OLIGOHIDRAMNIOS

Jovian Lutfi Daniko

406172079
• This is an abnormally decreased amount of
amnionic fluid
• complicates approximately 1 to 2 percent of
pregnancies
• The sonographic diagnosis of oligohydramnios is
usually based on an AFI ≤ 5 cm or on a single
deepest pocket of amnionic fluid ≤ 2 cm (ACOG
2012)
• AFI below the 5th or 2.5th percentile determined
by a gestational-age-specific nomogram.
 Etiology
Early onset
• When amnionic fluid volume is abnormally
decreased from the early second trimester 
fetal abnormality that precludes normal
urination or
• placental abnormality severe enough to
impair perfusion
After midpregnancy
• amnionic fluid volume becomes abnormally decreased
in the late second or in the third trimester, it more
likely is associated with fetal-growth restriction,
placental abnormality,
• underlying etiology is often presumed to be
uteroplacental insufficiency, which can impair fetal
growth and reduce fetal urine output
• Oligohydramnios is commonly encountered in
postterm pregnancies, amnionic fluid volume
decreased by approximately 8 percent per week
beyond 40 week
Medication
• exposure to drugs that block the renin-angiotensin
system include angiotensin converting enzyme (ACE)
inhibitors and nonsteroidal antiinflammatory drugs
(NSAIDs)
• When taken in the 2nd or 3rd trimester, ACE inhibitors
and angiotensin-receptor blockers fetal hypotension,
renal hypoperfusion, renal ischemia
• NSAIDs have been associated with fetal ductus
arteriosus constriction and with decreased fetal urine
production. In neonates, their use may result in acute
and chronic renal insufficiency
 Pregnancy outcomes
Pulmonary hypoplasia
• When decreased amnionic fluid is first
identified before the mid- second trimester,
particularly before 20 to 22 weeks, pulmonary
hypoplasia is a significant concern
• Underlying etiology is a major factor in the
prognosis for such pregnancies. Severe oligo-
hydramnios secondary to a renal abnormality
generally has a lethal prognosis
 Management
• Initially, an evaluation for fetal anomalies and
growth is essential.
• Evidence for fetal or maternal compromise will
override potential complications from preterm
delivery. But, oligo- hydramnios detected
before 36 weeks in the presence of normal
fetal anatomy and growth may be managed
expectantly