Book contents
- Fetal Therapy
- Fetal Therapy
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Section 1: General Principles
- Section 2: Fetal Disease: Pathogenesis and Treatment
- Red Cell Alloimmunization
- Structural Heart Disease in the Fetus
- Fetal Dysrhythmias
- Manipulation of Fetal Amniotic Fluid Volume
- Chapter 19 Manipulation of Amniotic Fluid Volume: Homeostasis of Fluid Volumes in the Amniotic Cavity
- Chapter 20 Oligohydramnios and Polyhydramnios: Therapeutic Manipulation of Amniotic Fluid Volume
- Fetal Infections
- Fetal Growth and Well-being
- Preterm Birth of the Singleton and Multiple Pregnancy
- Complications of Monochorionic Multiple Pregnancy: Twin-to-Twin Transfusion Syndrome
- Complications of Monochorionic Multiple Pregnancy: Fetal Growth Restriction in Monochorionic Twins
- Complications of Monochorionic Multiple Pregnancy: Twin Reversed Arterial Perfusion Sequence
- Complications of Monochorionic Multiple Pregnancy: Multifetal Reduction in Multiple Pregnancy
- Fetal Urinary Tract Obstruction
- Pleural Effusion and Pulmonary Pathology
- Surgical Correction of Neural Tube Anomalies
- Fetal Tumors
- Congenital Diaphragmatic Hernia
- Fetal Stem Cell Transplantation
- Gene Therapy
- Section III: The Future
- Index
- References
Chapter 20 - Oligohydramnios and Polyhydramnios: Therapeutic Manipulation of Amniotic Fluid Volume
from Manipulation of Fetal Amniotic Fluid Volume
Published online by Cambridge University Press: 21 October 2019
- Fetal Therapy
- Fetal Therapy
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Section 1: General Principles
- Section 2: Fetal Disease: Pathogenesis and Treatment
- Red Cell Alloimmunization
- Structural Heart Disease in the Fetus
- Fetal Dysrhythmias
- Manipulation of Fetal Amniotic Fluid Volume
- Chapter 19 Manipulation of Amniotic Fluid Volume: Homeostasis of Fluid Volumes in the Amniotic Cavity
- Chapter 20 Oligohydramnios and Polyhydramnios: Therapeutic Manipulation of Amniotic Fluid Volume
- Fetal Infections
- Fetal Growth and Well-being
- Preterm Birth of the Singleton and Multiple Pregnancy
- Complications of Monochorionic Multiple Pregnancy: Twin-to-Twin Transfusion Syndrome
- Complications of Monochorionic Multiple Pregnancy: Fetal Growth Restriction in Monochorionic Twins
- Complications of Monochorionic Multiple Pregnancy: Twin Reversed Arterial Perfusion Sequence
- Complications of Monochorionic Multiple Pregnancy: Multifetal Reduction in Multiple Pregnancy
- Fetal Urinary Tract Obstruction
- Pleural Effusion and Pulmonary Pathology
- Surgical Correction of Neural Tube Anomalies
- Fetal Tumors
- Congenital Diaphragmatic Hernia
- Fetal Stem Cell Transplantation
- Gene Therapy
- Section III: The Future
- Index
- References
Summary
The volume of amniotic fluid, for which nomograms exist [1], is the result of a balance between its production and removal. Amniotic fluid production largely reflects fetal urine production, but includes respiratory tract and oral secretions. Amniotic fluid removal relies on fetal swallowing. Fluid dynamics across the membranes are the third component of this balance. In current clinical practice a surrogate estimate for amniotic volume is made by 2-dimensional ultrasound-derived measurements of vertical cord-free liquor pools, either by amniotic fluid index (AFI) – a cumulative measurement of vertical pools made within 4 quadrants of the uterus – or by the measurement of the single deepest vertical pocket (DVP) within the uterus. Increased production or decreased removal will result in the development of polyhydramnios. The converse will result in development of oligohydramnios. The importance of these abnormalities of amniotic fluid volume is that they are a marker for fetal pathology. Their significance in isolation is limited, as are indications for their manipulation.
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- Information
- Fetal TherapyScientific Basis and Critical Appraisal of Clinical Benefits, pp. 200 - 214Publisher: Cambridge University PressPrint publication year: 2020