Amniotic fluid is a protective liquid in the amniotic sac that safeguards the fetus, allows movement, prevents limb contracture, and facilitates lung development. The volume of amniotic fluid changes throughout pregnancy, increasing until about 38 weeks and then decreasing post-term. Conditions such as oligohydramnios (low fluid) and polyhydramnios (excess fluid) are associated with various complications and require specific monitoring and treatment strategies.

1. AMNIOTIC FLUID

2. Amniotic Fluid
Definition and Functions
■ Amniotic fluid is the clear yellowish protective liquid contained by amniotic sac of
gravid amniote.
■ It protects the fetus from mechanical injury
■ Permit movement of fetus while preventing limb contracture
■ Prevent adhesion between fetus and amnion
■ Permit fetal lung development

4. Formation and absorption
■ (upto 20 weeks)
Ultrafiltrate of maternal plasma,Transudate of fetal plasma
(through uterine decidua , through fetal skin and umbilical cord )
■ (20 weeks to term)
(majorly via fetal urine beacuse fetal skin undergo keratinization )
Reabsorbed by
■ ( upto 20 weeks)
Into maternal plasma
■ (After 20 weeks)
Fetal gut and lungs after swallowing

5. ■ Amniotic fluid increases progressively
■ 10 weeks : 30ml
■ 20 weeks : 300ml
■ 30 weeks : 600ml
■ 38 weeks :1000ml
■ Amniotic fluid decreases rapidly after term
■ 40 weeks : 800ml
■ 42 weeks : 350ml

6. Amniotic Fluid Index
■ Total of deepest pool (DVP) in four quadrants of uterus
■ Deepest vertical pool /Maximum vertical pool is the vertical
measurement of fluid that is free of umbilical cord in each quadrant.
Their sum is called Amniotic Fluid Index (AFI)

7. Oligohydramnios
■ Reduced amniotic fluid i.e AMI <5cm or DVP <2cm

8. ■ Diagnosed by
■ Vaginal leakage of fluid
■ Small size of uterus
■ Decreased movements of baby
■ Not gaining enough weight
■ Results in
■ Deformities
■ Preterm birth
■ Miscarriage
■ Stillbirth
■ infection
■ Cord compression, FGR, early delivery

10. Treatment
■ Adequate rest ,Oral / IV fluids
■ Serial AFI measurement,Non StressTest( Fetal USN and CTG)
■ Amniofusion
■ Delivering the baby if lung maturity attained, severe IUGR and
malfromations

11. Polyhydramnios
■ Excessive amniotic fluid i.e AFI >25cm or DVP >8cm

12. ■ Signs
■ Enlarged uterus
■ Difficult to palpate fetal parts and auscultate fetal heart
■ Ballotable fetues
■ Symptoms
■ Dyspnea
■ Abdominal pain
■ Edema due to venous stasis
■ Contractions leading to preterm labour
Complications : cord prolapse, placental abruption, preterm delivery
uterine atony

13. Treatment
■ Bed rest
■ Mother’s glycemic control
■ NSAIDS
■ Amniodrainage
■ Laser ablation of placental vascular connection inTTTS