Amniotic Fluid

By: Group C
Amniotic Fluid Volume
• Amniotic fluid volume is related to gestational age. It measures about
50 mL at 12 weeks, 400 mL at 20 weeks and reaches its peak of 1 liter
at 36–38 weeks.
• Thereafter the amount diminishes, till at term it measures about
600–800 mL.
• As the pregnancy continues post term, further reduction occurs to the
extent of about 200 mL at 43 weeks.
 Physical Features
Appearance Significance
Colourless with slight to Normal
moderate turbidity
Dark/Blood- streaked Traumatic tap, abdominal trauma,
concealed accidental haemorrhage
Yellow/Golden HDN/Rhesus Incompatibility
Dark- green Meconium
Dark red/ brown Fetal Death/IUD
Greenish yellow Post maturity
Amniotic Fluid Circulation
Function
Its main function is to protect the fetus.
• During pregnancy:
(1) It acts as a shock absorber, protecting the fetus from possible
extraneous injury
(2) Maintains an even temperature
(3) The fluid distends the amniotic sac and thereby allows for growth and
free movement of the fetus and prevents adhesion between the fetal
parts and amniotic sac
(4) Its nutritive value is negligible because of small amount of protein and
salt content; however, water supply to the fetus is quite adequate.
Function cont.
• During labor:
(1)The amnion and chorion are combined to form a hydrostatic wedge
which helps in dilatation of the cervix
(2)During uterine contraction, it prevents marked interference with the
placental circulation so long as the membranes remain intact
(3)It guards against umbilical cord compression
(4)It flushes the birth canal at the end of first stage of labor and by its
aseptic and bactericidal action protects the fetus and prevents
ascending infection to the uterine cavity.
CLINICAL IMPORTANCE
• Study of the amniotic fluid provides useful information about the well
being and also maturity of the fetus
• Intra-amniotic instillation of chemicals is used as method of induction
of abortion.
• Excess or less volume of liquor amnii is assessed by amniotic fluid
index (AFI). It is measured to diagnose the clinical condition of
polyhydramnios or oligohydramnios respectively
• Rupture of the membranes with drainage of liquor is a helpful
method in induction of labor.
POLYHYDRAMINOS
• Defined as excessive amount of amniotic fluid of 2000 ml or more
• AFI of > 25cm
• or the deepest vertical pool of > 8 cm
• 95th or 97.5th percentile of GA
Oligohydramnios
• Abnormally small amount of amniotic fluid which is less than 300 –
500 ml at term.
• AFI <5cm
• Deepest Vertical pocket <2cm
• Less than 5th centile for GA
Management of Oligohydramnios
• ADEQUATE REST – decreases dehydration
• HYDRATION – Oral/IV Hypotonic fluids(2 Litres/day)
• Amino infusion by normal saline (helpful during labour, prior to ECV,
USG
• SERIAL USG – Monitor growth, AFI,BPP
• INDUCTION OF LABOUR