Oligohydramnios Causes Pathophysiology Symptoms Diagnosis Complications and Treatment

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Oligohydramnios means reduced amount of liquor around the baby. Quantitatively it is defined as an Amniotic fluid Index(AFI) of less than 5 cm or maximum vertical pool ( MVP ) of less than 2 cm . There are many causes of Oligohydramnios . The common causes include maternal causes like CKD , hypertension , diabetes insipidus and dehydration. The fetal causes include dysplastic kidneys , urethral obstruction , VACTERL Syndrome , Meckle Gruber Syndrome , pregnancy related complications include TTTS and IUGR . the iatrogenic causes of Oligohydramnios include the use of drugs like ACE inhibitors like Enalapril and Prostaglandin Synthase inhibitors like Indomethacin and Ibuprofen etc. In some patients the cause of Oligohydramnios is know , and that is called Idiopathic Oligohydramnios. • Oligohydramnios is caused by many conditions which tend to decrease the liqour production. In the first 16 weeks of pregnancy , it is caused by alteration in the filteration of fluids and sloutes across the placenta. After 16 weeks of gestation as most of the liqour comes from fetal urine , so any condition which decreases the urine production by the fetus result in decreased amount of amniotic fluid. The renal perfusion gets disturbed by several factors like maternal diabetes insipidus, maternal hypertension and chronic kidney diseases and this reduced renal perfusion causes Oligohydramnios. Details discussion on the mechanism of reduced liqour formation is also explained in this video. • Oligohydramnios is diagnosed by using specific ultrasound parameters , which include (1)-Subjective assessment of Amniotic Fluid estimation , (2)- Measurement of Maximum vertical pool and (3)- Measurement of Amniotic Fluid Index. Subjective assessment of amniotic fluid estimation carry very high inter and intra observer errors and variations in the assessment . The maximum vertical pool is measured before 24 weeks of gestation . • After 24 weeks , the abdomen of a patient is divided into four quadrants and the maximum vertical deepest pools are measured in each of the four quadrants , which are added up in the end to get complete Amniotic Fluid Index . A normal AFI is about 5 - 24 cm . If it is less than 5 cm that indicates Oligohydramnios and when the Amniotic Fluid Index is more than 24 cm , it is called Polyhydrmanios. This videos also explains how we take all these measurements . • This video also explains the management of Oligohydramnios , which is defined as the reduced amount of amniotic fluid around the baby. In order to diagnose a case of Oligohydramnios , first of all , we need to do proper counseling of the patient regarding the diagnosis and the possible complications . The complications of Oligohydrmanios include the maternal complications like increased risks of Instruemental vaginal delivery and cesarean section. The fetal complications include increased risk of Preterm delivery , intrauterine growth retardation and intrauterine death before 38 weeks of gestation. The mild type of Oligohydramnios is managed by doing Conservative Management which include Regular A/N visits, Adivise regarding intake of plenty of water , Steroid cover and IOL and Delivery. For the management of Severe Oligohydramnios first of all admit the patient in the hospital and advise the propped up position along-with analgesia, daily FKCC, FHS auscultation , twice daily BPP and AFI , iv fluids , steroid cover and Induction of Labour after 38 weeks of gestation. • #definitionofoligohydramnios • #oligohydramniosriskfactors • #complicationsofoligohydramnios • #oligohydramniossignsandsymptoms • #oligohydramniosmanagement • #oligohydramnioseffectsonbaby • #oligohydramnioseffectsonbaby • #complicationsofoligohydramniosinpregnancy • #complicationsoligohydramnios • #differentialdiagnosisofoligohydramnios • #oligohydramniosradiology • #oligohydramniosmanagement • #meaningofoligohydramnios • #oligohydramnioscomplications • #oligohydramniosandpolyhydramnios

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