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    Abnormalities of Amniotic Fluid

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    Muhammad Abdillah
    1. Amniotic fluid volume normally increases throughout pregnancy, reaching about 1 liter by 36 weeks. Abnormalities include polyhydramnios (excess fluid over 2 liters) and oligohydramnios (marked deficiency below normal limits). 2. Polyhydramnios can be caused by fetal anomalies, maternal diabetes, or preeclampsia. It is diagnosed via ultrasound measurement of vertical pocket depth and amniotic fluid index. Treatment may include amniocentesis to reduce volume. 3. Oligohydramnios can result from fetal or placental causes like growth restriction. It is associated with complications like cord compression and limb deformities. Treatment may include am

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    Abnormalities of Amniotic Fluid

    Uploaded by

    Muhammad Abdillah
    29 views32 pages
    1. Amniotic fluid volume normally increases throughout pregnancy, reaching about 1 liter by 36 weeks. Abnormalities include polyhydramnios (excess fluid over 2 liters) and oligohydramnios (marked deficiency below normal limits). 2. Polyhydramnios can be caused by fetal anomalies, maternal diabetes, or preeclampsia. It is diagnosed via ultrasound measurement of vertical pocket depth and amniotic fluid index. Treatment may include amniocentesis to reduce volume. 3. Oligohydramnios can result from fetal or placental causes like growth restriction. It is associated with complications like cord compression and limb deformities. Treatment may include am

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    kelainan amnion

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    K15 - Amnion Kelainan

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    1. Amniotic fluid volume normally increases throughout pregnancy, reaching about 1 liter by 36 weeks. Abnormalities include polyhydramnios (excess fluid over 2 liters) and oligohydramnios (marked deficiency below normal limits). 2. Polyhydramnios can be caused by fetal anomalies, maternal diabetes, or preeclampsia. It is diagnosed via ultrasound measurement of vertical pocket depth and amniotic fluid index. Treatment may include amniocentesis to reduce volume. 3. Oligohydramnios can result from fetal or placental causes like growth restriction. It is associated with complications like cord compression and limb deformities. Treatment may include am

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    29 views32 pages

    Abnormalities of Amniotic Fluid

    Uploaded by

    Muhammad Abdillah
    1. Amniotic fluid volume normally increases throughout pregnancy, reaching about 1 liter by 36 weeks. Abnormalities include polyhydramnios (excess fluid over 2 liters) and oligohydramnios (marked deficiency below normal limits). 2. Polyhydramnios can be caused by fetal anomalies, maternal diabetes, or preeclampsia. It is diagnosed via ultrasound measurement of vertical pocket depth and amniotic fluid index. Treatment may include amniocentesis to reduce volume. 3. Oligohydramnios can result from fetal or placental causes like growth restriction. It is associated with complications like cord compression and limb deformities. Treatment may include am

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    © All Rights Reserved
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    of 32

    Abnormalities of

    Amniotic fluid
    Disorders of
    Amniotic fluid
    volume
    Normally:
    Amnionic fluid volume increases
    to about 1 lit or more by 36 wks

    In postterm there may by only


    100-200ml
    .

    Normal volumes of amniotic fluid


    varies with the duration of pregnancy
    Average of amniotic fluid volume
    12 w: 50 ml
    24 w: 500 ml
    36 w: 1000 ml & decreases thereafter.
    At term: The normal range in a singleton
    pregnancy is large: 500-1500 ml
    polyhydramnios
    Definition
    Amniotic fluid volume (AFV) >2 L
    Incidence
    1-4% pregnancies.
    Types
    1. Chronic:
    Excess fluid accumulates gradually & it is only
    noticed after the 30th w of pregnancy. It is 10
    times more common than acute PH.
    2. Acute:
    Excess fluid accumulates more quickly & it
    occurs earlier in pregnancy. It is usually
    associated with twin pregnancy
    With sonography:

     Mild 8-11cm 80%


     Moderate 12-15cm 15%
     Sever >16cm 5%
    .

    Causes
    *Fetal:
    1- Multiple pregnancy
    2- Hydrops fetalis
    3- Fetal anomalies
    .

    Fetal anomalies
    Neural tube defect (Anencephaly , Spina bifida )
    1- Increased transudation of CSF
    2- Excessive urination
    * stimulation of cerebrospinal centers

    * impaired arginine vasopressin secretion

     Duodenal atresia

     Thoraco-oesophageal fistula
    .
    * Maternal:
    Diabetes mellitus
    Maternal hyperglycemia Fetal hyperglycemia

    Osmotic diuresis

     Pre-eclampsia
     Heart or renal failure

    *Idiopathic
    Symptoms
    Dyspenea
    Edema
    Oliguria
    Dyspepsia
    Diagnosis
    Uterine enlargment ( larger than
    the period of pregnancy)
    Difficulty in palpating fetal part
    Difficulty in hearing fetal heart
     Sonography
    .
    With sonography
    A. Confirm diagnosis:
    *Vertical pocket >8cm
    *AFI >24 cm (AFI > 97.5 percentile for gestational age)

    B. Detect the degree:


    * mild
    * Moderate
    * severe

    C. Detect the cause


    . Differential Diagnosis

    1. Twins
    2. Ovarian cyst
    3. Full bladder
    4. Hydatiform mole
    5. Ascite

    All are resolved by U/S


    Complication
     PROM
     Prolapses of umblical cord
     Placental abruption
     Uterine dysfunction
     Post partum hemorrhage
    Pregnancy Outcome
    In general, the more sever degree
    of hydramnios

    The higher perinatal mortality


    rate
    Managment
     Minor degrees of hydramnios rarely
    require treatment
     Moderate degrees can usually managed
    until labor ensues
     Sever degrees ( dyspnea or abdominal
    pain or other complication),
    hospitalization become necessary
    Treatment
    Amniocentesis
     500 ml/h
     1500-2000 ml/d
    Indometacin
     Decreases lung liquid production
     Decreases fetal urine production
     Increases fluid movement across fetal
    membranes
    Oligohydramnios
    Definition
    Marked deficiency of the amniotic
    fluid volume (below the normal limits)

    incidence
    0.5-5% of all pregnancies
    In general:
    Oligohydramnios developing early
    in pregnancy is less common
    and
    Has a bad prognosis
    Causes
    Fetal
    Chromosomal abnormalities Placenta
    Congenital anomalies Abruption
    Fetal death
    IUGR Drug
    Postterm Prostaglandin synthetase
    PROM inhibitors,
    Twin-twin transfusion Angiotensin converting
    enzyme inhibitors
    Maternal
    uteroplacental insufficiency idiopatic
    Hypertension
    Diabetes
    Clinical picture
    Uterus is small for date
    Fetus:
     easily felt & immobile
     FHS easily heard

    U/S:
     Vertical pocket <1cm or <2cm;
     AFI <5 cm
    Complications
     During pregnancy
    1. Fetal hypoxia (cord compression)
    2. Persistent position of the fetus
    3. Limb deformities: (pressure or amniotoic bands)
    * talipes (clubfoot)
    * ankylosis of joins

    4. Pulmonary hypoplasia
    During labor
     Increased variable deceleration
     Increased cesarean section rate
    Treatment
    Amnioinfusion:
    infusion of saline into the uterine cavity
    through the abdominal wall by a spinal
    needle
    To increase the AFV
    To dilute meconium
    Prognosis
    Fetal outcome is poor with
    early-onset oligohydramnios

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