Oligohydraminos (Complete) Flashcards
(10 cards)
Define oligohydraminos
Amniotic fluid index below 5th percentile
Give examples of underlying aetiological causes of oligohydraminos
Uteroplacental insufficiency
- Blood diverted to foetal brain versus kidneys, resulting in reduced urine production
Foetal urinary system abnormalities
- Potter sequence
- Renal agenesis
- Polycystic kidneys
- Urethral obstruction
PROM
Post-term gestation
Chromosomal abnormalities
Maternal medications
- ACEi/ARBs
- NSAIDs
Give examples of causes of uteroplacental insufficiency
Hypertension
Pre-eclampsia
Placental abruption
Smoking
What complications are associated with oligohydraminos
Clubbed foot
Developmental dysplasia of the hip
Facial deformity
Pulmonary hypoplasia
N.B. Basically developmental complications due to foetal compression
Define potter syndrome
Atypical physical appearance of a baby due to oligohydramnios experienced when in the uterus
What investigations are conducted in patients with suspected oligohydraminos?
Bedside:
Pregnant abdomen examination:
- FSH smaller than expected
- Easier to feel/firmer foetal parts
Speculum examination: Check for PROM
- Amnisure (PAMG-1)
- Actim-PROM (IGFBP-1).
Imaging:
USS: Definitive diagnosis
What is the definitive diagnosis for oligohydraminos?
Ultrasound
- Reduced AFI
- Reduced signle deepest pocket (SDP)
What is the management plan for oligohydraminos?
Treat underlying cause
Conservative:
Maternal rehydration
Medical:
Amnioinfusion
- Infusion of saline into the amniotic cavity to increase amniotic fluid volume
Surgical:
Delivery (If signs of foetal distress)
What medical management may be considered in patients with oligohydraminos?
Amnioinfusion
Typicall conservative management only but may be used in cases of foetal distress/complications
What is amnioinfusion?
Infusion of saline into the amniotic cavity to increase amniotic fluid volume
