Window to the Womb: Amniotic Fluid and Postnatal Outcomes

Abstract

Amniotic fluid volumes are tightly regulated, and amniotic fluid derangement can indicate maternal complications or fetal abnormalities. Ultrasound estimate of amniotic fluid provides a tool to evaluate the maternal-fetal-placental interface in real-time. Oligohydramnios and polyhydramnios are associated with adverse maternal and neonatal outcomes. Oligohydramnios is associated with adverse maternal and neonatal outcomes including cesarean delivery, operative vaginal delivery, induction of labor, postpartum hemorrhage, small for gestational age neonate, intrauterine demise, neonatal death, NICU admission, and APGAR less than 7 at. 5 minutes of life Polyhydramnios is associated with adverse outcomes including cesarean delivery, induction of labor, placental abruption, shoulder dystocia, cord prolapse, postpartum hemorrhage, intrauterine fetal demise, NICU admission, neonatal death, APGAR less than 7 at 5 minutes of life, large for gestational age neonate, and respiratory distress syndrome. Therefore, Amniotic fluid should be evaluated when maternal or fetal well-being is in question.

ISUOG Practice Guidelines: performance of third‐trimester obstetric ultrasound scan

“…Polyhydramnios (Figure 10) may be associated with maternal diabetes (20-25% of cases), fetal abnormalities (mostly gastrointestinal obstructions and cardiac and CNS anomalies), placental tumors, fetal infections, conditions that result in anemia and hyperdynamic circulation, and chromosomal and genetic abnormalities, or it can be idiopathic (50-60% of cases) 79,80 . Therefore, identification of polyhydramnios should lead to a detailed sonographic examination of the fetus and placenta, examination for signs of anemia (including MCA peak systolic velocity) and review of the results of any previous screening tests for fetal aneuploidy or congenital infection, as idiopathic polyhydramnios is a diagnosis of exclusion.…”

Frequency of Ultrasonographically Detectable Fetal Anomalies in Pregnancies Complicated by Polyhydramnios

“…Numerous issues related to pregnancy are correlated with abnormalities in amniotic fluid volume, both low (oligohydramnios) and excessive (polyhydramnios). 2,3 Amniotic fluid volume can significantly increase in response to any disease that causes even a small daily increase in foetal urine production or a decline in foetal swallowing. Although the management of this process is not fully understood, the volume of amniotic fluid reflects the equilibrium between fluid production and transportation out of the amniotic sac.…”

The Effect of Sildenafil Citrate on Improving Amniotic Fluid Index in Pregnant Women with Oligohydramnios and Borderline Oligohydramnios: A Randomized Controlled Trial

“…This fluid supplies the environment and essential growth factors for the fetal organs, including the musculoskeletal, digestive, and pulmonary systems, normal growth, and maturation. Doctors can use amniotic fluid to track a pregnancy's development and forecast fetal outcomes (2). A woman's amniotic sac is determined by how much fluid enters and leaves.…”