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UNIT 3 - POLYHYDRAMNIOS, UNIT 3 - OLIGOHYDRAMNIOS - Coggle Diagram
UNIT 3 - POLYHYDRAMNIOS
-
ETIOLOGY
FETAL
- fetal swallowing defect - inability of amniotic fluid absorption
- intrapartum infections
- chromosomal abnormalities
- urogenital disorders
- neuromuscular disorders
MATERNAL
- gestational diabetes
- alloimmunization secondary to maternal antibodies resulting in fetal hemolytic anemia
SIGNS AND SYMPTOMS
- tightness of the maternal abdomen
- swelling of the lower extremities
- fundal height 3 cm above expected gestational age
- rapid uterine enlargement
DIAGNOSTIC EVALUATIONS
- ULTRASONOGRAPHY: aminiotic fluid assessment and fetal evaluation
- AMNIOTIC FLUID ALPHA FETOPROTIEN: open neural tube defects
MANAGEMENT
- treatment varies based on the severeity of polyhydramnios and its underlying cause
- Reductive Amniocentesis
- Indomethacin, a prostaglandin synthetase inhibitor: Decrease amniotic fluid volume
- Continuous electronic fetal monitoring
- neonatal support should be available
- preparation should be made to respond to postpartum hemorrhage promptly
COMPLICATIONS
- intrauterine fetal demise
- Preterm labor
- premature rupture of membranes
- cord prolapse
- fetal macrosomia
- breech presentation
- cesarean delivery
- postpartum hemorrhage
UNIT 3 - OLIGOHYDRAMNIOS
-
ETIOLOGY
MATERNAL
- hypertensive disorders
- uteroplacental insufficiency
- dehydration
- idiopathic
- post term pregnancy
- prelabour rupture of membranes
FETAL
- renal agenesis
- urinary tract obstruction
- spontaneous rupture of membranes
- intrauterine infection
- IUGR
- Drugs: PG inhibitors, ACE inhibitors
- Fetal chromosomal and structural abnormalities
- amnion nodosum
SIGNS AND SYMPTOMS
- Smaller uterine size
- less fetal movements
- uterus is "full of fetus"
- malpresentation
- evidences of IUGR
DIAGNOSITIC EVALUATION
- ULTRASOUND: asess for structural abnormalities, for fetal growth restriction and markers of aneuploidy, umbilical artery
- NONSTRESS TESTS: performed atleast once per week until delivery
MANAGEMENT
- treatment based on underlying causes and gestational age
- amnioinfusion - reduce complication early pregnancy
- weekly maximum vertical pocket measurements and nonstress tests
- maternal hydration
COMPLICATION
- increased risk of umbilical cord compression
- meconium aspiration
- cesarean delivery
- fetal heart rate decelerations
- nonreactive fetal tracings