Oligohydramnios
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This document discusses disorders of amniotic fluid, specifically oligohydramnios. It defines oligohydramnios as amniotic fluid volume less than the 5th percentile for gestational age or an amniotic fluid index less than 5. The incidence is 0.5-5% and causes can be fetal, maternal, or placental in nature. Diagnosis is made through ultrasound measurement of the amniotic fluid index or single vertical pocket. Management depends on the cause, gestational age, and fetal status, and may include hydration, monitoring with serial ultrasounds, induction of labor or C-section, and amniotic fluid replacement through amnioinfusion in some cases.
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Oligohydramnios
This document discusses disorders of amniotic fluid, specifically oligohydramnios. It defines oligohydramnios as amniotic fluid volume less than the 5th percentile for gestational age or an amniotic fluid index less than 5. The incidence is 0.5-5% and causes can be fetal, maternal, or placental in nature. Diagnosis is made through ultrasound measurement of the amniotic fluid index or single vertical pocket. Management depends on the cause, gestational age, and fetal status, and may include hydration, monitoring with serial ultrasounds, induction of labor or C-section, and amniotic fluid replacement through amnioinfusion in some cases.
Rupture uterus
Uterine rupture is a life-threatening condition where the wall of the uterus tears, potentially exposing the fetus and placenta to the mother's abdominal cavity. It most commonly occurs in women with a previous cesarean section scar. Signs include acute abdominal pain, fetal distress, and hemorrhage. Diagnosis is often made using ultrasound or MRI to detect tears in the uterine wall. Immediate exploratory laparotomy and cesarean delivery is usually required for treatment. Conservative uterine repair may be attempted for some cases but hysterectomy is often necessary due to severe hemorrhage. Prevention focuses on careful management of trial of labor for women with previous scars.
Obstructed labour
This topic contains definition, incidence, causes, effect on mother and fetus, clinical features, prevention, management of Obstructed labour.
Precipitate labour
Precipitate labor is defined as labor with a combined duration of the first and second stages of less than two hours. It is more common in multiparous women and occurs due to hyperactive uterine contractions and diminished soft tissue resistance, allowing a dilation rate of 5 cm per hour or more. Risks for both mother and baby include lacerations, postpartum hemorrhage, uterine inversion or rupture, intracranial hemorrhage in the baby from rapid delivery without time for molding. Treatment involves hospitalizing women with a history of precipitate labor prior to delivery, suppressing contractions during labor, controlling delivery of the head, liberal episiotomy use, and inducing labor through membrane rupture and controlled delivery
Gynecological and Obstetrics instruments
This document provides information on various gynecological and obstetric instruments including their indications. It describes forceps such as artery forceps, Allis' forceps, and Babcock's forceps. It also discusses dilators like Hegar's dilator and cervical dilators. Additionally, it mentions speculums including Cusco's speculum and Sims' speculum. The document provides details on 3 or more instruments and their uses in a variety of procedures.
Fetal position
Learn what is "fetal attitude", "fetal lie", different types of fetal presentation (cephalic, breech, compound, shoulder), how to determine fetal position, and how to do Leopold's maneuvers
Induction and augmentation of labour
Induction and augmentation of labour done in indicated cases.M.K.C.G MEDICAL COLLEGE, BERHAMPUR, ORISSA,
DR.S.N.BERA,& DR. M.DASH
Ectopic pregnancy
Ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, usually in the fallopian tubes. There are several types of ectopic pregnancies classified by location, with tubal pregnancies making up about 90% of cases. Risk factors include previous ectopic pregnancy, PID, tubal ligation or surgery. Symptoms include abdominal pain and vaginal bleeding. Diagnosis involves ultrasound, serum hCG levels, and sometimes laparoscopy. Treatment options range from expectant management for very early, low risk cases to surgical intervention like salpingectomy for ruptured ectopic pregnancies.
