OLIGOHYDRAMNIOS DIAGNOSTIC PROCEDURES

 Ultrasonographic measurement of amniotic fluid volume

 Comprehensive ultrasonographic examination, including evaluation for fetal malformations
 Testing for clinically suspected maternal causes

Oligohydramnios may be suspected if uterine size is less than expected for dates or if fetal movements
are decreased; it may also be suspected based on incidental ultrasonographic findings. However,
qualitative estimates of amniotic fluid volume tend to be subjective. If oligohydramnios is suspected,
amniotic fluid should be assessed quantitatively using the amniotic fluid index (AFI).

The volume of amniotic fluid cannot be safely measured directly, except perhaps during cesarean
delivery. Thus, excessive fluid is defined indirectly using ultrasonographic criteria, typically the AFI. The
AFI is the sum of the vertical depth of fluid measured in each quadrant of the uterus. The normal AFI
ranges from > 5 to < 24 cm; values ≤ 5 cm indicate oligohydramnios.

TREATMENT

 Serial ultrasonography to determine AFI and monitor fetal growth

 Nonstress testing or biophysical profile

Ultrasonography should be done at least once every 4 weeks (every 2 weeks if growth is restricted) to
monitor fetal growth. The AFI should be measured at least once a week. Most experts recommend fetal
monitoring with nonstress testing or biophysical profile at least once a week and delivery at 36 to 37
weeks/6 days if oligohydramnios is isolated and uncomplicated (1). However, this approach has not
been proved to prevent fetal death.

Also, optimal time for delivery is controversial and can vary based on patient characteristics and fetal
complications.

POLYHYDRAMNIOS DIAGNOSTIC PROCEDURES

If your health care provider suspects polyhydramnios, he or she will do a fetal ultrasound. This
test uses high-frequency sound waves to produce images of your baby on a monitor.

If the initial ultrasound shows evidence of polyhydramnios, your health care provider may do a more
detailed ultrasound. He or she will estimate the amniotic fluid volume (AFV) by measuring the single
largest, deepest pocket of fluid around your baby. An AFV value of 8 centimeters or more suggests
polyhydramnios.

An alternative way of measuring amniotic fluid is measuring the largest pocket in four specific parts of
your uterus. The sum of these measurements is the amniotic fluid index (AFI). An AFI of 25 centimeters
or more indicates polyhydramnios. Your health care provider will also use a detailed ultrasound to
diagnose or rule out birth defects and other complications.