amniotic fluid disorders Flashcards
what are the pathways associated with the formation of amniotic fluid in late gestation ?
fetal urination
fetal swallowing
fetal lung fluid secretion
intramembranous flow
what are the functions of amniotic fluid ?
protection of the fetus protection of the umbilical cord protection from infectious agents a reservoir of fluids and nutrients allows normal development of fetal structures
how is the assessment of amniotic fluid volume achieved ?
single deepest pocket measurement
the 4 quadrant method (AFI) sum of all four quadrants
what is the AFI value for both oligohydraminous and polyhydramnios ?
oligohydraminous < 5
polyhydramnios > 25
what are the maternal risk factors associated with polyhydramnios ?
maternal diabetes mellitus
RH alloimmunization
maternal congestive heart failure
what are the fetal factors that may cause polyhydramnios ?
duodenal atresia
esophageal atresia
fetal anemia
multiple pregnancies
what are generally the treatment options for polyhydramnios ?
amnioreduction
pharmacological treatments
what medication can be used for the reduction of amniotic fluid level ?
prostaglandin synthetase inhibitor
what are the indications associated with the use of indomethacin for the reduction of amniotic fluid levels ?
associated with premature closure of PDA if given beyond 32 weeks
what are the placental factors associated with oligohydraminous ?
uteroplacental insufficiency
placental abruption
post date pregnancy
what drugs have been associated with oligohydraminous ?
ACE inhibitors
NSAIDS
what is the management associated with oligohydraminous ?
treat the underlying cause
umbilical artery doppler is indicated
oligo before 36 with a normal fetus is managed expectantly
simple maternal hydration
amnioinfusion - although not commonly used
