From Bench to Bedside
Ornella Parolini, Antonietta Silini in Placenta, 2016
Morbus hemolyticus neonatorum may cause changes in the amniotic fluid and also some discoloration of tissues, which are refused later in the transplantation procedure. Placental insufficiency, premature placental detachment, and placenta previa lead to stressful complications coinciding with tears in amniotic membranes or disruption of the placenta. Preeclampsia and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome are associated with severe placental pathology. Oligohydramnios (low amniotic fluid levels) may be a sign of overdue pregnancy and is often associated with insufficiency of the placenta or with problems in the development of the kidneys or urinary tract of the fetus. Placental abnormalities may lead to intrauterine growth restriction. Cervical insufficiency is often a problem leading to preterm birth, and although treated well by cervical cerclage, it requires medication with antibiotics.
Amniotic Fluid Abnormalities
Asim Kurjak in CRC Handbook of Ultrasound in Obstetrics and Gynecology, 2019
Oligohydramnios is a term which describes a gravid uterus with a very small amount of amniotic fluid. There is still no uniform definition of this finding. Its presence has been suggested by a total intrauterine volume 2 SD below the mean, as well by a scarcity of fluid in the area of the fetal arms and legs, which produces an image of crowding.10 Manning et al.13 have defined oligohydramnios if the largest pocket of amniotic fluid measures less than 1 cm in the broadest diameter. The criterion was later revised upward to 2 cm.14 The third and probably most widely used method is subjective of amniotic fluid quantity. Even the less experienced ultrasonographer can easily recognize significant oligohydramnios. Of course, in borderline cases, the reproducibility (and value) of such an assessment is doubtful.
Ureteral duplication anomalies
Prem Puri in Newborn Surgery, 2017
The kidneys can be imaged at the 12th gestational week by abdominal ultrasound. With the increased availability and use of maternal ultrasonography, the incidence of urinary tract disorders diagnosed in utero has increased considerably. Oligohydramnios or anhydramnios in the mother is usually due to diminished amniotic fluid. Because amniotic fluid after 18 weeks of gestation is voided urine, it suggests bilateral renal agenesis or outflow obstruction. In order to be certain that renal development is normal, ultrasound at or beyond 20 weeks of gestation is necessary. An obstruction anomaly is recognized by demonstrating a dilated renal pelvis, calyces, or ureter. However, it is not possible to detect an uncomplicated duplex anomaly prenatally.21 Detection of duplex kidney in the prenatal period offers several potential benefits. For affected fetus, there is the opportunity to plan postnatal management to minimize the risk of long-term renal impairment, by early administration of antibiotics, investigation, and treatment.
Cerebroplacental doppler ratio and perinatal outcome in late-onset foetal growth restriction
Published in Journal of Obstetrics and Gynaecology, 2022
Ozge Kahramanoglu, Oya Demirci, Mucize Eric Ozdemir, Agnese Maria Chiara Rapisarda, Munip Akalin, Ali Sahap Odacilar, Hayal Ismailov, Gizem Elif Dizdarogullari, Aydin Ocal
The data on maternal age, parity, body mass index, gestational age at diagnosis, foetal sex, obstetric complications such as hypertensive disorders, gestational diabetes mellitus, amniotic fluid volume, premature rupture of membranes, gestational age at delivery, delivery mode, Caesarean indication, neonatal birth weight, Apgar scores, cord pH and neonatal intensive care unit (NICU) admission were collected prospectively. Oligohydramnios was defined as no vertical pocket of amniotic fluid more than 2 cm or an amniotic fluid index 5 cm or less. Foetal distress was defined as suspected foetal hypoxia which was observed indirectly by electronic foetal heart rate monitoring. Adverse perinatal outcome (APO) was defined as the presence of one of the following: foetal distress, NICU admission, an Apgar score of less than 7 at 5 min after birth, cord pH less than 7.1, and neonatal death. Foetal distress was defined as the presence of one of the following: baseline heart rate of <100 or >170 bpm, persistence of heart rate variability of <5 bpm for more than 40 minutes, severe variable decelerations, prolonged decelerations, or late decelerations.
A case of gestational central diabetes insipidus with oligohydramnios
Published in Journal of Obstetrics and Gynaecology, 2018
Jeong Woo Park, Hye Yeon Park, Yoon Joon Hwang, Sang Youb Han
A 30-year-old primipara, who delivered her baby 2 weeks earlier, was admitted to the medical ward because of confused mentality. Although she had no previous medical problems, general weakness and anorexia had developed after 30 weeks of gestation. At 36 weeks of gestation, the symptoms worsened, so she was admitted to a private maternity hospital and was diagnosed with oligohydramnios without any of the typical causes such as foetal growth restriction or congenital malformation. The deepest vertical pocket of amniotic fluid volume was less than 2 cm. Fluid therapy was initially started with Hartmann’s solution. She improved after fluid therapy. At 37 weeks of gestation, caesarean section was performed on maternal request and a healthy infant was delivered. There was no excessive haemorrhage or hypotensive episode during and after delivery. One week after discharge, she was referred due to disorientation.
Megacystis Microcolon Intestinal Hypoperistalsis Syndrome in Which a Different De Novo Actg2 Gene Mutation was Detected: A Case Report
Published in Fetal and Pediatric Pathology, 2018
Elif Ünver Korğalı, Amine Yavuz, Cemile Ece Çağlar Şimşek, Cengiz Güney, Hande Küçük Kurtulgan, Burak Başer, Mehmet Haydar Atalar, Hatice Özer, Hatice Reyhan Eğilmez
The female/male ratio in MMIHS patients has been determined as 2.4/1 and life expectancy has been reported to be shorter in males (1,5,17). It has been stated in many studies, as in the current case, that antenatal diagnosis for MMIHS is difficult. The most frequent findings in fetal USG are large bladder (88%) and hydronephrosis (10%), as was the case in the current patient (4,18). The presence of polyhydramnios and oligohydramnios has been reported in 33% and 7% of patients, respectively. Amniotic fluid is seen in adequate amounts in the other 60% of patients, as in the current case. In addition to fetal USG, fetal MRI images and enzyme analysis made of amniotic fluid also contribute to the diagnosis of MMIHS (1). When the intraabdominal cystic structure was first detected in the 21st week on the fetal USG and MRI of the current patient, it was thought to be megacystis. However, the definitive diagnosis was made with postnatal USG/MRI and barium rectal X-ray. Only 9 cases with antenatal diagnosis with a decision for termination have been reported in the literature (1,4).
Related Knowledge Centers
- Amniotic Fluid
- Amniotic Fluid Index
- Amniotic Sac
- Connective Tissue Disease
- Thrombophilia
- Hypertension
- Pregnancy
- Polyhydramnios
- Pre-Eclampsia
- Kidney Disease