Oligohydramnios (too little Amniotic Fluid) is best defined as an Amniotic Fluid


It has been described as:

• Diminished Amniotic Fluid volume
• Amniotic Fluid volume of less than 500 mL at 32-36 weeks' gestation
• Maximum vertical pocket (MVP) of less than 2 cm
• Amniotic Fluid index (AFI) of less than 5 cm, or less than the 5th percentile. This is an AFI of <6.8 cm at term.

Ultrasound and a sterile speculum examination should be performed to check for ruptured membranes. Amniotic Fluid may pool in the vagina.

The abdomen may look smaller than you would expect for gestation, however this is not always the case.

Management

Management of oligohydramnios is based on gestational age. Transfer to a tertiary referral centre may be appropriate if oligohydramnios is severe.

Before term
Expectant management is often the most appropriate course of action, depending on maternal and fetal condition. Ongoing antepartum surveillance,(including assessment of fetal growth and follow-up monitoring of AFV) is necessary. Continuous fetal heart rate monitoring has been advocated for all pregnancies complicated by oligohydramnios.

At term
Delivery is often the most appropriate management. With reassuring fetal testing, delivery may be safely delayed on the basis of the parity, the gestational age, the inducibility of the mother's cervix, and the severity of the oligohydramnios.

After term
Oligohydramnios in the post-term client is associated with more fetal decelerations, a higher incidence of meconium-stained fluid, and an increased risk for caesarean delivery. Oligohydramnios is considered an indication for delivery in a post-term pregnancy.

References

http://www.americanpregnancy.org/pre...hydramnios.htm

http://www.patient.co.uk/showdoc/40024667/

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