Oligohydramnios

1. INTRODUCTION

• Oligohydramnios is a condition in pregnancy characterized by reduced amniotic fluid volume, which is essential for fetal growth, movement, and protection.

  
  

2. DEFINITION

• Amniotic Fluid Index (AFI) < 5 cm

OR

• Single deepest vertical pocket < 2 cm

  
  

3. CAUSES

Maternal Causes

• Dehydration

• Hypertension / Preeclampsia

• Uteroplacental insufficiency

• Post-term pregnancy (> 42 weeks)

Fetal Causes

• Congenital anomalies (especially renal agenesis, urinary tract obstruction)

• Intrauterine Growth Restriction (IUGR)

• Fetal death

Placental Causes

• Placental insufficiency

• Abruptio placenta

Other Causes

• Premature rupture of membranes (PROM)

• Drugs (ACE inhibitors, NSAIDs)

  
  

4. RISK FACTORS

• Maternal hypertension

• Diabetes

• Multiple pregnancy

• Previous history of oligohydramnios

• Post-term pregnancy

• Smoking

• Poor maternal nutrition

  
  

5. CLINICAL MANIFESTATIONS

Maternal Findings

• Decreased abdominal size (fundal height less than gestational age)

• Reduced fetal movements

• Easily palpable fetal parts

• Uterus feels small and tight

Fetal Findings

• Fetal distress (abnormal heart rate)

• Growth restriction

• Malpresentation

  
  

6. COMPLICATIONS

During Pregnancy

• IUGR

• Fetal deformities (Potter sequence: limb deformities, facial anomalies)

• Pulmonary hypoplasia (especially early pregnancy)

During Labour

• Cord compression

• Meconium-stained liquor

• Fetal distress

• Prolonged labour

After Birth

• Low Apgar score

• Respiratory distress

• Perinatal mortality

  
  

7. TREATMENT / MANAGEMENT

General Management

• Adequate maternal hydration (oral/IV fluids)

• Bed rest (left lateral position)

• Regular antenatal check-ups

Monitoring

• Ultrasound (AFI measurement)

• Non-stress test (NST)

• Biophysical profile (BPP)

Medical Management

• Treat underlying cause (e.g., hypertension)

• Stop harmful drugs

Interventions

• Amnioinfusion (during labour to prevent cord compression)

• Early induction of labour if fetal maturity achieved

• Cesarean section if fetal distress present

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🚀Here’s a short “exam trick” version for Oligohydramnios — super quick points you can remember :

Introduction:

↓ Amniotic fluid condition affecting fetal growth and safety

Definition:

AFI < 5 cm or deepest pocket < 2 cm

Causes:

Placental insufficiency, PROM, fetal anomalies, post-term pregnancy, maternal HTN

Risk factors:

Hypertension, diabetes, post-term, smoking, poor nutrition

Clinical manifestations:

Small uterus, ↓ fetal movement, palpable fetal parts, fetal distress

Complications:

IUGR, pulmonary hypoplasia, cord compression, fetal distress, ↑ perinatal death

Treatment:

Hydration, monitoring (NST/BPP), treat cause, amnioinfusion, timely delivery

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🚀Here’s a set of 07 MCQs on Oligohydramnios for practice :

1. Single deepest pocket in oligohydramnios is:

A. > 5 cm

B. < 2 cm

C. 3–4 cm

D. > 8 cm

Answer: B. < 2 cm

2. Which maternal condition is a risk factor?

A. Hypotension

B. Hypertension

C. Asthma

D. Thyroid disorder

Answer: B. Hypertension

3. Oligohydramnios is commonly seen in:

A. Preterm pregnancy

B. Post-term pregnancy

C. First trimester

D. Twin pregnancy only

Answer: B. Post-term pregnancy

4. Which drug can cause oligohydramnios?

A. Iron supplements

B. ACE inhibitors

C. Calcium tablets

D. Folic acid

Answer: B. ACE inhibitors

5. Earliest complication in severe oligohydramnios:

A. Jaundice

B. Pulmonary hypoplasia

C. Polycythemia

D. Anemia

Answer: B. Pulmonary hypoplasia

6. Fetal heart rate abnormality occurs due to:

A. Increased fluid

B. Cord compression

C. Placental growth

D. Maternal fever

Answer: B. Cord compression

7. Best position advised for mother:

A. Supine

B. Right lateral

C. Left lateral

D. Sitting

Answer: C. Left lateral