Oligohydramnios and Polyhydramnios

Question 1

What is Oligohydramnios, RF

Answer 1

Oligohydramnios- decreased volume of amniotic fluid - <5th centile. Deepest pool 2cm
4% of pregnancies

RF/aetiology
Reduced fluid input- placental insufficiency, pre-eclampsia
Reduced output- structural (PDK), medication (ACEi, NSAIDS)
Lost fluids - ROM, IUGR, TTTS
Chromosomal abnormalities

Question 2

Sx and Ix of Oligohydramnios

Answer 2

Hx of PV fluid leak, Rupture of membranes
often asympto

abdoexam - decreased fundal height, foetal parts easily palpable
Speculum for membrane rupture

Ix –USS for liquor volume, foetal anomalies
CTG- foetal wellbeing

Question 3

Mx and complications of Oligohydramnios

Answer 3

Mx == Term - delivery is appropriate, can induce
pre-term- monitor USS for growth, liquor volume, dopplers, CTGs
Delivery if further anomalies apprear

complications -
labour- increased CTG abnormalities, meconium liquor, emergency CS
Neonate- pul hyperplasia, limb deformities

Prog- increas perinatal death rates with early onset

Question 4

What is Polyhydroamnios (RF)

Answer 4

Polyhydroamnios= AFI >95th centile
2-3L of liquid, deepest poor 8Cm (1-4% preg)

RF /Aetiology (can be idiopathic)
Failure of foetal swallow (neuro or gastro)
Neuro - neuro, chomosomal abnormal
GI- Duedenal atresia, oesophageal atresia

Congenital infections
Foetal polyuria - Maternal diabetes, TTTS

Question 5

Sx and Ix of Polyhydroamnios

Answer 5

sx of underlying cause
Abdoment- increased fundal height, impalpable foetal parts, tense abdo

Ix - Liquor volime., foetal growth, umbilicar dopplers, exclude foetal abnormalities
exclude GDM/DM in mother

Question 6

Mx and complications of Polyhydroamnios

Answer 6

antenatal monitoring of foetus, diabetes control
peads present at delivery
Amnioreduction (if creating discomfort)
COX inhibitors for foetal urine output

complications - Preterm labour (PTL), malpresentation, abruption, cord prolapse, PPH, Cesarian

prog = increased perinatal death due to PTL/congenital