Management involves close monitoring and serial ultrasonographic assessments. Maximal amniotic fluid index as a prognostic factor in pregnancies complicated by polyhydramnios. Sometimes, the only treatment necessary is a rehydration plan, either through drinking more fluids or iv injections. Oligohydramnios is a condition during pregnancy where theres lowerthanexpected amniotic fluid surrounding a baby for his or her gestational age. Including all grades of pre eclampsia, pregnancy induced hypertension and essential hypertension table 2.
Rapid growth of the uterus is the first noticeable sign of hydramnios. Oligohydramnios is a decrease in the volume of amniotic fluid, with the diagnosis usually being made using ultrasound. The condition can occur at any stage of pregnancy but it is most common in the last trimester. It protects your baby and aids in the development of muscles, limbs, lungs and digestive system. Oligohydramnios, small for gestational age and pregnancy.
Gestational age at delivery, rates of nulliparity and induction of labor were significantly different between cases with oligohydramnios and those with normal afi all p oligohydramnios during pregnancy see section 3. Postterm pregnancy a pregnancy that goes 2 or more weeks past the due date. National institute for health and clinical excellence. Chapter 14 abnormalities of the amniotic fluid volume. The lungs are also filled with amniotic fluid, and the baby will practice breathing toward the end of pregnancy.
Polyhydramnios means having too much amniotic fluid in the womb. Oligohydramnios can be caused by a number of different conditions, some of which are out of your control, including your family history of genetic disorders, chronic maternal diseases like diabetes or lupus. It is a condition where too little amniotic fluid surrounds the fetus in the womb. Your search for management of oligohydramnios resulted in 1 matches knowledge area 5 antenatal care knowledge, clinical skills and professional values for the provision of highquality and safe patientcentred care 6. Polyhydramnios and oligohydramnios clinical presentation.
Oligohydramnios may complicate pregnancy if it occurs over a long period of time. What causes oligohydramnios and what it means for you and. Oligohydramnios sequence, or potters syndrome, is a chain of events that result in severe. Oligohydramnios in complicated and uncomplicated pregnancy. Perinatal outcome in oligohydramnios and borderline amniotic.
Fetal mortality rates as high as 8090% have been reported with oligohydramnios diagnosed in the second trimester. Our malaysian mums guide to prenatal health explains how polyhydramnios is usually managed and what you can expect if it affects your pregnancy. Therapeutic amnioinfusion in oligohydramnios during pregnancy. However, there are several ways you can decrease your risk of oligohydramnios and keep your level of amniotic fluid balanced. Generally, oligohydramnios is less prevalent in early pregnancy and at this time it usually is associated with poor prognosis 1.
Nearly 1% of pregnancies are affected by some type of midtrimester oligohydramnios. The occurrence of oligohydramnios complicating a pregnancy is seen in 0. Oligohydramnios in complicated pregnancy is associated with an increased risk of delivery of an infant with low birth weight, but this may be. Size difference between gestational sac and crownrump length is less than 5 mm. Oligohydramnios is a deficient volume of amniotic fluid. When theres too little amniotic fluid in your uterus at any point in your pregnancy, its called oligohydramnios. Williams ob page 233 nomogram a diagram representing the relations between three or more variable quantities by means of a number of scales, so arranged that the value of one variable can be found by a simple geometric construction, for example, by drawing a straight line intersecting the other. Studies show that oral hydration, by having the women drink 2 liters of water, increases the afi by 30%. Your baby may need to be delivered, even if he is not full term. This is where there is too much amniotic fluid present in the womb. Feb 03, 2020 oligohydramnios is a condition that causes you to have too little amniotic fluid during pregnancy. Oligohydramnios occurs when the volume of fluid in the amniotic sac is too low. Full text full text is available as a scanned copy of the original print version. Amniotic fluid is produced soon after the amniotic sac forms at about 12 days after conception.
Methods women with singleton pregnancies complicated by pprom at a. Sep 14, 20 oligohydramnios is a disorder that occurs in pregnancy and is characterized by an amniotic fluid deficiency. Perinatal outcome associated with oligohydramnios in. In singleton pregnancies where oligohydramnios is present without maternal and fetal complications, evidence exists that either oral or intravenous maternal hydration 15002500 mlday is associated with a 2030% improvement in afi and a reduction in cesarean delivery. The fetuses with this condition have less than 500 ml of amniotic fluid 1. Amniotic fluid plays an important role in fetal health and development, and is far from the. During the first trimester of pregnancy, the main component of amniotic fluid is fluid supplied by the mother via the placenta maternal plasma, nutrients and. Severe oligohydramnios, though not clearly defined, but clinically with an afi of less than 5 cm. About 4 out of 100 4 percent pregnant women have oligohydramnios. Most of this mortality is a result of major congenital malformations and pulmonary hypoplasia secondary to prom before 22 weeks gestation. This symptom occurs later in the development of the disease. Nov 22, 2006 during pregnancy, the level of amniotic fluid increases rapidly to reach a peak at about 36 weeks gestation after which time it may start to gradually decrease. It is a condition that occurs in about 1 in 250 pregnancies.
