Amniotic Fluid

Question 1

Volume of amniotic fluid

Answer 1

34 weeks (32-34 weeks): 1000 ml (Max)
At term/ 40 weeks: 800 ml
>=42 weeks: 200 ml

Question 2

Source of amniotic fluid in 1st trimester

Answer 2

Maternal fluid

Question 3

Source of amniotic fluid from 12-20 weeks GA

Answer 3

Fetal skin

Question 4

Source of amniotic fluid from >20 weeks GA

Answer 4

Fetal urine

Question 5

Colour of amniotic fluid in term pregnancy

Answer 5

Straw coloured

Question 6

Colour of amniotic fluid in fetal distress, transverse lie/breech, Listeria infection

Answer 6

Green colour (d/t biliverdin in meconium)

Question 7

Colour of amniotic fluid in Rh incompatibility

Answer 7

Golden colour (d/t bilirubin)

Question 8

Colour of amniotic fluid in intrauterine fetal death

Answer 8

Tobacco juice/Brown

Question 9

Colour of amniotic fluid in post term pregnancy

Answer 9

Saffron colour, yellowish green

Question 10

Colour of amniotic fluid in concealed hemorrhage

Answer 10

Dark red

Question 11

Normal AFI value

Answer 11

5-24 cm

Question 12

Normal SVP value

Answer 12

2-8 cm

Question 13

AFI in oligohydramnios

Answer 13

<5 cm

Question 14

SVP in oligohydramnios

Answer 14

<2 cm

Question 15

AFI in polyhydramnios

Answer 15

> 25 cm

Question 16

SVC in polyhydramnios

Answer 16

> 8 cm

Question 17

M/C cause of mild oligohydramnios

Answer 17

Idiopathic

Question 18

M/C cause of mild polyhydramnios

Answer 18

Idiopathic

Question 19

M/C cause of severe oligohydramnios

Answer 19

Fetal renal anomalies
1. Renal agenesis
2. Post urethral valve

Question 20

M/C cause of severe polyhydramnios

Answer 20

Fetal GIT anomalies
1. Esophageal atresia
2. Duodenal atresia
3. Cleft lip/ Cleft palate

Question 21

Other causes of Oligohydramnios

Answer 21

1. Dec transudation across placenta:
   > PIH
   > IUGR
   > UPI
2. Dec urine output
   > Renal disorder
   > Drugs: ACE inhibitors/Indomethacin
3. Dec vol of amniotic fluid
   > Post term pregnancy
   > PROM
   > Leaking after anastomosis
4. Chromosomal anomaly:
   > 69 chr Triploidy

Question 22

Other causes of Polyhydramnios

Answer 22

1. Inc transudation across placenta:
   > Placentomegaly d/t DM, twin pregnancy, Rh negative pregnancy
2. Inc urine output:
   > Twin pregnancy
   > Diabetes
   > Barter syndrome
   > Fetal anemia (thalassemia, Rh negative pregnancy, parvo virus infection)
3. Inc transudation from fetal skin:
   > NTD
   > Abdominal wall defect
4. Chromosomal defect
   > Trisomy

Question 23

Conditions leading to both oligo and polyhydramnios

Answer 23

1. TTTS
2. TORCH infections

Question 24

Indomethacin can be used to treat oligo/polyhydramnios

Answer 24

Polyhydramnios

Question 25

Side effect of Indomethacin

Answer 25

Premature closure of ductus arteriosus

Question 26

Indomethacin C/I in (GA)

Answer 26

> 32 weeks of pregnancy

Question 27

PSV of MCA in Polyhydramnios

Answer 27

>=1.5 MOM (Fetal anemia)

Question 28

PSV of MCA in Oligohydramnios

Answer 28

<0.8 MOM (Fetal polycythemia)

Question 29

M/C CTG finding in oligohydramnios

Answer 29

Variable deceleration

Question 30

Only indication for amnioinfusion

Answer 30

Persistent variable deceleration

Question 31

Syndromes related to Oligohydramnios

Answer 31

1. Potters syndrome 2. Amniotic band syndrome

Question 32

What is Potters syndrome?

Answer 32

Severe oligohydramnios d/t kidney defects C/f: 1. Lung hypoplasia 2. Typical flat facies

Question 33

What is Amniotic band syndrome?

Answer 33

Severe oligohydramnios d/t PPROM C/f: 1. Distal digit amputation 2. Craniofacial abnormalities

Question 34

Proximal limb amputation is d/t

Answer 34

Phocomelia d/t Thalidomide

Question 35

Presentation of Oligohydramnios in Early pregnancy

Answer 35

1. Lung hypoplasia 2. Limb amputation

Question 36

Presentation of Oligohydramnios in Late pregnancy

Answer 36

1. Cord compression 2. Fetal distress 3. Meconium aspiration syndrome 4. Club foot/CTEV

Question 37

If chr anomalies are absent in case of polyhydramnios, r/o which conditions?

Answer 37

1. Diabetes 2. Fetal anemia: PSV of MCA >=1.5 MOM

Question 38

If chr anomalies are absent in case of oligohydramnios, r/o which conditions?

Answer 38

1. PPROM 2. UPI: S/D ration >=3 on umbilical artery doppler