Ob CH 61

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Author:
rbeacr
ID:
150678
Filename:
Ob CH 61
Updated:
2012-04-28 12:11:22
Tags:
Fetal Anterior Abd wall
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Description:
Fetal Anterior Abd wall
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  1. midgut returns to abdomen by
    • 12week
    • 7-12
  2. three layers of embryo disk
    • ectoderm
    • endoderm
    • mesoderm
  3. which umbilical vein atrophies
    • right
    • 7th week
  4. three most common wall defects
    • gastrochisis
    • omphalocele- umb hernia
  5. prevelence of omphalocele
    1 in 4000
  6. prevalence of gastroschisis
    12 per 10,000
  7. which omp or gast has membrane
    omph
  8. gast is found on which side of chord
    right
  9. what organ is almost never in gast
    liver
  10. which has associated anomolies gast or omph
    omph
  11. what is the membrane of omph
    amnion and peritoneum
  12. two types of omph
    • 1- contain liver
    • 2- bowel without liver (higher risk for aneuploidy)
  13. prognosis for omph
    • depends on defect and structures and chrom anom
    • 80% with more than one abnormality
    • without other anom 10% mortality
  14. omph sonographic features
    • involvement of umb cord
    • ascites
    • hydraminos (1/3)
    • omph may occur with hernia
    • chrom anom in 35-60% omph
  15. gastroschisis
    • umb wall defect to right of umb cord
    • herniation of bowel no membrane- can be other org (no liver)
    • thought to be consequence of right umb vein atrophy
    • 2-4cm defect
    • next to cord insertion
  16. omph or gast AFP levels higher
    gast
  17. prevelence of gast
    • 1.75-2.5 in 10,000
    • males
  18. which is more prevelent gast or omph
    omph
  19. ischemia
    • compression of mesenteric vessles or bowel torsion
    • can get gangrene bowel or perforation
  20. prognosis for uncomplicated gastrosch
    • excellent
    • surgical repair in hrs of delivery
  21. when can you detect gastroch
    • 12 weeks
    • high afp
    • free floating bowel
  22. amniotic band syndrome
    ruptue of amnion which leads to entrapment or entaglement of fetal parts by sticky chorion
  23. early entrapment amniotic band
    • craiofacial defects
    • internal malformations
  24. late entrapment amniotic band
    amputation of limb restrictions
  25. prevelance of amniotic band synd
    7.8 in 10,000
  26. beckwith- widemann syndrome
    • rare group of disorders with omphalocele, macroglossia, viseromegaly
    • can have embryonic tumors (Wilms, hepatoblastoma, neuroblastoma)

    • macrosomia
    • 3rd tri polyhydraminos
  27. bladder exstrophy
    lower structures protrude (bladder)
  28. cloacal exstrphy
    two hemibladders seperated by intestinal mucosa and are extrophied
  29. pentalogy of cantrell
    • rare cleft of distal sternum, midline ant wall, internal
    • cardiac defect
    • high or super umb omphalocele
    • mayhave heart displacement
  30. ectopic cordis
    • heart outside chest through sternum
    • cleft sternum
  31. limb body wall complex
    • death
    • large cranial defect
    • facial cleft

    • body defect (abdomen thorax limb)
    • may have scoliosis
    • when fusion of amnion and chorion- amnion doesnt cover umb cord but is a sheet cont with body and placenta
    • short cord adhered to placenta
  32. which sid more common with limb body
    left 3xs more common

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