Scribd Logo
Upload

Welcome to Scribd!

  • 200 views

    18 - Oligohydramnios and Polyhydramnios

    Uploaded by

    Su Oo
    Oligohydramnios and polyhydramnios refer to low or high amniotic fluid levels, respectively. Amniotic fluid is produced by fetal urine and removed through fetal swallowing. The normal amniotic fluid index ranges from 5-25 cm. Oligohydramnios can be caused by premature rupture of membranes or fetal growth restriction and can lead to pulmonary hypoplasia and limb deformities in severe early cases. Polyhydramnios has many potential causes including maternal diabetes, multiple gestation, or fetal conditions preventing swallowing. Management involves determining the cause and relieving maternal discomfort through amniodrainage if needed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    18 - Oligohydramnios and Polyhydramnios

    Uploaded by

    Su Oo
    200 views3 pages
    Oligohydramnios and polyhydramnios refer to low or high amniotic fluid levels, respectively. Amniotic fluid is produced by fetal urine and removed through fetal swallowing. The normal amniotic fluid index ranges from 5-25 cm. Oligohydramnios can be caused by premature rupture of membranes or fetal growth restriction and can lead to pulmonary hypoplasia and limb deformities in severe early cases. Polyhydramnios has many potential causes including maternal diabetes, multiple gestation, or fetal conditions preventing swallowing. Management involves determining the cause and relieving maternal discomfort through amniodrainage if needed.

    Original Title

    18- Oligohydramnios and polyhydramnios

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Oligohydramnios and polyhydramnios refer to low or high amniotic fluid levels, respectively. Amniotic fluid is produced by fetal urine and removed through fetal swallowing. The normal amniotic fluid index ranges from 5-25 cm. Oligohydramnios can be caused by premature rupture of membranes or fetal growth restriction and can lead to pulmonary hypoplasia and limb deformities in severe early cases. Polyhydramnios has many potential causes including maternal diabetes, multiple gestation, or fetal conditions preventing swallowing. Management involves determining the cause and relieving maternal discomfort through amniodrainage if needed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    200 views3 pages

    18 - Oligohydramnios and Polyhydramnios

    Uploaded by

    Su Oo
    Oligohydramnios and polyhydramnios refer to low or high amniotic fluid levels, respectively. Amniotic fluid is produced by fetal urine and removed through fetal swallowing. The normal amniotic fluid index ranges from 5-25 cm. Oligohydramnios can be caused by premature rupture of membranes or fetal growth restriction and can lead to pulmonary hypoplasia and limb deformities in severe early cases. Polyhydramnios has many potential causes including maternal diabetes, multiple gestation, or fetal conditions preventing swallowing. Management involves determining the cause and relieving maternal discomfort through amniodrainage if needed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 3

    Oligohydramnios and polyhydramnios

    ▪ Amniotic fluid is produced almost from fetal urine from the second trimester onwards.

    ▪ mechanisms of removal include fetal swallowing, removing 200–1500 mL/day .

    Amniotic fluid volume


     Increases progressively

    ➢ 10 weeks: 30 ml
    ➢ 20 weeks: 300 ml
    ➢ 30 weeks: 600 ml
    ➢ 38 weeks:1,000 ml

    o but from term there is a rapid fall in volume (40 weeks: 800 ml; 42 weeks: 350 ml).

    o The reason for the late reduction has not been explained.

    Amniotic fluid function


    ▪ protecting the developing baby from pressure or trauma

    ▪ allowing limb movement, hence normal postural development

    ▪ permitting the fetal lungs to expand and develop .

    ▪ Amniotic fluid index is calculated as the total measurement of the deepest pool in the
    four quadrants of the uterus normal( 5-25cm)

    ▪ Deepest vertical pool normal (2-8 cm)


    Oligohydramnios And Anhydramnios
    ➢ amniotic fluid index (AFI) less than the 5th centile for gestation

    Clinically

    • history of clear fluid leaking from the vagina; this may represent PPROM .

    • on abdominal palpation the fetal poles may be very obviously felt and ‘hard’.

    • small for dates uterus.

    • No Liquor >>> fundal level less than date

    o What is possible causes of

    oligohydramnios and Anhydramnios?

    ➢ The fetal prognosis depends on the cause of oligohydramnios


    1. pulmonary hypoplasia and limb deformities (contractures, talipes” Club foot”) are common to severe early-onset
    (<24 weeks’ gestation) oligohydramnnios.

    2. Renal agenesis and bilateral multicystic kidneys carry a lethal prognosis.

    3. Oligohydramnios due to FGR/uteroplacental insufficiency is usually of a less severe degree and less commonly
    causes limb and lung problems

    Complication

    • pulmonary hypoplasia
    • limb deformities (contractures, talipes)

    Management

    • Fetal assessment congenital anomaly

    • Delivery when indicated


    Polyhydramnios
     Polyhydramnios is the term given to an excess of amniotic fluid (i.e. AFI >95thcentile for
    gestation on ultrasound estimation)

    ➢ Clinically
    1. severe abdominal swelling and discomfort.

    2. On examination(increased SFH).fundal level more than date

    3. abdomen may be tense and tender

    4. the fetal poles will be hard to palpate

    5. Fetal heart difficult to hear

    ➢ Causes of polyhydramnios

    -1Idiopathic.

    -2Maternal -3Fetal

    • Diabetes. • Multiple gestation (in mono-chromic twins it may be twin-to-twin


    • Placental. transfusion syndrome).
    • Chorio-angioma. • Esophageal atresia/tracheo-oesophageal fistula.
    • Arteriovenous fistula • Duodenal atresia.
    • Neuromuscular fetal condition (preventing swallowing). Myasthenia gravis
    • Anencephaly.

    ➢ Management
    • directed towards establishing the cause Anencephaly.
    o (and hence determining fetal prognosis)

    • relieving the discomfort of the mother (if necessary by amniodrainage) bed rest

    • assessing the risk of preterm labour due to uterine over distension and give steroid
    • Polyhydramnios due to maternal diabetes needs glycaemic control. Bqs hyperglycemia >>increase baby urination

    • Twin-to-twin transfusion syndrome is a rare cause of acute polyhydramnios.

    o Treatment by amnio drainage and laser removal of the placental vascular connections

    • Most cases of polyhydramnios respond to treatment with indo.methacin . reduce the AF and Renal
    flow

    You might also like