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Oligohydramnios
This document discusses disorders of amniotic fluid, specifically oligohydramnios. It defines oligohydramnios as amniotic fluid volume less than the 5th percentile for gestational age or an amniotic fluid index less than 5. The incidence is 0.5-5% and causes can be fetal, maternal, or placental in nature. Diagnosis is made through ultrasound measurement of the amniotic fluid index or single vertical pocket. Management depends on the cause, gestational age, and fetal status, and may include hydration, monitoring with serial ultrasounds, induction of labor or C-section, and amniotic fluid replacement through amnioinfusion in some cases.
Rupture uterus
Uterine rupture is a life-threatening condition where the wall of the uterus tears, potentially exposing the fetus and placenta to the mother's abdominal cavity. It most commonly occurs in women with a previous cesarean section scar. Signs include acute abdominal pain, fetal distress, and hemorrhage. Diagnosis is often made using ultrasound or MRI to detect tears in the uterine wall. Immediate exploratory laparotomy and cesarean delivery is usually required for treatment. Conservative uterine repair may be attempted for some cases but hysterectomy is often necessary due to severe hemorrhage. Prevention focuses on careful management of trial of labor for women with previous scars.
Obstructed labour
This topic contains definition, incidence, causes, effect on mother and fetus, clinical features, prevention, management of Obstructed labour.
Precipitate labour
Precipitate labor is defined as labor with a combined duration of the first and second stages of less than two hours. It is more common in multiparous women and occurs due to hyperactive uterine contractions and diminished soft tissue resistance, allowing a dilation rate of 5 cm per hour or more. Risks for both mother and baby include lacerations, postpartum hemorrhage, uterine inversion or rupture, intracranial hemorrhage in the baby from rapid delivery without time for molding. Treatment involves hospitalizing women with a history of precipitate labor prior to delivery, suppressing contractions during labor, controlling delivery of the head, liberal episiotomy use, and inducing labor through membrane rupture and controlled delivery
Gynecological and Obstetrics instruments
This document provides information on various gynecological and obstetric instruments including their indications. It describes forceps such as artery forceps, Allis' forceps, and Babcock's forceps. It also discusses dilators like Hegar's dilator and cervical dilators. Additionally, it mentions speculums including Cusco's speculum and Sims' speculum. The document provides details on 3 or more instruments and their uses in a variety of procedures.
Fetal position
Learn what is "fetal attitude", "fetal lie", different types of fetal presentation (cephalic, breech, compound, shoulder), how to determine fetal position, and how to do Leopold's maneuvers
Induction and augmentation of labour
Induction and augmentation of labour done in indicated cases.M.K.C.G MEDICAL COLLEGE, BERHAMPUR, ORISSA,
DR.S.N.BERA,& DR. M.DASH
Ectopic pregnancy
Ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, usually in the fallopian tubes. There are several types of ectopic pregnancies classified by location, with tubal pregnancies making up about 90% of cases. Risk factors include previous ectopic pregnancy, PID, tubal ligation or surgery. Symptoms include abdominal pain and vaginal bleeding. Diagnosis involves ultrasound, serum hCG levels, and sometimes laparoscopy. Treatment options range from expectant management for very early, low risk cases to surgical intervention like salpingectomy for ruptured ectopic pregnancies.
Malpresentation
This document discusses fetal malpresentation and malposition, which refer to abnormal positions of the fetus within the uterus. Fetal malpresentation means any position other than vertex, such as breech or transverse lie. Malposition refers to positions other than occiput anterior, such as occiput posterior or occiput transverse. Types and management of different malpresentations and malpositions are described, along with risks to mother and fetus. Nursing care focuses on close monitoring for abnormal labor, supporting the mother physically and emotionally, and preparing for potential operative delivery.
Breech presentation
Breech presentation refers to when the fetus is in a longitudinal lie with its buttocks as the lowest part. The document discusses the different types of breech presentations as well as their incidence, classifications, positions, etiology, diagnosis, and management both during pregnancy and delivery. Management during pregnancy includes attempting external cephalic version after 36 weeks to convert the fetus to head-first position. Management during delivery depends on factors such as gestational age and fetal/maternal conditions, and may involve vaginal delivery with assistance, total breech extraction, or cesarean section to avoid risks to the mother and fetus.
