Oligohydramnios
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Oligohydramnios refers to a situation where the amniotic fluid volume is less than expected for gestational age. Often these fetuses have <500 mL of amniotic fluid.
Epidemiology
The estimated prevalence can be up to ~6% of pregnancies 4.
Pathology
Causes
Aetiology
The causes of oligohydramnios are protean and one way to simplify them is by using the mnemonic DRIPPC:
-
D:
- demise
- drugs: e.g. prostaglandin inhibitors
(indomethacin(indometacin)
- R: renal abnormalities (from decreased urine output)
- I: IUGR (intra-uterine growth restriction): 80% may occur from decreased renal perfusion due to sparing effect
- P: premature rupture of membranes
- P: post dates
- C: chromosomal anomalies (especially if other anomalies are found)
Associations
- Potter sequence
- underlying fetal hypoxia and fetal cardiovascular compromise: from preferential flow to the fetal brain at the expense of diminished renal blood flow
- twin pregnancy-related complications:
- twin to twin transfusion syndrome: in pump twin
- maternal dehydration
Radiographic features
Antenatal ultrasound
Several sonographic criteria can be used which include:
- four quadrants amniotic fluid index (AFI): <5 cm
- two diameter pocket method: <1 x 1 cm or <15 cm2
- maximum vertical pocket depth: <2 cm
Treatment and prognosis
DevelopmentThe development of oligohydramnios early in pregnancy is generally a poor prognostic marker. Amnio-infusion can be attempted in severe cases if appropriate.
Complications
- first-trimester oligohydramnios can result in failure of pregnancy in up to 95% from complications such as
- pulmonary hypoplasia: implies a very poor prognosis
- fetal limb contractures
See also
-<p><strong>Oligohydramnios</strong> refers to a situation where the <a href="/articles/amniotic-fluid-volume">amniotic fluid volume</a> is less than expected for gestational age. Often these fetuses have <500 mL of amniotic fluid.</p><p>Epidemiology</p><p>The estimated prevalence can be up to ~6% of pregnancies <sup>4</sup>.</p><p>Pathology</p><p>Causes</p><p>The causes of oligohydramnios are protean and one way to simplify them is by using the mnemonic <a href="/articles/causes-of-oligohydramnios-mnemonic-1">DRIPPC</a>:</p><ul>- +<p><strong>Oligohydramnios</strong> refers to a situation where the <a href="/articles/amniotic-fluid-volume">amniotic fluid volume</a> is less than expected for gestational age. Often these fetuses have <500 mL of amniotic fluid.</p><h4>Epidemiology</h4><p>The estimated prevalence can be up to ~6% of pregnancies <sup>4</sup>.</p><h4>Pathology</h4><h5>Aetiology</h5><p>The causes of oligohydramnios are protean and one way to simplify them is by using the mnemonic <a href="/articles/causes-of-oligohydramnios-mnemonic-1">DRIPPC</a>:</p><ul>
-<li>drugs: e.g. prostaglandin inhibitors (indomethacin)</li>- +<li>drugs: e.g. prostaglandin inhibitors (indometacin)</li>
-</ul><p>Associations</p><ul>- +</ul><h5>Associations</h5><ul>
-</ul><p>Radiographic features</p><p>Antenatal ultrasound</p><p>Several sonographic criteria can be used which include:</p><ul>- +</ul><h4>Radiographic features</h4><h5>Antenatal ultrasound</h5><p>Several sonographic criteria can be used which include:</p><ul>
-</ul><p>Treatment and prognosis</p><p>Development of oligohydramnios early in pregnancy is generally a poor prognostic marker. <a href="/articles/amnio-infusion">Amnio-infusion</a> can be attempted in severe cases if appropriate.</p><p>Complications</p><ul><li>first-trimester oligohydramnios can result in failure of pregnancy in up to 95% from complications such as<ul>- +</ul><h4>Treatment and prognosis</h4><p>The development of oligohydramnios early in pregnancy is generally a poor prognostic marker. <a href="/articles/amnio-infusion">Amnio-infusion</a> can be attempted in severe cases if appropriate.</p><h4>Complications</h4><ul><li>first-trimester oligohydramnios can result in failure of pregnancy in up to 95% from complications such as<ul>
-</li></ul><p>See also</p><ul>- +</li></ul><h4>See also</h4><ul>
References changed:
- 1. Ralph Weissleder, Jack Wittenberg, Mukesh G. Harisinghani. Primer of Diagnostic Imaging. (2003) ISBN: 0323023282 - <a href="http://books.google.com/books?vid=ISBN0323023282">Google Books</a>
- 1. Ralph Weissleder, Jack Wittenberg, Mukesh G. Harisinghani. Primer of Diagnostic Imaging. (2002) ISBN: 0323023282 - <a href="http://books.google.com/books?vid=ISBN0323023282">Google Books</a>
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