Oligohydramnios

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Oligohydramnios
Classification and external resources
ICD-10 O41.0
ICD-9 658.0
DiseasesDB 9202
eMedicine radio/898
MeSH D016104

Oligohydramnios is a condition in pregnancy characterized by a deficiency of amniotic fluid. It is the opposite of polyhydramnios.

Contents

[edit] Clinical Features

The common clinical features are smaller symphysio fundal height, fetal malpresentation, undue prominence fetal parts and reduced amount of amniotic fluid.

[edit] Diagnosis

Diagnosis is made by ultrasound measurement of the amniotic fluid index (AFI) <5cm. Several different methods exist for calculating AFI, that produce different index numbers below which oligohydramnios is said to be present.

[edit] Causes

It is typically caused by fetal urinary tract abnormalities such as bilateral renal agenesis ( Potter's syndrome ), fetal polycystic kidneys, or genitourinary obstruction. Uteroplacental insufficiency is another common cause. Most of these abnormalities can also be detected by obstetric ultrasound. It may also occur simply due to dehydration of the mother, maternal use of angiotensin converting enzyme inhibitors, or without a determinable cause (idiopathic).

[edit] Complications

Complications may include cord compression, musculoskeletal abnormalities such as facial distortion and clubfoot, pulmonary hypoplasia and intrauterine growth restriction. Amnion nodosum is frequently also present (nodules on the fetal surface of the amnion).[1]

The use of oligohydramnios as a predictor of gestational complications is controversial.[2][3]

[edit] Treatment

A Cochrane Review concluded that simple maternal hydration appears to increase amniotic fluid volume and may be beneficial in the management of oligohydramnios and prevention of oligohydramnios during labour or prior to external cephalic version.[4]

In severe cases oligohydramnios may be treated with amnioinfusion during labor to prevent cord compression.

[edit] See also

[edit] References

  1. ^ Adeniran AJ, Stanek J, (2007). "Amnion nodosum revisited: clinicopathologic and placental correlations". Arch Pathol Lab Med 131 (12): 1829–33. doi:10.1043/1543-2165(2007)131[1829:ANRCAP]2.0.CO;2. PMID 18081444. 
  2. ^ Johnson JM, Chauhan SP, Ennen CS, Niederhauser A, Magann EF (2007). "A comparison of 3 criteria of oligohydramnios in identifying peripartum complications: a secondary analysis". Am. J. Obstet. Gynecol. 197 (2): 207.e1–7; discussion 207.e7–8. doi:10.1016/j.ajog.2007.04.048. PMID 17689653. 
  3. ^ Elsandabesee D, Majumdar S, Sinha S (2007). "Obstetricians' attitudes towards 'isolated' oligohydramnios at term". Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology 27 (6): 574–6. doi:10.1080/01443610701469669. PMID 17896253. 
  4. ^ Hofmeyr GJ, Gülmezoglu AM (2000). Novikova, Natalia. ed. "Maternal hydration for increasing amniotic fluid volume in oligohydramnios and normal amniotic fluid volume". Cochrane Database of Systematic Reviews (Online) (2): CD000134. doi:10.1002/14651858.CD000134. PMID 10796151. 

[edit] External links


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