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Cervical ripening and the bishop score
Cervical ripening is the preparation of the cervix for labour and delivery. The Bishop score is the commonest used methodology to assess it. For more like this visit my page on YouTube https://www.youtube.com/@mudiagaakpoghene2243
Shoulder,face ,braw,,compound presention for undergraduate
Shoulder,face ,braw,,compound presention for undergraduateFaculty of Medicine,Zagazig University,EGYPT
Unergraduate course lectuers in Obstetrics&Gynecology,Faculty of medicine,Zagazig University Prepared by Dr Manal BeheryProlonged labour
Definition , Latent phase,prolonged latent phase , Causes, diagnosis first stage , second stage , treatment first stage ,second stage
Partograph
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Intrauterine Fetal Death (IUFD),(Kurdistan)
This document provides an overview of intrauterine fetal death (IUFD), also known as stillbirth. It defines IUFD as the death of a baby in the uterus after 20 weeks of gestation. The document discusses the epidemiology, etiology, risk factors, clinical features, diagnosis, treatment and management, and nursing care of IUFD. It also provides references for additional information.
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Pre mature rupture of membrene
1) Premature rupture of membrane (PROM) is defined as the rupture of amniotic sac more than 1 hour before the onset of labor.
2) PROM can be classified as preterm (before 37 weeks gestation), prolonged (rupture of membranes for over 24 hours before onset of labor), or pre-viable (before 24 weeks gestation).
3) Causes and risk factors of PROM include infections, smoking, previous preterm labor or PROM, polyhydramnios, multiple gestation, bleeding during pregnancy, invasive procedures, and cervical insufficiency. Diagnosis involves history collection, examination, and tests to assess fetal wellbeing.
Operative obstrectric
This document provides information on operative vaginal delivery using forceps. It describes the types of forceps including long curved forceps, short curved forceps, and Kielland's forceps. It details the parts of the forceps including the blades, shanks, locks, handles, and screws. It explains how to identify and apply the forceps blades for low forceps delivery. The steps taken are identification and application of the blades, locking the blades, applying traction, and removing the blades. Precautions and techniques are outlined to ensure a safe operative vaginal delivery using forceps.
3 malpresentations.warda (3)- FACE PRESENTATION
Face presentations occur when the fetal chin is the presenting part instead of the vertex. They are classified into four positions based on the position of the chin. Mentoanterior positions are more common and favorable than mentoposterior positions. Labor is usually prolonged in face presentations due to delayed engagement and lack of molding of the facial bones. Management depends on the position, with mentoanterior positions usually allowing vaginal delivery while mentoposterior positions often requiring assistance. Brow presentations are the rarest type and usually do not have a defined mechanism of labor.
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The document discusses malpositions and malpresentations during childbirth. It notes that occipito-posterior is a common malposition where the fetal back is directed posteriorly during delivery. Factors that can cause malpositions include defects in the powers of labor, the birth canal, or the fetus itself. Complications of malpositions include prolonged labor, increased need for interventions, and higher rates of maternal and neonatal morbidity. Management depends on the specific presentation and may involve inducing rotation, instrumental delivery, or cesarean section in difficult cases.
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- Recurrent miscarriage is defined as 2 or more losses and can be caused by genetic, endocrine, immune, or inherited factors.
- Ectopic pregnancies implant outside the uterus, most commonly in the fallopian tubes. Risk factors
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This document discusses breech presentation, including its definition, types, diagnosis, and management. Some key points:
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- Types include complete breech, frank breech, and footling breech. Diagnosis is made through inspection, palpation, auscultation, and ultrasound.
