Amniotic Fluid Disorders: From Prenatal Management to Neonatal Outcomes

Abstract

Amniotic fluid volume assessment has become standard in the surveillance of fetal well-being, especially in high-risk pregnancies. Amniotic fluid disorders are a frequent and important topic in fetal and perinatal medicine. However, although important advances have been achieved, many important and challenging questions remain unanswered to date. An abnormally low amniotic fluid volume, referred to as oligohydramnios, has been traditionally considered a possible indicator of placental insufficiency or fetal compromise and is associated with an increased rate of obstetric interventions. An excess of amniotic fluid, referred to as polyhydramnios, may be secondary to fetal or maternal conditions and has been associated with a variety of adverse pregnancy outcomes, especially when it is severe. The ultrasonographic detection of an amniotic fluid disorder should prompt a proper workup to identify the underlying etiology. Data on the association of isolated oligohydramnios or idiopathic polyhydramnios with adverse obstetric and perinatal outcomes are conflicting. While the management of secondary oligohydramnios is usually guided by the underlying condition, the management of isolated oligohydramnios is poorly defined. Similarly, the management of idiopathic and secondary polyhydramnios is not yet standardized. There is an urgent need for randomized clinical trials to provide stronger recommendations on the management of these two common conditions.

Fetal-maternal interactions with gluten immunogenic peptides during pregnancy: a new determinant on the coeliac exposome

“…After 25 weeks of gestation, the foetal skin is fully keratinised and can no longer absorb or transfer fluids easily. Consequently, respiration, swallowing, and urination are the primary means of exchange between the foetus and AF to maintain homeostasis and volume (12–14). To study and compare potential differences in GIP content in healthy pregnant women, we recruited AF samples to compare the GIP content of healthy pregnant women at various stages of pregnancy, specifically in the second (15-25 weeks) and third trimesters (37-40 weeks).…”

“…After 25 weeks of gestation, the foetal skin is fully keratinised and can no longer absorb or transfer fluids. Respiration, swallowing, and urination are the main routes of exchange between the foetus and AF to maintain homeostasis and volume (12–14).…”

Perinatal Outcome in Pregnant Women With Isolated Oligohydramnios Diagnosed With the Single Deepest Pocket Method

“…With the Single Deepest Pocket Method abnormalities (8,12). After exclusion of these causes of reduced amniotic fluid volume, isolated oligohydramnios is diagnosed.…”

“…After exclusion of these causes of reduced amniotic fluid volume, isolated oligohydramnios is diagnosed. The origin of isolated oligohydramnios is still not well known (12,13).…”

To study the correlation between severe oligohydramnios with perinatal outcome along with histopathology of placenta

“…Oligohydramnios poses a challenge in obstetric management, particularly when it is diagnosed before term. It is one of the major causes of antenatal fetal surveillance, and its estimation has become an integral part of antepartum fetal evaluation [1].…”