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Oligohydramnion in post
term pregnancyKheluwis.s
406148098
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,hysiology
uring the 7rst hal o pregnancy!transer o water and other smallmolecules ta*es place across the
amnion intramem/ranous fow! andacross etal s*in
'etal urine 8 and 11 wee*s (/ecamemaor component ater 18 wee*s+
%ransport across the etal s*incontinues until *eratiniation occursat )) to ): wee*s.
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Amniotic 'luid 2olume ;egulationin ate ,regnancy
Pathway Efect on Volume Approximate DailyVolume (mL)
'etal urination ,roduction 1000
'etal swallowing ;esorption
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Amniotic fuid "olume assessment
O/ecti"e assessment depends on =>? tomeasure
eepest "ertical poc*et (2,+
Amniotic fuid inde (A'#+ #t is a total o the
2,s in each o the our @uadrants o theuterus. it is a more sensiti"e indicator o A'2throughout pregnancy
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Amniotic fuid a/normalities
Oligohydramnios:
e7ned as reduced amniotic fuid
i.e. amniotic fuid inde o : cm or
less or the deepest "ertical pool ) cm
Polyhydramnios: e7ned as ecessi"e amount o amnioticfuid o )000 ml or more (A'# o B )4 cmor the deepest "ertical pool o B 8 cm+.
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ETIOLOGY
FETAL PROM
CHROMOSOMAL ANOMALIES
CONGENITAL ANOMALIES
IUGR
IUFD POSTTERM PREGNANCY
MATERNAL PREECLAMPSIA
CHRONIC HT
PLACENTAL CHRONIC ABRUPTION TTTS CVS
DRUGS NSAIDs
ACE INHIBITORS
IDIOPATHIC
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DIAGNOSIS
SYMPTOMS
NO SPECIFICSYMPTOMS
Postterm
preeclampsaLess !etal mo"eme#ts
SIGNS
Uter$s % small!or &ate
Feels !$ll o!!et$sMalprese#tato#sIUGR
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=?$
METHODS
DVP '( cms
)'* se"ere+
AFI ', cms
),-./or&erl#e+
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%echni@ue o A'#
Uter$s &"&e& #to 0 1$a&ra#tsTra#s&$cer # "ertcal pla#eS$m o! 0 1$a&ra#ts ma2 poc3et
&ept4 e2cl$ cor& 6 lm/s7Pror to (8 93s ( 4al"esT9#s: composte AFI or #&"&$al
"ertcal poc3ets
1)
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O-,#A%#O?
FETAL
A/orto#Premat$rt;
IUFD
De!ormtes %CTEV
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MANAGEMENT
C,C? =,O
ETIOLOGYGESTATIONAL AGESEVERITYFETAL STATUS 6 =ELL BEING
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DETERMINE ETIOLOGY
R>O PROM< 4>o me&cal ll#essTARGETED USG FOR ANOMALIESR>O IUGR
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TREATMENT ADEQUATE REST – decreases dehydration
HYDRATION – Oral/IV Hypotonic l!ids"# $it/d%
help!l d!rin& la'o!r(prior
to E)V( US*
SERIA$ US* – +onitor &ro,th(A-I
INDU)TION O- $A.OUR
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TREATMENT ACC7 TO CAUSE
Dr$5 #&$ce&PROM % INDUCTIONPPROM % A#t/otcs
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