- Management options are external cephalic version, vaginal delivery for some cases, or caesarean section which is recommended for complicated breeches or large babies. Vaginal delivery carries risks of complications for
Amniotic fluid disorder prof.salah
The document discusses amniocentesis, which involves extracting a small amount of amniotic fluid from the amniotic sac using ultrasound guidance to analyze fetal cells for chromosomal abnormalities, genetic disorders, and lung maturity. Amniocentesis allows for diagnosis of conditions like Down syndrome and helps assess risks from factors like advanced maternal age or family history. While generally low risk, potential complications include abortion and uterine infection in rare cases.
polyhydramnios and oligohydramnios.pptx
The document discusses amniotic fluid abnormalities, including polyhydramnios (excess amniotic fluid) and oligohydramnios (low amniotic fluid). It covers the functions, measurement, causes, symptoms, complications, diagnosis and management of both conditions. Polyhydramnios can be caused by maternal diabetes, fetal anomalies, or twin-twin transfusion syndrome. Oligohydramnios can result from premature rupture of membranes or fetal structural abnormalities. Ultrasound is used to measure amniotic fluid levels. Management depends on the severity and may include bed rest, hydration, induction of labor or cesarean section.
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Malpresentation
This document discusses fetal malpresentation and malposition, which refer to abnormal positions of the fetus within the uterus. Fetal malpresentation means any position other than vertex, such as breech or transverse lie. Malposition refers to positions other than occiput anterior, such as occiput posterior or occiput transverse. Types and management of different malpresentations and malpositions are described, along with risks to mother and fetus. Nursing care focuses on close monitoring for abnormal labor, supporting the mother physically and emotionally, and preparing for potential operative delivery.
Breech presentation
Breech presentation refers to when the fetus is in a longitudinal lie with its buttocks as the lowest part. The document discusses the different types of breech presentations as well as their incidence, classifications, positions, etiology, diagnosis, and management both during pregnancy and delivery. Management during pregnancy includes attempting external cephalic version after 36 weeks to convert the fetus to head-first position. Management during delivery depends on factors such as gestational age and fetal/maternal conditions, and may involve vaginal delivery with assistance, total breech extraction, or cesarean section to avoid risks to the mother and fetus.
Eclampsia
The document discusses hypertensive disorders in pregnancy, specifically pre-eclampsia and eclampsia. It notes that pre-eclampsia is characterized by new hypertension and proteinuria after 20 weeks of gestation, and can progress to eclampsia involving seizures. Risk factors include primigravidas, family history, and obesity. Magnesium sulfate is the primary treatment for preventing seizures, while antihypertensives are used if blood pressure remains high. Timely treatment is important but outcomes depend on severity of symptoms and can include maternal and fetal complications like premature birth.
Prolonged labour
subject: Obstetrics and Gynaecological Nursing. This topic contains Detail information about prolonged labour and it's management
Cervical ripening and the bishop score
Cervical ripening is the preparation of the cervix for labour and delivery. The Bishop score is the commonest used methodology to assess it. For more like this visit my page on YouTube https://www.youtube.com/@mudiagaakpoghene2243
Shoulder,face ,braw,,compound presention for undergraduate
Shoulder,face ,braw,,compound presention for undergraduateFaculty of Medicine,Zagazig University,EGYPT
Unergraduate course lectuers in Obstetrics&Gynecology,Faculty of medicine,Zagazig University Prepared by Dr Manal BeheryProlonged labour
Definition , Latent phase,prolonged latent phase , Causes, diagnosis first stage , second stage , treatment first stage ,second stage
Partograph
This document discusses the partograph, which is a composite graphical record used to monitor labor. It is used to assess the progress of normal and abnormal labor and the fetal response. The partograph allows providers to visualize cervical dilation over time and identify issues early. It includes components like maternal information, fetal well-being, labor progress, medications, and maternal condition. Using a partograph has benefits like early detection of problems, prevention of prolonged labor, and improved outcomes for mothers and babies.
Intrauterine Fetal Death (IUFD),(Kurdistan)
This document provides an overview of intrauterine fetal death (IUFD), also known as stillbirth. It defines IUFD as the death of a baby in the uterus after 20 weeks of gestation. The document discusses the epidemiology, etiology, risk factors, clinical features, diagnosis, treatment and management, and nursing care of IUFD. It also provides references for additional information.