Over time, most of the amniotic fluid will be urine created by the baby. Oligohydramnios is likely in the case of twintotwin transfusion syndrome, in which one twin has too little amniotic fluid while the other has too much. An estimated 4 percent of pregnant women are diagnosed with oligohydramnios, and that rate rises to 12 percent among overdue women, since amniotic fluid levels tend to decrease late in pregnancy. The indications of ultrasound examination were similar for cases and controls. Get a printable copy pdf file of the complete article 464k, or click on a page image below to browse page by page. Chapter 14 abnormalities of the amniotic fluid volume amniotic fluid is produced by fetal urination but in the first 16 weeks of gestation additional sources include the placenta, amniotic membranes, umbilical cord and fetal skin. There is increased risk of early pregnancy failure in such cases. The finding of oligohydramnios in pregnancy is problematic. Approximately 4% of women will be diagnosed with low amniotic fluid levels oligohydramnios during pregnancy. During pregnancy, the level of amniotic fluid increases rapidly to reach a peak at about 36 weeks gestation after which time it may start to gradually decrease.
The outcome of pregnancy in study group was compared with that of control group. Oligohydramnios in women with preterm prelabor rupture of. Patients were excluded if they delivered elsewhere or if there were other major congenital anomalies or aneuploidy. Therapeutic amnioinfusion in oligohydramnios during. It also keeps your babys body from compressing the umbilical cord against the uterine wall. Mar 11, 2016 the earlier in pregnancy that oligohydramnios occurs, the poorer the prognosis. Being well past your due date decreased amniotic fluid is one of the risks of post term pregnancy. Oligohydramnios is an abnormally decreased amount of amniotic fluid in pregnancy. Links to pubmed are also available for selected references. The earlier in pregnancy oligohydramnios occurs, the poorer the prognosis.
Pregnancies with oligohydramnios have a bimodal distribution. Throughout pregnancy, your amniotic fluid cushions your baby and allows him to grow and move. Patients with reactive cardiotocography hoursctg test, amniotic fluid index pregnancy fluidof 24 weeks onwards excluding labour. Objective to determine the association between the presence of oligohydramnios, determined as an amniotic fluid index. 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. The earlier in pregnancy that oligohydramnios occurs, the poorer the prognosis. If you are discharged before your baby is born, you will need to watch for serious signs and symptoms. Causes of fetal death autopsy andor placental histological results. Management of oligohydramnios in pregnancy request pdf. The frequency of different risk factors in pregnancy included gestational diabetes. From january 1997 to december 2000 all uncomplicated pregnancies reaching 40. Measured by the amniotic fluid index afi, oligohydramnios is diagnosed as having less than the fifth percentile of fluid for your gestational age.
The ultrasound examination of patients was done and an amniotic fluid index of 5cm or less was taken as the criteria for diagnosis of oligohydramnios. The various mechanisms that control amniotic fluid, the inability to precisely measure and quantify. The code is valid for the year 2020 for the submission of hipaacovered transactions. Treatment of low urinary tract blockage in an unborn baby using a vesicoamniotic shunt. Oligohydramnios sequence is the condition that develops during pregnancy when oligohydramnios occurs. Perinatal outcomes in uncomplicated late preterm pregnancies with borderline oligohydramnios. A pregnancy that goes past 42 weeks is at risk of oligohydramnios because the amniotic fluid can decrease by half after this time. A reduced amount of amniotic fluid has been linked with poorly developed fetal lungs pulmonary hypoplasia or other physical deformities. Patients with second trimester oligohydramnios have a higher prevalence of congenital anomalies 50. Therapeutic amnioinfusion for oligohydramnios during. Causes of oligohydramnios include ruptured membranes, placental insufficiency, fetal anomalies, maternal injestion of medications, complications of a multiple gestation, chromosomal abnormalities, and idiopathic. Biostatistics, university of arkansas for medical sciences, little rock, ar, usa. Jan 07, 2016 the earlier in pregnancy that oligohydramnios occurs, the poorer the prognosis.
At least 2 ultrasound examinations checkfor gestational age confirmation and confirmation minutesof oligohydramnios. Ounpraseuth2 1department of obstetrics and gynecology, university of arkansas for medical sciences, little rock, ar, usa. Oligohydramnios is a condition that causes you to have too little amniotic fluid during pregnancy. About 8 percent of pregnant women will experience low amniotic fluid levels, although. Oligohydramnios low amniotic fluid amniotic fluid is the fluid around the baby that protects them in the womb. Its most common late in the third trimester, particularly if youre overdue, and not usually a sign of a problem. Polyhydramnios in singleton pregnancies dsog danish society of obstetrics and gynecology approved on january 21st, 2016 by the participants at the national dsog. Difficulty in auscultating the heart rate is also a symptom yet develops later in the progress of the disease. T1 oligohydramnios, small for gestational age and pregnancy outcomes.
