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AFS in Second Trimester: Implications?

AFS in Second Trimester: Implications?

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Amniotic Fluid Sludge (AFS) has been theorized to be sonographic evidence of an underlying infection/inflammation. Others have proposed it may represent an organized clot from the placental surface. At the same time, the finding of AFS may be more common as a benign finding especially at/after 40 weeks as the amniotic fluid accumulates shed skin cells, vernix, and possibly meconium past 41 weeks. What can be tell the patient when we identify AFS in the early second trimester? What do we do with this? In this episode, we will summarize the data on second trimester AFS and review the evidence-based “next steps” in care. Does this require empiric antibiotic therapy in the asymptomatic patient? Listen in for details.

  1. Zimmer EZ, Bronshtein M. Ultrasonic features of intra-amniotic "unidentified debris' at 14-16 weeks' gestation. Ultrasound Obstet Gynecol. 1996 Mar;7(3):178-81. doi: 10.1046/j.1469-0705.1996.07030178.x. PMID: 8705409.
  2. Pannain GD, Pereira AMG, Rocha MLTLFD, Lopes RGC. Amniotic Sludge and Prematurity: Systematic Review and Meta-analysis. Rev Bras Ginecol Obstet. 2023 Aug;45(8):e489-e498. doi: 10.1055/s-0043-1772189. Epub 2023 Sep 8. PMID: 37683661; PMCID: PMC10491474.

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