Oligohydramnios

From oligohydramnios is spoken in the prenatal when below during pregnancy the amount of amniotic fluid from 200 to 500 ml. An amniotic fluid index (AFI ) of less than 5.1 cm or amniotic fluid deposits under 2 cm between the fetus, placenta ( placenta ) and uterine wall In other words called oligohydramnios.

Frequency

Oligohydramnios occurs in about 0.5 to 4 % of all pregnancies. In the last trimester of pregnancy ( trimester ) is about 3-5 % of all pregnancies before a decreased amount of amniotic fluid. The ICD -10 code O41.0 is specified in the care of the expectant mother in the presence of a Oligohydramnions (without rupture of membranes ).

Notes

Unusually small uterus and the reduction of fetal movement (due to the restricted space ): the following markers on oligohydramnios especially one overlooking the gestational ( pregnancy week say ) apply.

Causes

The most most obvious cause is the ( premature) of the amniotic sac through which the amniotic fluid leaves the uterus.

In addition, oligohydramnios is often caused by

• A decreased urine production or excretion of the growing child, for example, when Potter Syndrome
• A very strong growth retardation of the baby
• Placental insufficiency ( poor performance of the placenta ), for example, with a significant excess over the expected birth date ( transfer )
• An inequality of the distribution of blood through the placenta monochorionic, diamnoten multiple pregnancies, especially when fetofetalen transfusion syndrome
• Other functional disorders of the placenta ( eg, due to high blood pressure or nicotine consumption of pregnant women), through which the kidney of the unborn child are less well perfused and therefore make it less amniotic fluid can

A Oligohydramnion causes a comparatively poor management of the ultrasonic waves ( the less amniotic fluid, the worse the sound conduction ) and is considered sonographic soft markers for:

• Generally malformations of the urogenital tract, in particular renal system disorders such as: Renal agenesis (absence or very severe underdevelopment of the kidneys)
• Renal hypoplasia ( underdevelopment of the kidneys)
• Cystic kidney disease

A more established and early oligohydramnios may favor a particular torticollis education, a Klumpfußbildung and the development of pulmonary hypoplasia by the lack of lung fluid. The underdevelopment of the lungs can lead to significant lung function impairments after birth. In oligohydramnios before the 24th week of pregnancy, the likelihood of pulmonary hypoplasia is about 24 to 40%.

Oligohydramnios sequence

As oligohydramnios sequence a number of effects is described, which are highlighted by this insufficient production of amniotic fluid during pregnancy and first described by Edith Louise Potter (1901-1993), an American pathologist and her honor, first as Potter syndrome or renofaziale dysplasia was designated.

Treatment

If there are no other reasons for the low amount of amniotic fluid present, the pregnant woman can often contribute through adequate fluid intake (especially water ) to a quantitative improvement in the amount of amniotic fluid. Evens the amount of amniotic fluid does not back off and are expected by the Oligohydramie harm to the child, the possibility of amnioinfusion ( Amnioninfusion ) is contemplated. In this measure the amniotic fluid space is filled with a sugar -salt solution through a needle or a catheter. The syringe or the catheter previously advanced under ultrasound guidance through the abdominal wall into the amniotic cavity. Is the general condition of the child bad or worsens, or is the cause of a transmission Oligohydramnions, the drug of choice is usually the birth of the child. Depending on the week of pregnancy should before a lung maturation induction be performed and depending on the week of pregnancy give birth vaginally may or must be done by Caesarean section.