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Amniocentesis is a medical procedure used primarily in the prenatal diagnosis of genetic conditions. It has other uses such as in the assessment of infection and fetal lung maturity. Prenatal diagnostic testing, which includes amniocentesis, is necessary to conclusively diagnose the majority of genetic disorders, with amniocentesis being the gold-standard procedure after 15 weeks' gestation.
Fetal distress, also known as non-reassuring fetal status, is a condition during pregnancy or labor in which the fetus shows signs of inadequate oxygenation. Due to its imprecision, the term "fetal distress" has fallen out of use in American obstetrics. The term "non-reassuring fetal status" has largely replaced it. It is characterized by changes in fetal movement, growth, heart rate, and presence of meconium stained fluid.
Prenatal testing is a tool that can be used to detect some birth defects at various stages prior to birth. Prenatal testing consists of prenatal screening and prenatal diagnosis, which are aspects of prenatal care that focus on detecting problems with the pregnancy as early as possible. These may be anatomic and physiologic problems with the health of the zygote, embryo, or fetus, either before gestation even starts or as early in gestation as practicable. Screening can detect problems such as neural tube defects, chromosome abnormalities, and gene mutations that would lead to genetic disorders and birth defects, such as spina bifida, cleft palate, Down syndrome, trisomy 18, Tay–Sachs disease, sickle cell anemia, thalassemia, cystic fibrosis, muscular dystrophy, and fragile X syndrome. Some tests are designed to discover problems which primarily affect the health of the mother, such as PAPP-A to detect pre-eclampsia or glucose tolerance tests to diagnose gestational diabetes. Screening can also detect anatomical defects such as hydrocephalus, anencephaly, heart defects, and amniotic band syndrome.
Polyhydramnios is a medical condition describing an excess of amniotic fluid in the amniotic sac. It is seen in about 1% of pregnancies. It is typically diagnosed when the amniotic fluid index (AFI) is greater than 24 cm. There are two clinical varieties of polyhydramnios: chronic polyhydramnios where excess amniotic fluid accumulates gradually, and acute polyhydramnios where excess amniotic fluid collects rapidly.
Oligohydramnios is a medical condition in pregnancy characterized by a deficiency of amniotic fluid, the fluid that surrounds the fetus in the abdomen, in the amniotic sac. It is typically diagnosed by ultrasound when the amniotic fluid index (AFI) measures less than 5 cm or when the single deepest pocket (SDP) of amniotic fluid measures less than 2 cm. Amniotic fluid is necessary to allow for normal fetal movement, lung development, and cushioning from uterine compression. Low amniotic fluid can be attributed to a maternal, fetal, placental or idiopathic cause and can result in poor fetal outcomes including death. The prognosis of the fetus is dependent on the etiology, gestational age at diagnosis, and the severity of the oligohydramnios.
Twin-to-twin transfusion syndrome (TTTS), also known as feto-fetal transfusion syndrome (FFTS), twin oligohydramnios-polyhydramnios sequence (TOPS) and stuck twin syndrome, is a complication of monochorionic multiple pregnancies in which there is disproportionate blood supply between the fetuses. This leads to unequal levels of amniotic fluid between each fetus and usually leads to death of the undersupplied twin and, without treatment, usually death or a range of birth defects or disabilities for a surviving twin, such as underdeveloped, damaged or missing limbs, digits or organs, especially cerebral palsy.
Placental abruption is when the placenta separates early from the uterus, in other words separates before childbirth. It occurs most commonly around 25 weeks of pregnancy. Symptoms may include vaginal bleeding, lower abdominal pain, and dangerously low blood pressure. Complications for the mother can include disseminated intravascular coagulopathy and kidney failure. Complications for the baby can include fetal distress, low birthweight, preterm delivery, and stillbirth.
Large for gestational age (LGA) is a term used to describe infants that are born with an abnormally high weight, specifically in the 90th percentile or above, compared to other babies of the same developmental age. Macrosomia is a similar term that describes excessive birth weight, but refers to an absolute measurement, regardless of gestational age. Typically the threshold for diagnosing macrosomia is a body weight between 4,000 and 4,500 grams, or more, measured at birth, but there are difficulties reaching a universal agreement of this definition.
Prelabor rupture of membranes (PROM), previously known as premature rupture of membranes, is breakage of the amniotic sac before the onset of labor. Women usually experience a painless gush or a steady leakage of fluid from the vagina. Complications in the baby may include premature birth, cord compression, and infection. Complications in the mother may include placental abruption and postpartum endometritis.
Fetal surgery also known as antenatal surgery, prenatal surgery, is a growing branch of maternal-fetal medicine that covers any of a broad range of surgical techniques that are used to treat congenital abnormalities in fetuses who are still in the pregnant uterus. There are three main types: open fetal surgery, which involves completely opening the uterus to operate on the fetus; minimally invasive fetoscopic surgery, which uses small incisions and is guided by fetoscopy and sonography; and percutaneous fetal therapy, which involves placing a catheter under continuous ultrasound guidance.
