OLIGOHYDRAMNIOS /

POLYGOHYDRAMNIOS
 OVERVIEW
Occasionally, a pregnancy can
produce either too little or too much
amniotic fluid, which is the fluid that
surrounds the baby. What results is a
set of possible risks or complications
known as oligohydramnios and
polyhydramnios.
 OLIGOHYDRAMNIOS
Oligohydramnios is when a mother have too
little amniotic fluid. Amniotic fluid is the fluid
that surrounds the baby in mother's uterus
uterus (womb). It’s very important for the
baby’s development.
 POLYHYDRAMNIOS
Polyhydramnios (pol-e-hi-DRAM-nee-os) is
the excessive accumulation of amniotic fluid
— the fluid that surrounds the baby in the
uterus during pregnancy. Polyhydramnios
occurs in about 1 to 2 percent of pregnancies.
SIGNS AND
SYMPTOMS
OLYGOHYDRAMNIOS POLYHYDRAMNIOS
Leaking of the amniotic fluid
Low amniotic fluid on an
ultrasound
Baby is smaller than what is
normal for gestational age
(IUGR)
Low maternal weight gain
Abdominal discomfort
Sudden drop in fetal heart rate
Shortness of breath or the
inability to breathe
Swelling in the lower
extremities and abdominal
wall
Uterine discomfort or
contractions
Fetal malposition, such as
breech presentation.
DIAGNOSTIC
AND
LABORATORY
TEST
ULTRASOUND
To measure how much amniotic fluid is in the
uterus. There are two ways to do this: amniotic
fluid index (AFI) and maximum vertical pocket
(MPV). AFI checks how deep the fluid is in four
areas of your uterus. The provider adds these
numbers up. MPV measures only the deepest
area of the uterus to check for fluid volume. If
one of these tests shows either oligohydramnios
or polyhydramnios, the provider will likely order
additional tests to check for congenital
disorders, diabetes or other conditions
 OTHER TESTS
FETAL ECHOCARDIOGRAM
A stronger ultrasound that can see the fetus's circulatory system.

NONSTRESS TEST
To check for abnormalities in the fetal heart rate.
RISK FACTORS
OLYGOHYDRAMNIOS POLYHYDRAMNIOS

Maternal Early labor.

hypertension/preeclampsia Premature birth (your baby is
Maternal diabetes born before 37 weeks).
Maternal dehydration Placental abruption.
Maternal hypoxia Postpartum hemorrhage.
Placental Issues Umbilical cord prolapse.
The fetus becomes breech.
Stillbirth.
PATHOPHYSIOLOGY
NURSING
DIAGNOSIS /
NURSING
MANAGEMENT
 ACUTE ABDOMINAL PAIN RELATED TO MOVEMENT OF THE BABY
SECONDARY TO DECREASED AMNIOTIC FLUID LEADING TO PRESSURE OF
THE FETUS WITHIN THE UTERUS

INTERVENTION RATIONALE

Assess the gestational To identify the growth

age, maternal factors and conditiong of the
like hypertension, fetus.
gestational DM and fetal To provide
heart rate. interventions based on
Monitor the vital signs the severity of the
and pain score regularly. pain.
 IMPAIRED GAS EXCHANGE (FETAL) RELATED TO INTERRUPTION OF
BLOOD FLOW FROM PLACENTA AND FETUS AS MANIFESTED BY FETAL
CONGENITAL ABNORMALITY (CLEF LIP AND PALATE)

INTERVENTION RATIONALE

Monitor maternal vital To determine what

signs.
Monitor fetal heart rate
frequently by obtaining
electrical fetal
monitoring tracing.
appropriate
intervention should be
given.
To obtain the result if
it is abnormal or not
and to report the
changes immediately.
 RISK FOR MATERNAL AND FETAL INJURY RELATED TO
POLYHYDRAMNIOS
INTERVENTION
Place the mother on
closed monitoring.
Prepare the patient for
admission if there is any
evidence of worsening
maternal and fetal
healthy due to
polyhydramnios.
RATIONALE
Pregnant women with
polyhydramnios may not
require active management
as they usually resolve on
their own.
To allow healthcare team to
monitor the mother and the
baby, and to provide
prescribed treatment as
deemed necessary.
MEDICAL / SURGICAL
MANAGEMENT
Don't hesitate to ask any questions!
MEDICAL MANAGEMENT
Indomethacin - this is to facilitate the
reduction of amniotic fluid volume
and fetal urine production. This
medication is usually not prescribed
for pregnant women above 31 weeks'
gestation.
SURGICAL MANAGEMENT
Amniocentesis - A method that
draines excess amniotic fluid. This is
also the treatment when preterm
labor occur due to polyhydramnios.

Amnioinfusion - A procedure in which

saline is put into the mother's uterus
via a catheter placed through the
cervix.