Amniotic Fluid Disorders

All are causes of polyhydramnios except

A. Maternal diabetes
B. Fetal heart failure
C. Abnormal swallowing
D. Amnion nodosum

Following congenital anomalies can cause oligohydramnios except

A. Renal agenesis
B. Intrauterine infection
C. Duodenal atresia
D. Fetal chromosomal defects

Not true of amniotic fluid disorders

A. Hydramnios is more common in monozygotic twins
B. In TTTS the recipient twin develops polyhydramnios
C. Viral infections which can lead to polyhydramnios include parvovirus B19, rubella, and cytomegalovirus
D. Oligohydramnios is associated with fetal anemia

Management of polyhydramnios does not include

A. Induction of labor is done if pregnancy is more than 37 weeks
B. Oxytocin infusion is contraindicated for induction of labor
C. Therapeutic amniocentesis if pregnancy pregnancy is less than 37 weeks:
D. Use of sulindac can lead to a reduction of amniotic fluid volume

True of oligohydramnios is

A. Isolated oligohydramnios in the third trimester with a normal fetus may be managed conservatively
B. In labor, cord prolapse is common
C. Oral administration of water does not improve amniotic fluid volume
D. Oligohydramnios with asymmetric growth restriction is associated with increased chromosomal abnormality in fetus

The gold standard for measuring amniotic fluid volume

A. Four-quadrant amniotic fluid index (AFI)
B. Single deepest pocket (SDP)
C. Invasive dye dilution technique
D. Osmolarity of amniotic fluid

In short

  • Oligohydramnios is defined as measurement of an Amniotic Fluid Index less than 5 cm in at least one ultrasound in the third trimester.

  • Based on AFI values obtained during prenatal screening, polyhydramnios is categorized into three groups according to severity: mild polyhydramnios (AFI of 25–30 cm), moderate polyhydramnios (30.1–35 cm) and severe polyhydramnios (≥ 35.1 cm).

  • SDP is a better method of diagnosing oligohydramnios because it has a lower detection rate although there is no change in the rate of intervention or adverse outcomes.

  • It is reasonable to perform an admission contraction stress test on patients undergoing induction of labor for isolated oligohydramnios. This may help predict which patients would benefit from a non-urgent Cesarean delivery.

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