Postterm pregnancy is when a woman has not yet delivered her baby after 42 weeks of gestation, two weeks beyond the typical 40-week duration of pregnancy. Postmature births carry risks for both the mother and the baby, including fetal malnutrition, meconium aspiration syndrome, and stillbirths. After the 42nd week of gestation, the placenta, which supplies the baby with nutrients and oxygen from the mother, starts aging and will eventually fail. Postterm pregnancy is a reason to induce labor.
An amniotic fluid embolism (AFE) is a life-threatening childbirth (obstetric) emergency in which amniotic fluid enters the blood stream of the mother, triggering a serious reaction which results in cardiorespiratory collapse and massive bleeding (coagulopathy). The rate at which it occurs is 1 instance per 20,000 births and it comprises 10% of all maternal deaths.
Maternal–fetal medicine (MFM), also known as perinatology, is a branch of medicine that focuses on managing health concerns of the mother and fetus prior to, during, and shortly after pregnancy.
Percutaneous umbilical cord blood sampling (PUBS), also called cordocentesis, fetal blood sampling, or umbilical vein sampling is a diagnostic genetic test that examines blood from the fetal umbilical cord to detect fetal abnormalities. Fetal and maternal blood supply are typically connected in utero with one vein and two arteries to the fetus. The umbilical vein is responsible for delivering oxygen rich blood to the fetus from the mother; the umbilical arteries are responsible for removing oxygen poor blood from the fetus. This allows for the fetus’ tissues to properly perfuse. PUBS provides a means of rapid chromosome analysis and is useful when information cannot be obtained through amniocentesis, chorionic villus sampling, or ultrasound ; this test carries a significant risk of complication and is typically reserved for pregnancies determined to be at high risk for genetic defect. It has been used with mothers with immune thrombocytopenic purpura.
An asynclitic birth or asynclitism are terms used in obstetrics to refer to childbirth in which there is malposition of the head of the fetus in the uterus, relative to the birth canal. Asynclitic presentation is different from a shoulder presentation, in which the shoulder is presenting first. Many babies enter the pelvis in an asynclitic presentation, and most asynclitism corrects spontaneously as part of the normal birthing process.
Velamentous cord insertion is a complication of pregnancy where the umbilical cord is inserted in the fetal membranes. It is a major cause of antepartum hemorrhage that leads to loss of fetal blood and associated with high perinatal mortality. In normal pregnancies, the umbilical cord inserts into the middle of the placental mass and is completely encased by the amniotic sac. The vessels are hence normally protected by Wharton's jelly, which prevents rupture during pregnancy and labor. In velamentous cord insertion, the vessels of the umbilical cord are improperly inserted in the chorioamniotic membrane, and hence the vessels traverse between the amnion and the chorion towards the placenta. Without Wharton's jelly protecting the vessels, the exposed vessels are susceptible to compression and rupture.
An obstetric labor complication is a difficulty or abnormality that arises during the process of labor or delivery.
Amnioinfusion is a method in which isotonic fluid is instilled into the uterine cavity.
The anomaly scan, also sometimes called the anatomy scan, 20-week ultrasound, or level 2 ultrasound, evaluates anatomic structures of the fetus, placenta, and maternal pelvic organs. This scan is an important and common component of routine prenatal care. The function of the ultrasound is to measure the fetus so that growth abnormalities can be recognized quickly later in pregnancy, to assess for congenital malformations and multiple pregnancies, and to plan method of delivery.
Epignathus is a rare teratoma of the oropharynx. Epignathus is a form of oropharyngeal teratoma that arises from the palate and, in most cases, results in death. The pathology is thought to be due to unorganized and uncontrolled differentiation of somatic cells leading to formation of the teratoma; sometimes it is also referred to as "fetus-in-fetu", which is an extremely rare occurrence of an incomplete but parasitic fetus located in the body of its twin. This tumor is considered benign but life-threatening because of its atypical features and high risk of airway obstruction, which is the cause of death in 80-100% of the cases at the time of delivery.
References
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- ↑ Jelin, Angie C.; Sagaser, Katelynn G.; Forster, Katherine R.; Ibekwe, Tochi; Norton, Mary E.; Jelin, Eric B. (2020-02-19). "Etiology and management of early pregnancy renal anhydramnios: Is there a place for serial amnioinfusions?". Prenatal Diagnosis. 40 (5): 528–537. doi: 10.1002/pd.5658 . ISSN 0197-3851. PMC 7780162 . PMID 32003482.
- ↑ Atkinson, Meredith A.; Jelin, Eric B.; Baschat, Ahmet; Blumenfeld, Yair J.; Chmait, Ramen H.; O'Hare, Elizabeth; Moldenhauer, Julie S.; Zaretsky, Michael V.; Miller, Russell S.; Ruano, Rodrigo; Gonzalez, Juan M.; Johnson, Anthony; Mould, W. Andrew; Davis, Jonathan M.; Hanley, Daniel F. (2022). "Design and Protocol of the Renal Anhydramnios Fetal Therapy (RAFT) Trial". Clinical Therapeutics. 44 (8): 1161–1171. doi: 10.1016/j.clinthera.2022.07.001 . ISSN 0149-2918. PMC 9847373 . PMID 35918190.
