6.3 - Abnormal Amniotic Fluid Flashcards
1
Q
Oligohyramnios
A
- less amniotic fluid for gestation age
- AFI <5 cm
2
Q
Polyhyramnios
A
- more amniotic fluid for gestational age
- AFI > 25cm
*
3
Q
Oligohydramnios - causes
A
- Causes:
- fetal urinary tract abnormality
- PPROM
- twin to twin transfusion affects the anaemic twin
- Anaemic twin
- Placental insufficiency
- Postmaturity >42 weeks - reduced placenta functioning
- Placental abruption
4
Q
Oligohydramnios - Management
A
- Investigate underlying cause
- Conservative v delivery
- optimise fetal and maternal outcome
- Maternal bed rest associated with improved liquor volume
5
Q
Oligohyramnios - diagnosis
A
- SFH < gestation
- reduced FM
- Abdo palp - fetal parts easily felt
- confirmed by u/s AFI
6
Q
Oligohydramnios - Prognosis
A
- Often poor if associated with PPROM or fetal abnormality
- pulmonary hypoplasia associated with long term oligohydramnios
7
Q
Polyhydramnios - causes
A
- Multiple pregnancy - recipient twin
- fetal abnormality of GIT
- renal - too much production of urine
- Maternal diabetes
- Resus isoimmunisation
- many are idiopathic
8
Q
Polyhydramnios - diagnosis
A
- U/S AFI
- Suspicious findings
- SFH>gestational age
- Fetus easily ballotable
- fetal parts difficult to palpate
- maternal symptoms associated with increased uterine size, respiratory, GIT & vascular
9
Q
Polyhydramnios - management
A
- Reductive amniocentesis
- monitor
- maternal medication - indomethacin - (a compound with anti-inflammatory, antipyretic, and analgesicproperties, used chiefly to treat rheumatoid arthritis and gout)
- labour management
10
Q
Polyhydramnios - Complications
A
- Preterm labour
- placental abruption
- fetal abnormality
- fetal mal position
- macrosomia
- cord prolapse
- post partum uterine atony
- beware of SROM
- pre 40 week birth - known increased risk of fetal demise beyond 40 weeks
