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Oligohydramnios

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Oligohydraminios is an abnormally small amount of amniotic fluid. At term it may be 300-500ml or even less. When diagnosed in the first half of pregnancy the condition is often found to be associated with renal agenesis (absence of kidneys) or Potter syndrome, in which the baby also has pulmonary hypoplasia. At any stage of pregnancy it may be due to fetal abnormality or preterm rupture of membranes where amniotic fluid fails to reaccumulate.

The lack of amniotic fluid reduces the intrauterine space and over time will cause compression deformities.

Diagnosis is with ultrasound examination to differentiate between oligohydramnios and intrauterine growth restriction.

Management

If the ultrasound demonstrates renal agenesis, the baby will not survive. Liqour volume will also be estimated from the scan; if renal agenesis is not present, further investigations will include careful placental function tests.

  • Prophylactic amnioinfusion with normal saline, Ringer's lactate or 5 per cent glucose may be performed to prevent compression deformities and hypoplastic lung disease, and to prolong the pregnancy.
  • Labour may occur spontaneously or be induced because of the possibility of placental insufficiency.
  • Epidural analgesia may be indicated because uterine contractions are often unusually painful
  • Continuous fetal heart rate monitoring is desirable.
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