Jun, 2016 that is y fetuses with lethal renal abnormalities may no manifest severe oligo until 18 weeks. Premature rupture of the membranes prom when the amniotic sac breaks after 37 weeks of pregnancy but before labor starts. Moreover, one study of 3050 uncomplicated pregnancies with singleton fetuses between 40 and 41. Oligohydramnios causes, symptoms, treatment, prognosis and. Because the amniotic fluid helps support the fetus, a deficiency can affect the development of organs. There may not be any prominently detectable signs in affected women. Varicosities and hemorrhoids are symptoms yet they do not appear first. Management of severe oligohydramnios with antepartum. You may need to be treated in the hospital for problems caused by oligohydramnios. The purpose of this study was to evaluate the effect of oligohydramnios on perinatal outcome in uncomplicated pregnancies between 40. Development of oligohydramnios early in pregnancy is generally a poor prognostic marker. Oligohydramnios causes, symptoms, treatment, prognosis. Several studies found oligohydramnios to be an independent risk factor of intrauterine fetal death. Oligohydramnios is the presence of an abnormally low volume of amniotic fluid af surrounding the fetus.
Birth defects, especially ones that affect the babys kidneys and urinary tract. Low levels of amniotic fluid can be a sign of a problem with the pregnancy. Respiratory morbidity was assessed by need for oxygen at 36 corrected weeks or at hospital discharge if this occurred prior to 36 corrected. Statistics included analysis of linear trends and multinomial logistic regression. Oligohydramnios with fetal symmetric growth retardation is associated with increased chromosomal abnormality. The impact of residual oligohydramnios following preterm. It is first made up of water from the mother, but over time becomes made up of fetal urine 1. Oligohydramnios, small for gestational age and pregnancy outcomes. The amniotic fluid is part of the babys life support system. Pregnancy outcome in oligohydramnios international. The prevalence of this disease can be up to 6% of all pregnancies 2.
In fetuses with severe oligohydramnios between and 24 weeks, 51% have fetal abnormalities 1% are aneuploidy, 34% have preterm premature rupture of membranes, 7% abruption, and 5% growth restriction. It can happen at any time during pregnancy, but its most common in the last trimester last 3 months. Evidence is currently accumulating that suggests the better efficacy of the new therapeutic procedures relative. Oligohydramnios is a disorder that occurs in pregnancy and is characterized by an amniotic fluid deficiency.
This prospective study was conducted over a period of 1 year jan 2014 to jan 2015. A fullterm pregnancy is one that lasts 39 to 41 weeks. Oligohydramnios refers to a pregnancy condition where the level of amniotic fluid in the womb is considered too low. The treatment for oligohydramnios depends on several factors, including. Oligohydramnios can happen at any time during the pregnancy. Three thousand and fortynine women met the inclusion criteria, 341 of which 11% had an afi. Sep 20, 2017 odibo in, newville tm, ounpraseuth st, et al. Therapeutic amnioinfusion in oligohydramnios during pregnancy excluding labor mahvish qazi1, najmus saqib2, abida ahmed1, imran wagay3 e introduction amniotic fluid surrounds the fetus in intrauterine life providing a protected, low resistance space suitable for fetal movements, growth and development. Evidence based management of oligohydramnios medwin. Pdf poligohydramnios is a threatening condition to fetal health and. Low amniotic fluid levels oligohydramnios bellybelly. Authors conclusions simple maternal hydration iv hypotonic fluid 2 lit appears to increase amniotic fluid volume and may be beneficial in the management of oligohydramnios and prevention of oligohydramnios during labour or prior to external cephalic version.
Most of this mortality is a result of major congenital malformations and pulmonary hypoplasia secondary to prom before 22 weeks of gestation. Amniotic fluid cushions the baby and is a vital part of its life support system in aiding the development of its muscles, lungs and digestive system. It complicates approximately 1 to 2 percent of pregnancies. Oligohydramnios is better known as having low amniotic fluid. Oligohydramnios gynecology and obstetrics merck manuals. Role of amniotic fluid index in pregnancy outcome cases of oligohydramnio s were studied and the mean maternal age found was 23. Placental lesions associated with oligohydramnios in fetal. The impact of residual oligohydramnios following preterm premature rupture of 1 membranes on adverse pregnancy outcomes. Oligohydramnios inpatient care what you need to know. It happens in about 12 out of 100 12 percent women whose pregnancies last about 2 weeks past their due dates. Renal agenesis, oligohydramnios and diabetes mellitus.
Oligohydramnios sequence definition and patient education. Diagnosis is by ultrasonographic measurement of amniotic fluid volume. Oligohydramnios may be the result of decreased fetal urine production or excretion, or excessive amniotic fluid loss. Pregnancy outcome in oligohydramnios international journal. Maternal obesity is defined as a body mass index bmi 30 kgm2 b. Oligohydramnios in complicated and uncomplicated pregnancies. Oligohydramnios ambulatory care what you need to know. Oligohydramnios low amniotic fluid birth injury cases. Amnioinfusion can be attempted in severe cases if appropriate.
1199 273 1661 292 1518 1119 1065 263 1565 516 611 876 718 612 1294 633 126 324 571 188 358 6 396 1279 172 653 1428 334 858 732 1055 204 674