Amniotic fluid


Published on

Amniotic fluid maintain the perfect homeostasis between mother and fetus. It protect both mother and fetus from various complications. Details is enclosed in presentation.

Published in: Health & Medicine, Technology
  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Amniotic fluid

  1. 1. • Screening for fetal malformation (serum α-fetoprotien). • Assessment of fetal well-being (amniotic fluid index). • Assessment of fetal lung maturity (L/S ratio). • Diagnosis and follow up of labour. • Diagnosis of PROM (ferning test).PROM: Premature rupture of membranes
  2. 2. • From 20 weeks up to term (mainly fetal urine) • At 18th week, the fetus voids 7-14ml/day; at term fetal kidneys secretes 600-700ml of urine/day into AF. - Fetal respiratory tract secretes 250ml/day into AF. - Fluid transfers across the placenta. - Fetal oro-nasal secretions. • Secretion is controlled by: - Fetal swallowing at term removes 500ml/day. - Reabsorption into maternal plasma (osmotic gradient).• AF constituents: - urea, creatinine & uric acid + desquamated fetal cells, vernix, lanugo hair & others→ hypo-osmolar amniotic fluid
  3. 3. • Clinical assessment is unreliable.• Objective assessment depends on U/S to measure: Deepest vertical pool (DVP) & Amniotic fluid index (AFI)
  4. 4. • Fundal height < gestational age• Decreased fetal movement• Fetal Heart Rate tracing abnormality• Diagnosis: Ultrasound
  5. 5. 2. Maternal causes:• Uteroplacental insufficiency.• Preeclampsia.3. Placental causes:• twin-twin transfusion.4. Drug causes:Prostaglandin synthase inhibitor as NSAID.5. Idiopathic
  6. 6. • In early pregnancy:• Amniotic adhesions or bands→ amputation/death.• Pressure deformities (club feet).• Pulmonary hypoplasia: - Thoracic compression. - No breathing movement. - No amniotic fluid retain. Flattened face. Postural deformities.
  7. 7. • In late pregnancy:• Fetal growth restriction.• Placental abruption.• Preterm labour.• Fetal distress.• Fetal death.• Meconium aspiration.• Labour induction/CS.
  8. 8. J Obstet Gynaecol Res. 2010 Apr;36(2):239-47Free Radic Biol Med. 2010 Aug 1;49(3):493-500 Pflugers Arch. 2010 May;459(6):841-51 Int J Gynaecol Obstet. 2005 Jan;88(1):15-8
  9. 9. The endothelium (inner lining) of blood vessels usesnitric oxide to relax smooth muscle, thus resulting invasodilation and increasing blood flow
  10. 10. NO causes vasodilation & increasing blood flow
  11. 11. • Fetal malformation: • Hydrops fetalis: congestive - GIT: esophageal/duodenal heart failure, severe atresia, tracheoesophageal anaemia or hypoproteinemia fistula. → placental transudation - CNS: anencephaly (↓swallowing, exposed • Diabetes mellitus (osmotic meninges, no antidiuretic diuresis). hormone).• Twin-twin transfusion → • Idiopathic. fetal polyuria.
  12. 12. • Fetal prognosis worsens with more severe hydramnios and congenital anomalies• 15-20% fetal malformations• Preterm delivery• Suspect diabetes• Prolapse of cord• Abruption
  13. 13. • Dyspnea• Venous Stasis• Placental abruption• Uterine dysfunction• Post-partum hemorrhage• Abnormal presentation -- C/S
  14. 14. • Minor degrees: no treatment.• Bed rest, diuretics, water and salt restriction: ineffective.• Hospitalization: dyspnea, abdominal pain or difficult ambulation.• Indomethacin therapy: . - impairs lung liquid production/enhances absorption. - ↓fluid movement across fetal membranes. * Complications: premature closure of ductus arteriosus, impairment of renal function, and cerebral vasoconstriction.• Amniocentesis: to relieve maternal distress and to test for fetal lung maturity. Complications: ruptured membrane, chorioamnionitis, placental abruption, preterm labour.