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
I. AFV Subjective: Normal Absent Reduced Increased Objective:
1.Maximum vertical pool (MVP) 2.Amniotic fluid index (AFI) Aboubakr
1. Maximum vertical pool (minimum of 1cm width) * How ?
Oligohyd: 8cm Mild 8-12 cm Severe > 16 Aboubakr Elnashar
2. Amniotic fluid index How ? Aboubakr Elnashar
Interpretation: Oligohyd: < 5 cm Reduced: 5-10 cm Normal:
10- 20 cm More than average: 20-25 cm Polyhyd: > 25 cm Aboubakr
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
Causes of polyhydramnios 1. Idiopathic 2. D. M. 3.
Isoimmunization Aboubakr Elnashar
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
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
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
II. Free floating particles What: Multiple linear densities, 1-
5 mm suspended, but gradually settling Significance: * No * F.
maturity * F. distress. * LFGA. Aboubakr Elnashar