Amniotic fluid index
Amniotic fluid index: the uterus was divided into four quadrants: upper left, upper right, lower left and lower right. The maximum vertical depth of amniotic fluid dark area in four quadrants was the amniotic fluid index (AFI). AFI (> 25 cm) was diagnosed as excessive amniotic fluid. Among them, AFI was mild excessive amniotic fluid in 25-35 cm, 36-45 cm was moderate excessive amniotic fluid and > 45 cm was severe excessive amniotic fluid. AFI < 5cm was diagnosed as oligohydramnios and less than 8cm.
Amniotic fluid depth: B ultrasonic examination showed the maximum vertical depth of the amniotic pool, < 2 cm for oligohydramnios, > 8 cm for oligohydramnios. It is a medical term and an important indicator of the number of amniotic fluid. The incidence of premature rupture of membranes, abnormal fetal position and premature delivery increased when the amniotic fluid was too much, and the perinatal mortality increased significantly when the amniotic fluid was too little. B-ultrasound showed the vertical depth of the largest amniotic fluid pool, and the depth of amniotic fluid 3-7cm was normal amniotic fluid volume.
Amniotic fluid measurement: measurement of amniotic fluid volume is an important indicator to assess whether pregnancy is normal or not. At present, most hospitals understand the status of amniotic fluid volume by ultrasound, and adopt “amniotic fluid index method” to determine whether the amniotic fluid volume is normal. The method is: divide the uterus into four quadrants, measure the maximum depth of amniotic fluid in each quadrant, and then add them together. The total value of amniotic fluid is normal in the range of 9-24 cm, less than 8 is oligohydramnios, less than 5 is oligohydramnios, and more than 25 cm is oligohydramnios.
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Common problems of amniotic fluid
Amniotic fluid: Amniotic fluid in normal pregnancy increases with gestational weeks, the last two to four weeks began to gradually reduce the amount of amniotic fluid in full-term pregnancy about 1000ml (800-1200ml), where the amount of amniotic fluid in any period of pregnancy more than 2000ml, known as excessive amniotic fluid. Up to 20000ml. Most pregnant women with amniotic fluid increased slowly, in a longer period of formation, known as chronic excessive amniotic fluid; a few pregnant women in a few days of rapid increase in amniotic fluid, known as acute excessive amniotic fluid.
Oligohydramnios: what are the symptoms of oligohydramnios? Oligohydramnios mainly manifested as gestational mothers with fetal movement and abdominal pain during fetal movement. The uterus is sensitive and often causes uterine contraction due to mild stimulation. Accelerated fetal heart examination showed that the abdominal circumference and uterine height were smaller than those in the same period. Oligohydramnios often leads to prolonged childbirth and intrauterine asphyxia. A small amount of viscous amniotic fluid can be seen if the membrane is broken. Oligohydramnios is sometimes difficult to diagnose and easily overlooked. B ultrasound showed that the amniotic fluid decreased significantly. It was also suggested that the possibility of oligohydramnios should be taken into account when postpartum pregnancy, pregnancy-induced hypertension syndrome, or fetal changes occur before delivery and no other cause can be found.
Amniotic fluid depth: the depth of amniotic fluid is a medical term, and it is an important indicator to determine the number of amniotic fluid. More amniotic fluid, then the fetus can grow up healthily; less amniotic fluid, you can cause meconium deposition in the fetus during labor, even premature delivery or asphyxia. B-ultrasound showed the vertical depth of the largest amniotic fluid pool, and the depth of amniotic fluid 3-7cm was normal amniotic fluid volume. Less than 2cm indicates oligohydramnios, or more than 8cm indicates hydramnios.
Amniotic fluid turbidity: Amniotic fluid at the end of pregnancy mild turbidity is due to amniotic fluid with fetal metabolites, belonging to normal. If there are amniotic cavity infection, excessive fetal fat, pregnant women with cholestasis syndrome, fetal hypoxia, amniotic fluid in the second trimester of pregnancy will be significantly turbid.
It is suggested that amniocentesis should be done to check the degree of amniotic fluid turbidity. If the amniotic fluid is really turbid, this is the fetus will be placed in the amniotic fluid performance, the most likely cause of this situation is fetal hypoxia asphyxia. We should actively look for the cause and treat it. The fetal heart rate is monitored immediately to see if the fetal heart rate is normal, so as to estimate fetal hypoxia. At the same time, the left lying position should be taken and oxygen inhaled to increase the blood supply of placenta and alleviate fetal oxygen supply. In addition, regular prenatal care should be done.
