The most common cause of perinatal mortality is:
Correct Answer D:
The perinatal period is defined as the period that commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth.
Perinatal mortality refers to the number of stillbirths and deaths in the first week of life (early neonatal mortality). Perinatal and maternal health are closely linked. During this time the top causes of death in the fetus are (in order): prematurity, congenital abnormalities, infections and Intra-uterine growth retardation (IUGR).
Oligohydramnios is seen in what perinatal condition?
Correct Answer A:
Oligohydramnios is the term used to describe when the level of amniotic fluid surrounding the baby is too low. In renal agenesis (absence of the kidneys) the fetus cannot produce urine to contribute to the volume of the amniotic fluid, therefore a relative oligohydramnios results.
The other answer choices are causes of polyhydramnios. For example in esophageal atresia, the fetus cannot swallow the amniotic fluid, so the amount of amniotic fluid that remains is increased.
Oligohydramnios is associated with which of the following fetal conditions?
Correct Answer B:
Potter syndrome is a term used to describe the typical physical appearances of a fetus or neonate due to a dramatically decreased amniotic fluid volume oligohydramnios, or absent amniotic fluid (anhydramnios), secondary to renal diseases such as bilateral renal agenesis. Other causes of Potter syndrome can be obstruction of the urinary tract, polycystic or multicystic kidney diseases, renal hypoplasia and rupture of the amniotic sac.
The decreased volume of amniotic fluid causes the growing fetus to become compressed by the mother's uterus. This compression can cause many physical deformities of the fetus, most common of which is Potter facies. Lower extremity anomalies are frequent in these cases, which often presents with clubbed feet and/or bowing of the legs.
Oligohydramnios is associated with which one of the following fetal conditions?
A previously low-risk primigravida is found to have a uterine measurement of 33 cm at her 37-week visit. On pelvic examination there is no evidence of leaking fluid. A sonogram shows borderline oligohydramnios with an amniotic fluid index (AFI) of 6.5. No anomalies are evident on the sonogram and the estimated fetal weight is at the 50th percentile for gestational age. A nonstress test is reactive.
Which one of the following would be most appropriate at this point?
Correct Answer D: Borderline oligohydramnios, defined as an amniotic fluid index (AFI) of 5.0-8.0, has not been associated with poor outcomes except when a fetal anomaly or growth restriction is present. After testing for normal growth and fetal well being, regular follow-up is adequate. Even in the presence of true isolated oligohydramnios (AFI <5), the patient can be followed if the hydration raises the AFI above 5, as long as intrauterine growth retardation and anomalies are not present. At 41 weeks gestation and beyond, oligohydramnios is an indication for induction of labor.
Click to expand