Oligohydraminos

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

 

DEFINITION

• AMNIOTIC FLUID VOLUME < 5 th  percentile for gestational age
• AMNIOTIC FLUID INDEX <  5
• SINGLE VERTICAL POCKET < 2 cms

INCIDENCE:  0.5 – 5%

SYMPTOMS

•  H/O leaking p/v
• Postterm
• s/o preeclampsia
• Drugs
• Less fetal movements

DIAGNOSIS

• AFI            <5 cm (5-8 borderline)
• 2D pocket     <15 sq cms

COMPLICATIONS

• Abortion
• Prematurity
• IUFD
• Fetal anomalies
• Potters syndrome - pulmonary hypoplasia
• Malpresentations
• Fetal distress
• Meconium Aspiration Syndrome
• Low APGAR

MANAGEMENT

DEPENDS UPON

• ETIOLOGY
• GESTATIONAL AGE
• SEVERITY
• FETAL STATUS & WELL BEING

TREATMENT

• closely monitoring the amount of amniotic fluid and frequent follow-up visits with the physician

• delivery (if oligohydramnios endangers the well-being of the fetus, then an early delivery may be necessary)

• ADEQUATE REST – decreases dehydration

• HYDRATION – Oral/IV Hypotonic fluids(2 Lit/d)

                         temperory increase

                         helpful during labour,prior

                         to USG

• SERIAL USG – Monitor growth,AFI,BPD

• INDUCTION OF LABOUR/ LSCS

                                       Lung maturity attained

                                       Lethal malformation

                                       Fetal jeopardy

                                       Severe IUGR

                                       Severe oligo

 

                                                                                                      

 

 

lAMNIOINFUSION

lInstilling fluid into the amniotic sac to replace lost or low levels of amniotic fluid.

lhelp prevent pulmonary hypoplasia (underdeveloped lungs)

lat delivery to help prevent compression of the umbilical cord.

lDilutes meconium

         

  

 

 

 

TREATMENT ACC. TO CAUSE

lDrug induced – OMIT DRUG

lPROM – INDUCTION

lPPROM – Antibiotics, steroid– Induction

lFETAL SURGERY

        VESICO AMNIOTIC SHUNT

        Laser photocoagulation for TTTS