- ↑ Riska, Anggun Hatika; Yusrawati, Yusrawati; Efrida, Efrida (2022-09-02). "Korelasi Asupan Vitamin C dan vitamin D dengan Kadar Timbal Ibu Hamil Preeklamsia". Indonesian Journal of Obstetrics & Gynecology Science. 5 (2): 284–292. doi: 10.24198/obgynia/v5n2.430 . ISSN 2615-496X.
- ↑ Vikraman, Seneesh Kumar; Chandra, Vipin; Balakrishnan, Bijoy; Batra, Meenu; Sethumadhavan, Sreeja; Patil, Swapneel Neelkanth; Nair, Sabila; Kannoly, Gopinathan (2017). "Impact of antepartum diagnostic amnioinfusion on targeted ultrasound imaging of pregnancies presenting with severe oligo- and anhydramnios: An analysis of 61 cases". European Journal of Obstetrics & Gynecology and Reproductive Biology. 212: 96–100. doi:10.1016/j.ejogrb.2017.03.026. ISSN 0301-2115. PMID 28349892.
- ↑ Palermo, Mario S. F.; Espinosa, Ana; Trasmonte, Mónica (2021-11-19), "Disorders of Amniotic Fluid Volume: Oligoamnios and Polyhydramnios", Perinatology, Cham: Springer International Publishing, pp. 687–705, doi: 10.1007/978-3-030-83434-0_39 , ISBN 978-3-030-83433-3 , retrieved 2023-11-21
- ↑ Hromadnikova, Ilona; Kotlabova, Katerina; Hympanova, Lucie; Krofta, Ladislav (2016). "Gestational hypertension, preeclampsia and intrauterine growth restriction induce dysregulation of cardiovascular and cerebrovascular disease associated microRNAs in maternal whole peripheral blood". Thrombosis Research. 137: 126–140. doi:10.1016/j.thromres.2015.11.032. ISSN 0049-3848. PMID 26632513.
- ↑ Paternoster, Delia M.; Snijders, Deborah; Manganelli, Francesca; Torrisi, Angela; Bracciante, Roberto (2003). "Anhydramnios and maternal thrombocytopenia after prolonged use of nimesulide". European Journal of Obstetrics & Gynecology and Reproductive Biology. 108 (1): 97–98. doi:10.1016/s0301-2115(02)00343-3. ISSN 0301-2115. PMID 12694979.
- ↑ Visvalingam, G.; Purandare, N.; Cooley, S.; Roopnarinesingh, R.; Geary, M. (2011-12-20). "Perinatal outcome after ultrasound diagnosis of anhydramnios at term". Journal of Obstetrics and Gynaecology. 32 (1): 50–53. doi:10.3109/01443615.2011.618891. ISSN 0144-3615. PMID 22185537. S2CID 23539855.
- ↑ Spiro, Judith Eva; Konrad, Martin; Rieger-Fackeldey, Esther; Masjosthusmann, Katja; Amler, Susanne; Klockenbusch, Walter; Schmitz, Ralf (2015-02-13). "Renal oligo- and anhydramnios: cause, course and outcome—a single-center study". Archives of Gynecology and Obstetrics. 292 (2): 327–336. doi:10.1007/s00404-015-3648-7. ISSN 0932-0067. PMID 25676656. S2CID 21433366.
- ↑ Bader, Arnim A; Schlembach, Dietmar; Tamussino, Karl F; Pristauz, Gunda; Petru, Edgar (2007). "Anhydramnios associated with administration of trastuzumab and paclitaxel for metastatic breast cancer during pregnancy". The Lancet Oncology. 8 (1): 79–81. doi:10.1016/s1470-2045(06)71014-2. ISSN 1470-2045.
- ↑ Io, Shingo; Kondoh, Eiji; Chigusa, Yoshitsugu; Tani, Hirohiko; Hamanishi, Junzo; Konishi, Ikuo (2017-11-20). "An experience of second-trimester anhydramnios salvaged by single amnioinfusion". Journal of Medical Ultrasonics. 45 (3): 525–527. doi:10.1007/s10396-017-0842-1. ISSN 1346-4523. S2CID 22787864.
- ↑ Hansen, Wendy F.; Cooper, Christopher S.; Yankowitz, Jerome (2002). "Ureterocele Causing Anhydramnios Successfully Treated With Percutaneous Decompression". Obstetrics & Gynecology. 99 (5, Part 2): 953–956. doi:10.1097/00006250-200205001-00033. ISSN 0029-7844.
- ↑ Gramellini, D.; Fieni, S.; Kaihura, C.; Piantelli, G.; Verrotti, C. (2003). "Antepartum amnioinfusion: a review". The Journal of Maternal-Fetal & Neonatal Medicine. 14 (5): 291–296. doi:10.1080/jmf.14.5.291.296. ISSN 1476-7058. PMID 14986801. S2CID 19890702.