Oligohydramnios/Polyhydramnios Flashcards
What is the 2/8/8/20 rule in oligo and polyhydramnios?
Oligohydramnios if DVP <2cm or AFI <8cm
Polyhydramnios if DVP >8cm or AFI >20cm
What do AFI and DVP stand for?
AFI = amniotic fluid index
DVP = deepest vertical pole
What are the seven parameters on ultrasound?
- Foetal movements
- Foetal heart rate
- Presentation
- Biometry
- Liquor volume
- Placenta
- Umbilical artery Doppler’s
What is oligohydramios?
Reduced amniotic fluid (DVP <2cm, AFI <8cm)
List 5 causes of oligohydramnios.
- Renal agenesis
- Multicystic kidneys
- Urinary tract obstruction
- IUGR/placental insufficiency
- Use of NSAIDs
How is SROM managed between 34-36 weeks?
Induction of labour unless there is indication for C-section
How is SROM managed <34 weeks?
Admit and monitor
- Prophylactic erythromycin
- Monitor every 4 hours for signs of infection
- Corticosteroids
What are the complications of oligohydramnios occurring at <24 weeks?
- Pulmonary hypoplasia
- Limb contractures
- Talipes
List three renal deformities that are not compatible with life related to oligohydramnios.
Renal agenesis
Multicystic kidneys
Urinary tract obstruction
What is polyhydramnios?
Overproduction of amniotic fluid (DVP >8cm, AFI >20cm)
How do patients with polyhydramnios present?
Abdominal swelling and discomfort
Tense and tender abdo
Difficult to palpate foetal poles
SFH large for dates
Give 1 maternal and 5 foetal causes of polyhydramnios.
Maternal: 1. Diabetes
Foetal:
1. Idiopathic
2. Twin pregnancy
3. Foetal hydrops
4. Oesophageal atresia
5. Duodenal atresia
How is polyhydramnios investigated?
OGTT at 24-28 weeks
Ultrasound
What are the goals of management in polyhydramnios?
- Reduce maternal discomfort
- Assess risk of PTL secondary to uterine overdistension
How can polyhydramnios be managed?
GDM - control sugars
AFI >40cm - amnioreduction or NSAIDs
Foetal abnormality - refer to foetal medicine
Pre-term - assess risk of PTL (U/S, FFT); steroids
