OLIGOHYDRAMNIOS

Dr Mona Shroff
www.obgyntoday.info

PHYSIOLOGY OF AMNIOTIC
FLUID

INFLOW

OUTFLOW
(1000 ml/d)

(1000 ml/d)

1.FETAL URINE
2.LUNG LIQUID

1.FETAL
SWALLOWING

INTRAMEMBRANOUS (placenta,cord)
TRANSMEMBRANOUS(amniotic membranes)
RECYCLING 3hrs
Dr Mona Shroff
www.obgyntoday.info

FUNCTIONS OF AMNIOTIC FLUID

Shock

absorber protects from external trauma.

Protects cord from compression.
Permits fetal movements development of
musculoskeletal system, prevents adhesions.
Swallowing of AF enhances growth & development
of GIT.
AF volume maintains AF pressure reduces loss of
lung liquid pulmonary development.
Maintenance of fetal body temperature.
Some fetal nutrition, water supply.
Bacteriostatic properties decreases potential for
infection
Dr Mona Shroff
www.obgyntoday.info

Dr Mona Shroff
www.obgyntoday.info

DEFINITION
AMNIOTIC

FLUID VOLUME < 5 th

percentile for gestational age

AMNIOTIC
SINGLE

FLUID INDEX < 5

VERTICAL POCKET < 2 cms

Dr Mona Shroff
www.obgyntoday.info

INCIDENCE
0.5 5%
Dr Mona Shroff
www.obgyntoday.info

AETIOLOGY
FETAL

PROM (50%)
CHROMOSOMAL ANOMALIES
CONGENITAL ANOMALIES
IUGR
IUFD
POSTTERM PREGNANCY

MATERNAL

DRUGS

PLACENTAL

CHRONIC ABRUPTION
TTTS
CVS

PREECLAMPSIA
APLA SYNDROME
CHRONIC HT

PG SYNTHETASE INHIBITORS
ACE INHIBITORS

IDIOPATHIC
Dr Mona Shroff
www.obgyntoday.info

DIAGNOSIS
SYMPTOMS
NO SPECIFIC
SYMPTOMS
H/O leaking p/v
Postterm
s/o preeclampsia
Drugs
Less fetal movements

SIGNS
Uterus small for
date
Feels full of fetus
Malpresentations
IUGR

Dr Mona Shroff
www.obgyntoday.info

USG
METHODS
MVP

AFI

<2 cms
(<1 severe)
<5 cms
(5-8 borderline)

2D pocket

<15 sq cms
Dr Mona Shroff
www.obgyntoday.info

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COMPLICATIONS

FETAL

Abortion
Prematurity
IUFD
Deformities
CTEV,contractures,amputation
Potters syndrome- pulmonary
hypoplasia
Malpresentations
Fetal distress
MSAF MAS
Low APGAR
Dr Mona Shroff

MATERNAL
Increased morbidity
Prolonged labour:
uterine inertia
Increased operative
intervention
(malformations,
distres)

www.obgyntoday.info

11

MANAGEMENT
DEPENDS UPON
AETIOLOGY
GESTATIONAL

AGE

SEVERITY
FETAL

STATUS & WELL BEING

Dr Mona Shroff
www.obgyntoday.info

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DETERMINE AETIOLOGY
R/O

PROM
TARGETED USG FOR ANOMALIES
R/O IUGR ,IUFD when suspected
Amniocentesis if chromosomal anomalies
suspected early symmetric IUGR
Tests for APLA Syndrome , if suspected
Dr Mona Shroff
www.obgyntoday.info

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TREATMENT

ADEQUATE REST decreases dehydration

HYDRATION Oral/IV Hypotonic fluids(2 Lit/d)
temperory increase
helpful during labour,prior
to ECV, USG
SERIAL USG Monitor growth,AFI,BPP
INDUCTION OF LABOUR/ LSCS
Lung maturity attained
Lethal malformation
Fetal jeopardy
Sev IUGR
Severe oligo
Dr Mona Shroff
www.obgyntoday.info

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 AMNIOINFUSION

INDICATIONS
1.Diagnostic
2.Prophylactic
3.Therapeutic
Decreases cord
compression
Dilutes meconium
Dr Mona Shroff
www.obgyntoday.info

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TREATMENT ACC. TO CAUSE

Drug

induced OMIT DRUG

PROM INDUCTION
PPROM Antibiotics,steroid Induction
FETAL SURGERY
VESICO AMNIOTIC SHUNT-PUV
Laser photocoagulation for TTTS

Dr Mona Shroff
www.obgyntoday.info

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Dr Mona Shroff
www.obgyntoday.info

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