CPAM Protocol

• For suspected or confirmed CPAM, obtain the following at every visit:

o Document FHR with M-mode.

o Image cranium. R/O scalp edema.

o Obtain HC measurement.

o Image chest. R/O pleural and/or pericardial effusion.

o Measure lesion at largest diameters: length, height and width to obtain volume.

o Image abdomen. R/O ascites.

o Dopplers- obtain UA Dopplers and MCA Dopplers

o Measure AFI.

o Image placenta. R/O placental thickening.

• Calculate CVR ratio and document.

o http://perinatology.com/calculators/CVR.htm

o CVR = (Length X Height X Width X 0.52)/Head Circumference

• Ratio should not exceed 1.6.

• Document presence/absence of hydrops, ascites, pleural and/or pericardial effusions.