ultrasonography of amniotic fluid
DESCRIPTION
ultrasonography of amniotic fluidTRANSCRIPT
![Page 2: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/2.jpg)
Amniotic Fluid
• Sources: Early stages: Skin & placenta
12 - 14 W: lung & kidney
20 W: kidney
• Amount: 33 - 34 W: 800-1000 ml
At term: 600 ml
• U/S parameters: I. AFV
II. FFP Aboubakr Elnashar
![Page 3: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/3.jpg)
Aboubakr Elnashar
![Page 4: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/4.jpg)
I. AFV
• Subjective:
Normal
Absent
Reduced
Increased
• Objective:
1.Maximum vertical pool (MVP)
2.Amniotic fluid index (AFI)
Aboubakr Elnashar
![Page 5: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/5.jpg)
1. Maximum vertical pool
(minimum of 1cm width)
* How ?
•Oligohyd: <2 cm
•Reduced: 2-3 cm
•Normal: 3 - 8 cm
•Polyhyd: >8cm
Mild 8-12 cm
Severe > 16
Aboubakr Elnashar
![Page 6: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/6.jpg)
Aboubakr Elnashar
![Page 7: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/7.jpg)
2. Amniotic fluid index
•How ?
Aboubakr Elnashar
![Page 8: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/8.jpg)
Aboubakr Elnashar
![Page 9: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/9.jpg)
Aboubakr Elnashar
![Page 10: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/10.jpg)
Aboubakr Elnashar
![Page 11: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/11.jpg)
Aboubakr Elnashar
![Page 12: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/12.jpg)
Aboubakr Elnashar
![Page 13: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/13.jpg)
Interpretation:
•Oligohyd: < 5 cm
Reduced: 5-10 cm Normal: 10- 20 cm More than average: 20-25 cm Polyhyd: > 25 cm
Aboubakr Elnashar
![Page 14: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/14.jpg)
AFI & gestational age
Ges age (W) 5th 50th 95th
28 94 mm 146 mm 228 mm
32 86 mm 144 mm 242 mm
36 77 mm 138 mm 249 mm
38 73 mm 132 mm 239 mm
40 71 mm 123 mm 214 mm
42 69 mm 110 mm 175 mm
Aboubakr Elnashar
![Page 15: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/15.jpg)
Causes of polyhydramnios
1. Idiopathic
2. D. M.
3. Isoimmunization
Aboubakr Elnashar
![Page 16: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/16.jpg)
4. Foetal anomalies:
• CNS: Hydrocephaly, Anencephaly, S.
bifida
• Neck &face: Cystic hygroma.
• Pulmonary: Diaphragmatic hernia.
• GIT: Oesophygeal atresia, Dud. atresia,
Omphalocele
• Other: Cong. infection, Chromosomal
anomalies
Aboubakr Elnashar
![Page 17: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/17.jpg)
Aboubakr Elnashar
![Page 18: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/18.jpg)
Aboubakr Elnashar
![Page 19: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/19.jpg)
Causes of oligohydramnios
1. Spontaneous ROM.
2. Placental insufficiency.
3. IUGR.
4. Renal agenesis, uretheral stenosis.
Aboubakr Elnashar
![Page 20: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/20.jpg)
Aboubakr Elnashar
![Page 21: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/21.jpg)
Keyhole bladder, posterior urethral valve
Cystic hygroma, olighyd, Turner s synd
Aboubakr Elnashar
![Page 22: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/22.jpg)
Fetal biophysical profile
Score 2 Score 0
CTG >2acc./40 min <
F. movements >3/30 min <
F.br. movements 30 sec sustained
fbm /30 min
<
F.tone closed fist or
flex .to ex.
movement
Neither
AFV >1 cm pocket <
Aboubakr Elnashar
![Page 23: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/23.jpg)
Interpretation:
If all parameters detected by U/S are
normal, no need to perform NST
8: reassuring.
6 or 7: equivocal, and must be repeated
within 24 hours.
4 or less: a positive test and strongly
suggests preparing the patient for delivery.
Aboubakr Elnashar
![Page 24: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/24.jpg)
•Modifications:
Manning (1990)
NST
MVP
Fetal breathing.
More recently
NST
AFI
It is less cumbersome than the original BPP
and its results are just as predictive. AFI is the
indicator of long term uteroplacental function
and the NST is the short term indicator of fetal
acid-base status.
Aboubakr Elnashar
![Page 25: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/25.jpg)
II. Free floating particles
•What: Multiple linear densities, 1- 5 mm
suspended, but gradually settling
•Significance: * No
* F. maturity
* F. distress.
* LFGA.
Aboubakr Elnashar
![Page 26: ultrasonography of amniotic fluid](https://reader036.vdocuments.us/reader036/viewer/2022082223/53f6bc918d7f72af7e8b4586/html5/thumbnails/26.jpg)
Aboubakr Elnashar