Fetal distres
Fetal distress is defined as a state of hypoxia and acidosis during pregnancy caused by depletion of oxygen and accumulation of carbon dioxide in the fetus. It can be caused by maternal factors like preeclampsia, anemia, bleeding, or infection, as well as placental or umbilical cord issues that obstruct blood flow. This leads to respiratory acidosis in the fetus and changes in fetal heart rate. Chronic fetal distress can cause intrauterine growth retardation. Clinical manifestations include meconium staining, abnormal fetal heart rate and movement patterns, and acidosis shown on fetal blood samples. Management involves addressing the cause, correcting acidosis, and potentially terminating the pregnancy through forceps delivery or c-section depending on severity of
Pre mature rupture of membrene
1) Premature rupture of membrane (PROM) is defined as the rupture of amniotic sac more than 1 hour before the onset of labor.
2) PROM can be classified as preterm (before 37 weeks gestation), prolonged (rupture of membranes for over 24 hours before onset of labor), or pre-viable (before 24 weeks gestation).
3) Causes and risk factors of PROM include infections, smoking, previous preterm labor or PROM, polyhydramnios, multiple gestation, bleeding during pregnancy, invasive procedures, and cervical insufficiency. Diagnosis involves history collection, examination, and tests to assess fetal wellbeing.
Operative obstrectric
This document provides information on operative vaginal delivery using forceps. It describes the types of forceps including long curved forceps, short curved forceps, and Kielland's forceps. It details the parts of the forceps including the blades, shanks, locks, handles, and screws. It explains how to identify and apply the forceps blades for low forceps delivery. The steps taken are identification and application of the blades, locking the blades, applying traction, and removing the blades. Precautions and techniques are outlined to ensure a safe operative vaginal delivery using forceps.
3 malpresentations.warda (3)- FACE PRESENTATION
Face presentations occur when the fetal chin is the presenting part instead of the vertex. They are classified into four positions based on the position of the chin. Mentoanterior positions are more common and favorable than mentoposterior positions. Labor is usually prolonged in face presentations due to delayed engagement and lack of molding of the facial bones. Management depends on the position, with mentoanterior positions usually allowing vaginal delivery while mentoposterior positions often requiring assistance. Brow presentations are the rarest type and usually do not have a defined mechanism of labor.
Malposition and malpresentations
The document discusses malpositions and malpresentations during childbirth. It notes that occipito-posterior is a common malposition where the fetal back is directed posteriorly during delivery. Factors that can cause malpositions include defects in the powers of labor, the birth canal, or the fetus itself. Complications of malpositions include prolonged labor, increased need for interventions, and higher rates of maternal and neonatal morbidity. Management depends on the specific presentation and may involve inducing rotation, instrumental delivery, or cesarean section in difficult cases.
Postpartum haemorrhage
This document discusses the prevention and management of uterine atony, which is the leading cause of primary postpartum hemorrhage. It defines postpartum hemorrhage and describes risk factors. Prevention methods include active management of the third stage of labor and use of uterotonic drugs. Medical management includes uterotonic drugs, fluid resuscitation, blood products, and monitoring for disseminated intravascular coagulation. Surgical techniques like uterine packing, arterial ligation, and hysterectomy may be used if bleeding cannot be controlled medically.
Hemorrhage in early pregnancy
This document discusses hemorrhage in early pregnancy, miscarriage, ectopic pregnancy, and hydatidiform mole. It provides definitions, risk factors, clinical features, management, and pathogenesis for each condition. Key points include:
- Miscarriage (spontaneous abortion) occurs in 10-20% of pregnancies and is often due to fetal chromosomal abnormalities or maternal factors like age. Management depends on severity from expectant to surgical evacuation.
- Recurrent miscarriage is defined as 2 or more losses and can be caused by genetic, endocrine, immune, or inherited factors.
