POLYHYDRAMNIOS

&
OLIGIOHYDRAMNIOS

Prof. Yasmin Raashid

MBBS, MCPS, FRCOG
King Edward Medical College Lahore
Amniotic Fluid
 It is derived from maternal plasma in early
pregnancy.
 Amniotic fluid later receives its major
contribution from fetal plasma as exudation
of extra cellular fluid.
 After 20 weeks when skin becomes
impermeable amniotic fluid is formed from
fetal urine, lung fluid and the amnion. Major
contribution is from fetal urine.
Amniotic Fluid
 The volume of fluid present around the
baby is an excellent indicator of fetal
condition.
 Excess of amniotic fluid is
polyhydramnios.
 Decrease amount of amniotic fluid is
called oligiohydramnios.
Normal Volume
 12 weeks – 50 ml
 16 weeks – 100 ml
 22 weeks – 400 ml
 32 and 36 weeks – 800 ml
 Maximum normal increase is 1000 ml
 In twin pregnancies it is in the range of 1500
ml at 36 weeks.
 After 36 weeks amniotic fluid decreases in
amount.
Circulation
 Fluid is produced in early pregnancy from
exudation of fetal plasma and after 20 weeks
maximum contribution is from the fetal urine.
There is contribution from placental
membranes.
 Amniotic fluid is swallowed by the fetus,
absorbed through the intestines into the fetal
circulation and then excreted from the urine.
 Anything which interferes in this circulation
will result in Polyhydramnios or
Oligiohydramnios
Functions of Amniotic Fluid
 Provides even temperature.
 Acts as a cushion against external trauma.
 Allows freedom of movement for fetal activity.
 Permits Breathing movement and is important for the
development of the lungs.
 It is becteriostatic and protects against infection.
 In labor even distribution of fluids allows the force of
uterine contraction to be applied evenly to the cervix.
 The presence of the amniotic fluid provides the
ultrasnographer with an excellent view of the fetus.
Polyhydramnios
 Polyhydramnios is excess of amniotic fluid. It
is associated with
 Maternal Diabetes
 Fetal Anomalies like esophageal atresia, duodenal
atresia.
 Neural tube defects like anencephaly, spinabifida
 Multiple pregnancy
 Choriohaemangioma of the placenta.
 Idiopathic
Oligiohydramnios
 Decrease amount of amniotic fluid is
called oligiohydramnios and is seen in
the following conditions.
 Intrauterine growth retardation
 Chromosomal abnormalities
 Congenital anomalies like renal agenesis,
uretheral flap syndrome.
 Ruptured membranes.
Diagnosis
 Clinical examination can help in diagnosing
increase or decrease of amniotic fluid.
 Ultrasound is the best diagnostic module:

1. Fluid volume of less than 2 cms in 2 perpendicular

planes is diagnostic of oligiohydramnios.

2. Presence of fluid volume of more than 8 cms in 2

perpendicular planes is suggestive of
polyhydramnios.
Clinical Application
 To monitor diabetic pregnancies.
 To monitor Intra-uterine growth
retardation in pregnancy induced
hypertension.
 Amniotic fluid is used for important
tests like chromosomal analysis, etc.
THANK YOU