Amniotic fluid maintain the perfect homeostasis between mother and fetus. It protect both mother and fetus from various complications. Details is enclosed in presentation.
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
Amniotic fluid
1.
2.
3.
4. • Screening for fetal malformation (serum α-fetoprotien).
• Assessment of fetal well-being (amniotic fluid index).
• Assessment of fetal lung maturity (L/S ratio).
• Diagnosis and follow up of labour.
• Diagnosis of PROM (ferning test).
PROM: Premature rupture of membranes
5.
6. • From 20 weeks up to term (mainly fetal urine)
• At 18th week, the fetus voids 7-14ml/day; at term fetal
kidneys secretes 600-700ml of urine/day into AF.
- Fetal respiratory tract secretes 250ml/day into AF.
- Fluid transfers across the placenta.
- Fetal oro-nasal secretions.
• Secretion is controlled by:
- Fetal swallowing at term removes 500ml/day.
- Reabsorption into maternal plasma (osmotic gradient).
• AF constituents:
- urea, creatinine & uric acid + desquamated fetal
cells, vernix, lanugo hair & others→ hypo-osmolar amniotic
fluid
7.
8. • Clinical assessment is unreliable.
• Objective assessment depends on U/S to
measure:
Deepest vertical pool (DVP) &
Amniotic fluid index (AFI)
9.
10.
11.
12.
13. • Fundal height < gestational age
• Decreased fetal movement
• Fetal Heart Rate tracing abnormality
• Diagnosis: Ultrasound
33. • Minor degrees: no treatment.
• Bed rest, diuretics, water and salt restriction: ineffective.
• Hospitalization: dyspnea, abdominal pain or difficult
ambulation.
• Indomethacin therapy: .
- impairs lung liquid production/enhances absorption.
- ↓fluid movement across fetal membranes.
* Complications: premature closure of ductus
arteriosus, impairment of renal function, and cerebral
vasoconstriction.
• Amniocentesis: to relieve maternal distress and to test for fetal
lung maturity. Complications: ruptured
membrane, chorioamnionitis, placental abruption, preterm
labour.