopathic
    • greater than 2000ml
    • cns disorders or gi problems (blocked espoph)
    • maternal diabetes
    • obesity
    • Rh incompatibility
    • syphlis
    • anemia
    • cardiac failure
  12. oligohydraminos
    • little fluid
    • congent anomolies
    • iugr
    • postterm preg
    • ruptured membranes
    • procedures (iatrogenesis)
  13. maternal htn, preeclampsia, cardia or renal disease
  14. biophysical profile
    • BPP
    • amniotic fluid volume
    • breathing movements
    • fetal tone
    • gross body movements
  15. amniotic band syndrome
    • anormality in membranes
    • fetal malformation
    • rupture of amnion early in preg
    • tanglled in fibrous bands from chorion
    • strong suggested when gastroschisis of liver
    • chorion is sticky
  16. amniotic sheets
    • from synechiae from previous instrumentation , c section or endometritis
    • thicker than amniotic bands
    • do not cause fetal malformations
  17. hydrops fetalis
    • disparity between amount of fluid produced and absobed
    • accumulation of fluid in fetus
  18. anasarca
    head to toe edema
  19. immune hydrops fetalis
    • IHF
    • Rh isoimmunization
    • high morbidity
  20. nonimmune hydrops fetalis
    • NIHF
    • cardiac insufficiency
    • fetal tumors
    • hypoproteinuria
    • poor prognosis

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