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Obstetrics > Antenatal: Oligohydramnios and Polyhydramnios > Flashcards

Antenatal: Oligohydramnios and Polyhydramnios Flashcards

1
Q

Define oligohydramnios

A

Amniotic fluid index below the 5th centile

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2
Q

What is oligohydramnios

A

Lack of amniotic fluid

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3
Q

What are 5 causes of oligohydramnios

A 
PPROM
Placental insufficiency 
Potter's syndrome 
Obstructive uropathy 
Chromosomal anomalies
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4
Q

Why does placental insufficiency cause oligohydramnios

A

Foetus preferentially diverts blood flow to it’s brain, opposed to the kidneys

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5
Q

What is potter’s syndrome

A

Renal agenisis

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6
Q

What imaging is ordered for oligohydramnios

A

US

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7
Q

What test is performed to check for oligohydramnios

A

IGFBP-1

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8
Q

What does the presence of insulin-like growth factor binding protein 1 indicate

A

Membranes have ruptured

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9
Q

When does amniotic fluid volume increase until

A

33W, then it plataus

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10
Q

What is amniotic fluid made of

A
  • Urine output
  • Respiratory secretions
  • Placental fluid
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11
Q

Explain processing of amniotic fluid

A

Foetus breathes and swallows amniotic fluid.

Kidneys then covert this to urine which is stored in the bladder and released

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12
Q

What can cause oligohydramnios in terms of pathophysiology

A

Anything that decreases kidney’s formation of urine our obstructs excretion leads to oligohydramnios.

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13
Q

How is olgiohydramnios investigated

A

US

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14
Q

What is used to assess amount of amniotic fluid

A

Amniotic fluid index

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15
Q

What are the two main causes of oligohydramnios

A

PPROM

Placental insufficiency

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16
Q

If oligohydamnios is due to rupture of membranes when does labour usually occur

A

24-48h after

17
Q

If PPROM and labour does not start what should be considered

A

IOL at 34-36W to prevent infection.

Give antibiotics and glucocorticoids

18
Q

If due to placental insufficiency when should delivery be aimed for depending on growth, doppler and CTG

A

37W

19
Q

Why does oligohydramnios carry a poor prognosis in second term

A

Due to premature delivery and causing pulmonary hypoplasia

20
Q

What are 2 complications of oligohydramnios

A

Pulmonary Hypoplasia

- Less fluid restricts ability foetus can move it’s limbs which can lead to severe contractures post-delivery

21
Q

Define polyhydramnios

A

Amniotic fluid index >95th centile for gestational age

22
Q

What is the main cause of polyhydramnios

A

Idiopathic (60%)

23
Q

What 3 conditions preventing swallowing can lead to polyhydramnios

A

Congenital diaphragmatic hernia
Oesophageal atresia
CNS Disorders

24
Q

What GI condition can cause polyhydramnios

A

Duodenal atresia

25
Q

What maternal condition increases risk of polyhydramnios and why

A

Diabetes - leads to macrosomia. Larger babies will produce more urine

26
Q

What can maternal use of lithium during pregnancy cause in a foetus

A

Foetal diabetes insipidus

27
Q

What can foetal diabetes inspidus lead to

A

Polyhydramnios

28
Q

How will uterus feel in polyhydramnios

A

Tense

29
Q

What test should mothers have if polyhydramnios found

A

OGTT

30
Q

How is polyhydramnios detected

A

US - amniotic fluid index

31
Q

How is polyhydramnios usually managed

A

No intervention required

32
Q

If mother is breathless, how is polyhydramnios managed

A

Amnioreduction or Indomethacin is given

33
Q

What timeframe should indomethacin not be used from and why

A

> 32W as indomethacin will cause pre-mature closure of ductus arteriosus

34
Q

If a baby has had known polyhydramnios of unknown aetiology what is done when it is born

A

NG tube must be passed prior to feeding to exclude oesophageal atresia or tracheo-oeseophageal fistula

35
Q

What are 3 complications of polyhydramnios and why

A
  1. Cord prolapse - increase room
  2. Malpresentation
  3. PPH

Obstetrics (27 decks)

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