ultrasonography of amniotic fluid
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This document discusses ultrasound assessment of amniotic fluid. It notes that amniotic fluid sources change over gestation, with the amount normally ranging from 800-1000 ml at 33-34 weeks to 600 ml at term. Ultrasound can evaluate amniotic fluid volume (AFV) and detect free floating particles (FFP). AFV is assessed subjectively as normal, reduced, or increased, and objectively using the maximum vertical pocket (MVP) or amniotic fluid index (AFI) methods. Polyhydramnios can indicate fetal anomalies while oligohydramnios suggests problems like premature rupture of membranes. The biophysical profile score assesses fetal wellbeing, originally using AFI,
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ultrasonography of amniotic fluid
- 1. U/S of Amniotic Fluid Aboubakr Elnashar elnashar53@hotmail.com Aboubakr Elnashar
- 2. Amniotic Fluid • Sources: Early stages: Skin & placenta 12 - 14 W: lung & kidney 20 W: kidney • Amount: 33 - 34 W: 800-1000 ml At term: 600 ml • U/S parameters: I. AFV II. FFP Aboubakr Elnashar
- 4. I. AFV • Subjective: Normal Absent Reduced Increased • Objective: 1.Maximum vertical pool (MVP) 2.Amniotic fluid index (AFI) Aboubakr Elnashar
- 5. 1. Maximum vertical pool (minimum of 1cm width) * How ? •Oligohyd: <2 cm •Reduced: 2-3 cm •Normal: 3 - 8 cm •Polyhyd: >8cm Mild 8-12 cm Severe > 16 Aboubakr Elnashar
- 7. 2. Amniotic fluid index •How ? Aboubakr Elnashar
- 13. Interpretation: •Oligohyd: < 5 cm Reduced: 5-10 cm Normal: 10- 20 cm More than average: 20-25 cm Polyhyd: > 25 cm Aboubakr Elnashar
- 14. AFI & gestational age Ges age (W) 5th 50th 95th 28 94 mm 146 mm 228 mm 32 86 mm 144 mm 242 mm 36 77 mm 138 mm 249 mm 38 73 mm 132 mm 239 mm 40 71 mm 123 mm 214 mm 42 69 mm 110 mm 175 mm Aboubakr Elnashar
- 15. Causes of polyhydramnios 1. Idiopathic 2. D. M. 3. Isoimmunization Aboubakr Elnashar
- 16. 4. Foetal anomalies: • CNS: Hydrocephaly, Anencephaly, S. bifida • Neck &face: Cystic hygroma. • Pulmonary: Diaphragmatic hernia. • GIT: Oesophygeal atresia, Dud. atresia, Omphalocele • Other: Cong. infection, Chromosomal anomalies Aboubakr Elnashar
- 19. Causes of oligohydramnios 1. Spontaneous ROM. 2. Placental insufficiency. 3. IUGR. 4. Renal agenesis, uretheral stenosis. Aboubakr Elnashar
- 21. Keyhole bladder, posterior urethral valve Cystic hygroma, olighyd, Turner s synd Aboubakr Elnashar
- 22. Fetal biophysical profile Score 2 Score 0 CTG >2acc./40 min < F. movements >3/30 min < F.br. movements 30 sec sustained fbm /30 min < F.tone closed fist or flex .to ex. movement Neither AFV >1 cm pocket < Aboubakr Elnashar
- 23. Interpretation: If all parameters detected by U/S are normal, no need to perform NST 8: reassuring. 6 or 7: equivocal, and must be repeated within 24 hours. 4 or less: a positive test and strongly suggests preparing the patient for delivery. Aboubakr Elnashar
- 24. •Modifications: Manning (1990) NST MVP Fetal breathing. More recently NST AFI It is less cumbersome than the original BPP and its results are just as predictive. AFI is the indicator of long term uteroplacental function and the NST is the short term indicator of fetal acid-base status. Aboubakr Elnashar
- 25. II. Free floating particles •What: Multiple linear densities, 1- 5 mm suspended, but gradually settling •Significance: * No * F. maturity * F. distress. * LFGA. Aboubakr Elnashar