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INFLOW
(1000 ml/d)
1.FETAL URINE
2.LUNG LIQUID
OUTFLOW
(1000 ml/d)
1.FETAL
SWALLOWING
INTRAMEMBRANOUS (placenta,cord)
TRANSMEMBRANOUS(amniotic membranes)
RECYCLING 3hrs
6
OLIGOHYRAMINOS
DEFINITION
INCIDENCE
0.5 5%
CAUSES OF OLIGOHYDRAMNIOS:
1. Fetal causes:
* Renal cause
(57%):
- Renal agenesis
(Potters
syndrome).
- Polycystic kidney.
Urethral obstruction
(atresia/posterior
urethral valve).
Fetal growth
restriction.
Fetal death.
Postterm
pregnancy.
Preterm premature
PROM (50%)
rupture membranes
Chromosomal
anomalies
Congenital anomalies
IUGR
IUFD
Postterm pregnancy
CAUSES OF
OLIGOHYDRAMNIOS:
2. Maternal causes:
Uteroplacental insufficiency.
Preeclampsia.
APLA syndrome
Chronic HTN
3. Placental causes:
twin-twin transfusion.
Chronic abruption
TTTS
4. Drug causes:
Prostaglandin synthase inhibitor as NSAID.
Ace Inhibitors
5. Idiopathic
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
USG
METHODS
MVP
AFI
<2 cms
(<1 severe)
<5 cms
(5-8 borderline)
2D pocket
<15 sq cms
13
COMPLICATIONS OF
OLIGOHYDRAMNIOS:
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.
In late pregnancy:
Fetal growth restriction.
Placental abruption.
Preterm labour.
Fetal distress.
Fetal death.
Meconium aspiration.
Labour induction/CS.
MANAGEMENT
DEPENDS UPON
AETIOLOGY
GESTATIONAL AGE
SEVERITY
FETAL STATUS & WELL BEING
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DETERMINE AETIOLOGY
R/O PROM
TARGETED USG FOR ANOMALIES
R/O IUGR ,IUFD when suspected
Amniocentesis if chromosomal anomalies
suspected early symmetric IUGR
Tests for APLA Syndrome , if suspected
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TREATMENT
AMNIOINFUSION
INDICATIONS
1.Diagnostic
2.Prophylactic
3.Therapeutic
Decreases cord
compression
Dilutes meconium
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THANK YOU