- Ectopic pregnancies implant outside the uterus, most commonly in the fallopian tubes. Risk factors
Induction of labor
Induction of labor involves initiating uterine contractions through medical, surgical, or combined methods to facilitate vaginal delivery after the fetus reaches viability. Common reasons for induction include preeclampsia, post-term pregnancy, premature rupture of membranes, and non-reassuring fetal status. It is important to confirm the indication for induction and rule out any contraindications. The document then discusses various methods for induction, including medical induction using prostaglandins or mifepristone, surgical induction through artificial rupture of membranes or membrane stripping, and combined methods. Risks of induction include iatrogenic prematurity and increased cesarean rates if induction fails. Proper patient counseling and assessment of cervical ripeness are important factors for
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Puerperal Pyrexia
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- Types include complete breech, frank breech, and footling breech. Diagnosis is made through inspection, palpation, auscultation, and ultrasound.
- Management options are external cephalic version, vaginal delivery for some cases, or caesarean section which is recommended for complicated breeches or large babies. Vaginal delivery carries risks of complications for
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Shoulder,face ,braw,,compound presention for undergraduate
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• Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. It is typically diagnosed by ultrasound examination and may be described qualitatively (eg, reduced amniotic fluid volume) or quantitatively (eg, amniotic fluid index ≤5 cm, single deepest pocket <2 cm).
• Oligohydramnios may be idiopathic or have a maternal, fetal, or placental cause The fetal prognosis depends on several factors, including the underlying cause, the severity (reduced versus no amniotic fluid), and the gestational age at which oligohydramnios occurs. Because an adequate volume of amniotic fluid is critical to normal fetal movement and lung development and for cushioning the fetus and umbilical cord from uterine compression, pregnancies complicated by oligohydramnios from any cause are at risk for fetal deformation, pulmonary hypoplasia, and umbilical cord compression.
• Oligohydramnios is associated with an increased risk for fetal or neonatal death, which may be related to the underlying cause of the reduced amniotic fluid volume or due to sequelae of the reduced amniotic fluid volume.
• This topic will discuss issues related to oligohydramnios. Methods of amniotic fluid volume assessment are reviewed separately.
• Oligohydramnios occurs when the amniotic fluid is < 5th centile for gestational age.
• The most common causes are premature rupture of membranes (often missed by the mother) and placental insufficiency, however structural abnormalities such as renal agenesis should be considered.
• Prognosis is linked to gestation at diagnosis and likely development of pulmonary hypoplasia and premature delivery.
• Treatment is by optimising gestation of delivery
Recent advances in male infertility
Normal fertile couples of reproductive age have a conception rate of 20% to 25% per month, with more than 90% conceiving within 1 year.
Male factor infertility is involved in approximately 50% of infertile couples.
In 30% of the cases, an abnormality is discovered solely in the man.
As many as 2% of all men will exhibit suboptimal sperm parameters.
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The document discusses various methods for assessing fetal well-being during pregnancy, including clinical evaluation, biochemical tests, and biophysical tests. Clinical evaluation involves monitoring the mother's weight, blood pressure, fetal growth and movement. Biophysical tests examine the fetus's heart rate and movement patterns in response to stimuli. These include the non-stress test (NST), biophysical profile (BPP), and contraction stress test. Ultrasound evaluates fetal anatomy and growth, while Doppler ultrasound assesses blood flow in vessels. Together these tools provide information on the fetus's health and help guide management to improve birth outcomes.
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SEMEN ANALYSIS
This document provides information about evaluating abnormalities in a semen analysis panel, including:
- The indications, sample collection/transport procedures, and normal ranges for semen volume, pH, motility, concentration, morphology, and other tests.
- How to interpret abnormalities in these parameters, such as low/high volume, pH, motility, oligospermia/azoospermia, teratozoospermia and their potential causes.
- Quality control procedures like repeat testing, and transient defects that could affect initial semen analysis results.
Four clinical cases are then presented to demonstrate applying this evaluation and interpretation of semen analysis results.
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Early pregnancy loss
This document summarizes common causes and management of early pregnancy loss. It discusses different types of spontaneous abortions including threatened, inevitable, incomplete, complete, blighted ovum, missed, septic, and recurrent abortions. Common causes of first trimester loss include chromosomal abnormalities, immunological factors, infections, and unexplained causes. Second trimester losses are commonly due to anatomical, autoimmune, medical diseases, and infections. Evaluation involves history, examination, baseline investigations, and specialized tests. Treatment depends on the underlying cause and may include progesterone, D&E, misoprostol, cervical cerclage, myomectomy, and low-dose aspirin with heparin.
