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Oligohydramnios
- 1. DISORDERS OF AMNIOTICFLUID- oligohydramnios DR.RUPAL 1
- 2. Contents โข Physiology ofamniotic fluid โข Normal volume of AF in varying gestation โข Definition of oligohydramnios โข Incidence & etiology โข Diagnosis โข Management 2
- 3. PHYSIOLOGY OF AMNIOTICFLUID 3
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- 7. NORMAL AMNIOTIC FLUIDVOLUME Weeks Gestation Fetus Amniotic Fluid Placenta (g) (ml) (g) 16 28 36 40 100 200 100 1000 1000 200 2500 900 400 3300 800 500 7
- 8. DEFINITION โข AMNIOTIC FLUIDVOLUME < 5 th percentile for gestational age โข AMNIOTIC FLUID INDEX < 5 โข SINGLE VERTICAL POCKET < 2 cms โข Amniotic fluid volume of less than 500 mL at 32-36 weeks' gestation 8
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- 11. AETIOLOGY FETAL โข PROM (50%) โขCHROMOSOMAL ANOMALIES โข CONGENITAL ANOMALIES โข IUGR โข IUFD โข POSTTERM PREGNANCY MATERNAL โข PREECLAMPSIA โข APLA SYNDROME โข CHRONIC HT PLACENTAL โข CHRONIC ABRUPTION โข TTTS โข CVS DRUGS โข PG SYNTHETASE INHIBITORS โข ACE INHIBITORS IDIOPATHIC 11
- 12. DIAGNOSIS SYMPTOMS NO SPECIFIC SYMPTOMS H/O leakingp/v Postterm s/o preeclampsia Drugs Less fetal movements SIGNS Uterus โ small for date Feels full of fetus Malpresentations IUGR 12
- 13. USG METHODS MVP <2 cms (<1severe) AFI <5 cms (5-8 borderline) 2D pocket <15 sq cms 13
- 14. Technique of AFI โขUterus divided into 4 quadrants โข Transducer in vertical plane โข Sum of 4 quadrants max pocket depth excluding cord & limbs. โข Prior to 20 wks 2 halves 14
- 15. COMPLICATIONS FETAL Abortion Prematurity IUFD Deformities โ CTEV,contractures,amputation Potters syndrome-pulmonary hypoplasia Malpresentations Fetal distress MSAF โ MAS Low APGAR MATERNAL Increased morbidity Prolonged labour: uterine inertia Increased operative intervention (malformations, distres) 15
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- 17. MANAGEMENT DEPENDS UPON โข AETIOLOGY โขGESTATIONAL AGE โข SEVERITY โข FETAL STATUS & WELL BEING 17
- 18. DETERMINE AETIOLOGY โข R/OPROM, h/o medical illness โข TARGETED USG FOR ANOMALIES โข R/O IUGR ,IUFD when suspected โข Amniocentesis if chromosomal anomalies suspected โ early symmetric IUGR โข Tests for APLA Syndrome , if suspected 18
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- 20. TREATMENT โข ADEQUATE RESTโ decreases dehydration โข HYDRATION โ Oral/IV Hypotonic fluids(2 Lit/d) โข SERIAL USG โ Monitor growth,AFI,BPP โข INDUCTION OF LABOUR/ LSCS 20
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- 22. TREATMENT ACC. TOCAUSE โข Drug induced โ OMIT DRUG โข PROM โ INDUCTION โข PPROM โ Antibiotics,steroid โ Induction โข FETAL SURGERY VESICO AMNIOTIC SHUNT-PUV Laser photocoagulation for TTTS 22
- 23. IMP QUESTIONS โข SHORTNOTES- OLIGOHYDRAMNIOS โข AFI -2 MARKS 23
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