Amniotic Fluid Disorders Flashcards
What is oligohydramnios?
Oligohydramnios is a condition characterized by reduced amniotic fluid volume.
What amniotic fluid index (AFI) is used to diagnose oligohydramnios?
An AFI < 5 cm or deepest vertical pool (DVP) < 2 cm indicates oligohydramnios.
What are the common risk factors for oligohydramnios?
Ruptured membranes (PROM/PPROM)
Placental insufficiency
Fetal renal anomalies (e.g., renal agenesis, polycystic kidneys)
Post-term pregnancy
Maternal conditions (e.g., pre-eclampsia, dehydration)
Uteroplacental insufficiency
A key cause of oligohydramnios is ____________, which refers to premature rupture of the membranes before labor begins.
PROM (Pre-labor rupture of membranes)
What are the clinical signs of oligohydramnios?
Small symphysis-fundal height (SFH) for gestational age
Reduced fetal movements
Leaking amniotic fluid (if due to rupture of membranes)
What investigations are performed to diagnose and assess oligohydramnios?
Ultrasound to assess amniotic fluid index (AFI) or DVP
Fetal biometry to assess growth restriction
Doppler studies for uteroplacental insufficiency
CTG to assess fetal well-being
Amniocentesis if infection is suspected
True/False
Q: Oligohydramnios is commonly associated with fetal renal anomalies.
True.
What are potential complications of oligohydramnios?
Fetal growth restriction (FGR)
Preterm birth
Fetal distress
Pulmonary hypoplasia (if severe and early onset)
Cord compression and variable decelerations
How is oligohydramnios managed when caused by ruptured membranes?
Antibiotics to prevent infection (if PPROM)
Corticosteroids for fetal lung maturity
Close monitoring of fetal well-being
How is severe oligohydramnios managed?
Maternal hydration (oral or IV)
Amnioinfusion during labor to increase fluid volume
Delivery if fetal distress or compromised growth is detected
A 34-week pregnant woman presents with reduced fetal movements and ultrasound confirms an AFI of 3 cm. What are the next steps?
Monitor with CTG for fetal well-being.
Administer corticosteroids for lung maturity.
Hydrate the mother to potentially improve fluid levels.
Consider early delivery if fetal distress is noted.
In cases of oligohydramnios, ____________ infusion during labor can help reduce umbilical cord compression.
Amnioinfusion
Match the condition with its role in oligohydramnios:
Placental insufficiency
Renal agenesis
PROM
A: Reduced fetal urine output
B: Direct fluid leakage
C: Reduced perfusion to the placenta
1 → C
2 → A
3 → B
Name fetal renal conditions that can lead to oligohydramnios.
Renal agenesis (absence of kidneys)
Polycystic kidney disease (PKD)
Obstructive uropathy
What factors influence the prognosis of oligohydramnios?
Gestational age at onset
Severity of fluid reduction
Underlying cause (e.g., renal anomalies have worse outcomes)
Timely management and delivery decisions
What are the differential diagnoses for oligohydramnios?
IUGR without fluid reduction
Fetal demise
Fetal abnormalities (without amniotic fluid reduction)
What is polyhydramnios?
Polyhydramnios is a condition characterized by excess amniotic fluid volume
What amniotic fluid index (AFI) indicates polyhydramnios?
AFI > 24 cm
Deepest vertical pool (DVP) > 8 cm
True/False
Q: Polyhydramnios is defined as a reduction in amniotic fluid volume.
False.
The two key measurements used to diagnose polyhydramnios are __________ and __________.
AFI (Amniotic Fluid Index) and DVP (Deepest Vertical Pool)
What are fetal causes of polyhydramnios?
Congenital anomalies (e.g., duodenal or esophageal atresia)
Neural tube defects (NTDs)
Chromosomal abnormalities (e.g., trisomy 21, 18)
Fetal infections (e.g., syphilis, parvovirus B19)
What maternal conditions are associated with polyhydramnios?
Diabetes mellitus (pre-gestational or gestational)
Multiple pregnancy
Rh incompatibility leading to fetal hydrops
What are the clinical features of polyhydramnios?
Rapidly increasing abdominal size
Increased symphysis-fundal height (SFH)
Breathlessness (due to uterine size)
Fetal malpresentation
Difficulty palpating fetal parts
A woman at 32 weeks gestation presents with breathlessness and a fundal height measuring 6 cm larger than expected. What condition should be suspected?
Polyhydramnios
What investigations should be performed in suspected polyhydramnios?
Ultrasound to confirm AFI or DVP measurements
Fetal anomaly scan to check for congenital anomalies
Glucose tolerance test (GTT) for maternal diabetes
Infection screening (e.g., TORCH, syphilis)
Karyotyping if chromosomal abnormalities are suspected
A key fetal anomaly associated with polyhydramnios is __________, which causes an inability to swallow amniotic fluid.
Esophageal atresia
What are the potential complications of polyhydramnios?
Preterm labor
Preterm prelabor rupture of membranes (PPROM)
Cord prolapse
Placental abruption
Fetal malposition
Postpartum hemorrhage (PPH)
True/False
Q: Polyhydramnios can lead to cord prolapse during labor.
true.
How is mild polyhydramnios typically managed?
Conservative management with regular monitoring and serial ultrasounds.
How is severe polyhydramnios managed?
Amnioreduction (removal of excess fluid via amniocentesis)
Indomethacin (to reduce fetal urine output in some cases)
Delivery planning if complications arise
Match the condition with its role in polyhydramnios:
Diabetes mellitus
Esophageal atresia
Rh incompatibility
A: Reduced amniotic fluid swallowing
B: Increased fetal urination
C: Fetal hydrops
1 → B
2 → A
3 → C
What factors influence the prognosis of polyhydramnios?
Severity of fluid excess
Presence of congenital anomalies
Maternal condition (e.g., uncontrolled diabetes)
Gestational age at diagnosis
A complication of polyhydramnios that may result in significant postpartum bleeding is __________.
Postpartum hemorrhage (PPH)
What are differential diagnoses for a large-for-gestational-age uterus that may mimic polyhydramnios?
Multiple pregnancy
Macrosomia
Incorrect dating of pregnancy
