- Ron Beloosesky, MD
Ron Beloosesky, MD
- Assistant Professor, Obstetrics and Gynecology Department
- Rambam Medical Center at the Technion Faculty of Medicine, Haifa, Israel
- Michael G Ross, MD, MPH
Michael G Ross, MD, MPH
- Distinguished Professor of Obstetrics and Gynecology
- David Geffen School of Medicine at UCLA
- Section Editors
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
- Deborah Levine, MD
Deborah Levine, MD
- Section Editor — Imaging
- Professor of Radiology
- Director of Ob/Gyn Ultrasound
- Department of Radiology
- Beth Israel Deaconess Medical Center
Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. It is typically diagnosed by ultrasound examination and may be described qualitatively (eg, normal, reduced) or quantitatively (eg, amniotic fluid index [AFI] ≤5). Methods of amniotic fluid volume assessment are reviewed separately. (See "Assessment of amniotic fluid volume".)
An adequate volume of amniotic fluid is critical to allow normal fetal movement and growth, and to cushion the fetus and umbilical cord. Oligohydramnios may inhibit these processes and can lead to fetal deformation, umbilical cord compression, and death.
Reported rates of oligohydramnios are influenced by variations in diagnostic criteria, the population studied (low or high risk, screening or indicated ultrasound examination), the threshold used, and the gestational age at the time of the ultrasound examination (preterm, term, or postterm).
A study of 3050 uncomplicated pregnancies with singleton non-anomalous fetuses between 40 and 41.6 weeks of gestation noted oligohydramnios (defined as AFI ≤5 cm) in 11 percent . The incidence is high in laboring women, largely due to rupture of fetal membranes during or just before labor [2-4].
The volume of amniotic fluid is ultimately determined by the volume of fluid flowing into and out of the amniotic sac. Fetal urination, lung fluid, and swallowing all make important contributions to fluid movement in late gestation, with minimal contributions from other sources. Fetal disorders that affect any of these processes will affect the amniotic fluid volume. As an example, growth restricted fetuses may redistribute blood flow away from their kidneys, which decreases fetal urine production, resulting in oligohydramnios .
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- First trimester
- Second trimester
- Third trimester
- CLINICAL MANIFESTATIONS AND DIAGNOSIS
- Multiple gestation
- EVALUATION OF PREGNANCIES WITH OLIGOHYDRAMNIOS
- METHODS OF INCREASING AMNIOTIC FLUID VOLUME
- Maternal hydration
- - Water and DDAVP
- Fetal membrane sealants
- PROGNOSIS AND MANAGEMENT
- First trimester
- Second trimester
- Third trimester
- Timing of delivery
- SUMMARY AND RECOMMENDATIONS