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amnion bands
fibrous mesodermic bands which emenate from the chorionic side of the amnion, they entrap fetal parts and can cause lymphodema, amputationh, or slash defects
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amniotic sheets
are believed to be caused by uterine scars, or synechiae, from previous instrumentation used in the uterus. the expanding membranes encounter the scar and wrap arount it. do not place the fetus at a risk
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where is the amniotic fluid produced from
by the umbilical cord, the membranes, lungs, skin, and kidneys
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when does production of urine and fetal swallowing begin
8 - 11 weeks of gestation
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the amniotic fluid is regulated by
directly related to kidney function. regulated by swallowing and urine production
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amniotic fluid volume
increases 25ml from 11th to 15th week
increases by 50ms from 15th to 28th wk
doesn't change significantly in last trimester
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sonographic signs of polyhydramnios
obvious discrepency between size of fetus, size of uterus, amount of fluid
appearance of freely floating fetus
accentuated fetal anatomy due to increased fluid
AFI equal to or greater than 20cm
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maternal conditions associated with polyhydramnios
pregnancy induced hypertension
preterm labor
postpartum hemorrhage
diabetes
fetal macrosomia
Rh isoimmunization
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what is associated with oligohydramnios
congenital anomalies
IUGR
post term pregnancy
ruptured membranes
iatrogenesis
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amniotic sheets are believed to be caused by
uterine scars
synechiae
cesarean section
episodes of endometritis
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syndactylism
most likely a result of amniotic band
two or more digits fused together
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amniotic fluid index (AFI)
used most frequently for evaluating fluid volume at different intervals of pregnancy
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subjective assessment
visual (eye-ball) assessment of the fluid, the lie of the fetus, and position of the placenta
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single pocket assessment
maximum vertical pocket, depth of the pocket is measured at right angles to uterine contour
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main source of amniotic production in early gestation
amniotic membrane
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twin pregnancies and AFI
have slightly lower AFI value
2 demensional pocket measurement appears to be better
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functions of amniotic fluid
cushion to protect the fetus
allows embryonic and fetal movement
prevents adherence of the amnion to the embryo
allows symetric growth
maintains constant temperature
acts as a resevoir to fetal metabolites before excretion
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gold standard for determination of AF volume
dye-dilution technique
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what technique is both valid and reproducablein the assessment of amniotic fluid
AFI
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congenital anomalies associated with polyhydrmnios
central nervous disorders
gastrointestinal
fetal hydrops
skeletal anomalies
some renal disorders
congenetal anomalies
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scars within the uterus
synechiae
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particles floating in the amniotic fluid
amniotic sheets
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using max vertical depth assessment, what is considered normal
2 - 8 cm
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polyhydramnios is defined by
greater than 2000 ml
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gestational age of post term pregnancy
42 weeks or more
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anomalies and conditions causing oligohydramnios
- IUGR
- premature rupture of membrane
- post date pregnancy
- chorionic villa sampling
- infantile polycystic kidney
- renal agenesis
- posterior urethral valve syndrome
- displastic kidney
- chromosomal abnormalities
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fetal face - sonographic views and what you see different planes
true coronal - maxilla and orbits
longitudinal - nasal bones, soft tissue, mandible
transverse - orbital abnormalities and intraorbital distrance
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pretrusion of the brain from the cranial cavity
cephalocele
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what hinders extensive facial screenings
bone shadowing
poor fetal position
oligohydramnios
maternal obesity
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craniosynostoses
premature closure of the cranial sutures
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abnormal protrusion of the eyeball
exophthalmia
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evaluation of the nasal triad includes
?
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cleft lip and cleft palate - what didn't fuse
incomplete fusion of the maxilary prominence to the medial prominence on one side
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epignathus
teratoma located in the oropharnyx
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most common neck mass
cystic hygroma
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disorder that enfalacele, macroglosia, and viseromegally have in common
Beckwith-Wiedemann syndrome
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bridge of nose originates from
frontal nasal prominence
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probascus suggests
the nose
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optimal age for measuring nucal lucency
11-13 weeks
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most common congenital anomolie of the face
cleft lip (with or without cleft palate)
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which syndrome is underdevelopment of the jaw and cheekbone associated with
treacher collins syndrome
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elongated forehead in sag and triangular in axial plane suggests
trigonocephaly
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what syndrome are ear malformations seen in
goldenhar's syndrome
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fetal goiters
thyromegaly - enlargement of the thyroid gland
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neck teratomas
usually unilateral and usually located anteriorly
complex sonographic patterns
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ratio of congenital anomalies
1 in 600 births
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