1. anaemia in pregnancy
This document discusses anemia in pregnancy, defining it as a hemoglobin level of 11gm/100ml or less. It classifies anemias and lists common types like iron deficiency. Causes include poor diet, blood loss, and increased demands during pregnancy. Symptoms are described along with diagnostic tests. Treatment involves oral iron supplementation as well as intravenous iron or blood transfusions for more severe cases. Nursing care focuses on nutrition education, activity tolerance, infection prevention, and ensuring continued treatment after discharge.
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Vbac
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Oligohydramnios
- 1. DISORDERS OF AMNIOTIC FLUID- oligohydramnios DR.RUPAL 1
- 2. Contents • Physiology of amniotic fluid • Normal volume of AF in varying gestation • Definition of oligohydramnios • Incidence & etiology • Diagnosis • Management 2
- 3. PHYSIOLOGY OF AMNIOTIC FLUID 3
- 4. 4
- 5. 5
- 6. 6
- 7. NORMAL AMNIOTIC FLUID VOLUME 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 • AMNIOTIC FLUID VOLUME < 5 th percentile for gestational age • AMNIOTIC FLUID INDEX < 5 • SINGLE VERTICAL POCKET < 2 cms • Amniotic fluid volume of less than 500 mL at 32-36 weeks' gestation 8
- 9. 9
- 11. AETIOLOGY FETAL • PROM (50%) • CHROMOSOMAL ANOMALIES • CONGENITAL ANOMALIES • IUGR • IUFD • POSTTERM PREGNANCY MATERNAL • PREECLAMPSIA • APLA SYNDROME • CHRONIC HT PLACENTAL • CHRONIC ABRUPTION • TTTS • CVS DRUGS • PG SYNTHETASE INHIBITORS • ACE INHIBITORS IDIOPATHIC 11
- 12. 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 12
- 13. USG METHODS MVP <2 cms (<1 severe) AFI <5 cms (5-8 borderline) 2D pocket <15 sq cms 13
- 14. Technique of AFI • Uterus divided into 4 quadrants • Transducer in vertical plane • Sum of 4 quadrants max pocket depth excluding cord & limbs. • Prior to 20 wks 2 halves 14
- 15. COMPLICATIONS FETAL Abortion Prematurity IUFD Deformities – CTEV,contractures,amputation Potters syndrome- pulmonary hypoplasia Malpresentations Fetal distress MSAF – MAS Low APGAR MATERNAL Increased morbidity Prolonged labour: uterine inertia Increased operative intervention (malformations, distres) 15
- 16. 16
- 17. MANAGEMENT DEPENDS UPON • AETIOLOGY • GESTATIONAL AGE • SEVERITY • FETAL STATUS & WELL BEING 17
- 18. DETERMINE AETIOLOGY • R/O PROM, h/o medical illness • TARGETED USG FOR ANOMALIES • R/O IUGR ,IUFD when suspected • Amniocentesis if chromosomal anomalies suspected – early symmetric IUGR • Tests for APLA Syndrome , if suspected 18
- 19. 19
- 20. TREATMENT • ADEQUATE REST – decreases dehydration • HYDRATION – Oral/IV Hypotonic fluids(2 Lit/d) • SERIAL USG – Monitor growth,AFI,BPP • INDUCTION OF LABOUR/ LSCS 20
- 21. • AMNIOINFUSION INDICATIONS 1.Diagnostic 2.Prophylactic 3.Therapeutic Decreases cord compression Dilutes meconium 21
- 22. TREATMENT ACC. TO CAUSE • Drug induced – OMIT DRUG • PROM – INDUCTION • PPROM – Antibiotics,steroid – Induction • FETAL SURGERY VESICO AMNIOTIC SHUNT-PUV Laser photocoagulation for TTTS 22
- 23. IMP QUESTIONS • SHORT NOTES- OLIGOHYDRAMNIOS • AFI -2 MARKS 23
- 24. THANK YOU 24