How can pregnant women have less amniotic fluid?
When oligohydramnios is found, treatment options can be chosen according to whether the fetus is abnormal or gestational age.
1. Oligohydramnios complicated with fetal malformation.
If fetal malformation is diagnosed, termination of pregnancy should be terminated as early as possible. B ultrasound guided transvaginal amniocentesis can be used for induction of labor by ethacridine.
2. Oligohydramnios combined with normal fetuses.
When oligohydramnios is found, normal fetal development should be sought and removed. By increasing the volume of fluid infusion, the placenta function can be improved and the infection can be prevented. Pregnant women should count their own fetal movements and count for monitoring, and doctors should carry out fetal biophysical score. The amniotic fluid volume and the ratio of the highest systolic velocity of umbilical artery to the lowest diastolic velocity (S/D) were monitored dynamically by B-mode ultrasound. The fetus was monitored electronically and the fetal intrauterine condition was closely monitored.
The specific treatment methods are the following two kinds:
1. Termination of pregnancy.
The pregnancy should be terminated in time. If the occurrence of placental dysfunction, fetal distress, or rupture of amniotic fluid and meconium serious pollution, it is estimated that a short time can not end the delivery, cesarean section should be taken to terminate pregnancy, in order to reduce the perinatal mortality.
For fetal reserve function is still good, no obvious intrauterine hypoxia, artificial amniotic fluid clear rupture, can be vaginal trial. If we choose vaginal trial production, we should closely observe the progress of labor and continuously monitor fetal heart rate.
2, increase amniotic fluid volume expectant treatment
It is feasible to increase the amniotic fluid volume expectant treatment and extend the pregnancy period for those who are not pregnant or have immature fetal lung. Amniotic fluid infusion can be used to reduce the incidence of fetal heart rate variability deceleration, amniotic fluid fecal staining rate and cesarean section rate. At the same time, uterine contraction inhibitors should also be used to prevent premature delivery.
Expectant mothers with oligohydramnios suggest that they should stay in bed on the left to improve the blood supply of placenta. At the same time, mothers-to-be with oligohydramnios are under great psychological pressure. Doctors are responsible for explaining the disease to pregnant women and their families, providing emotional support, and helping them actively participate in treatment and self-care care. Mothers should be told to stay happy and cooperate with treatment for fetal development. Family members should also give more psychological comfort and care to help eliminate the psychological worries of mothers.
What happens if there is too much amniotic fluid?
Pregnant women with amniotic fluid need to ensure a low salt diet and reduce the amount of drinking water. Rest in bed, take the left lying position, improve the uterus and placenta circulation, prevent premature delivery. The amniotic fluid index and fetal growth should be reviewed weekly.
The treatment of excessive amniotic fluid mainly depends on whether the fetus has abnormalities, gestational age and the severity of compressive symptoms of pregnant women. If the diagnosis of excessive amniotic fluid, the general doctor will require a high-definition B-ultrasound examination to see whether the fetus is malformed; and may also do amniocentesis to see whether the fetus has genetic defects. At the same time, during the rest of the pregnancy, fetal heart rate monitoring and B ultrasonic examination should be done regularly to closely monitor the growth and development of the fetus.
If there is amniotic fluid complicated with fetal malformation, termination of pregnancy is necessary. Usually artificial rupture of membranes is used to induce labor. If the fetus is normal, the following measures should be taken for treatment:
1. Amniocentesis decompression: severe compression symptoms, small gestational age, fetal lung immaturity, may consider transabdominal amniocentesis discharge to alleviate symptoms, prolong gestational age.
2, prostaglandin synthetase inhibitor treatment: indomethacin 2.2-2.4mg/ (kg? D), divided into 3 times orally. Indomethacin has the effect of inhibiting diuresis, and it can inhibit the urine output of the fetus to reduce the amount of amniotic fluid. However, the amniotic fluid volume and fetal heart rate should be closely observed at the same time. If the amniotic fluid volume is significantly reduced or arterial catheter stenosis occurs, the drug should be stopped immediately.
3. Etiological treatment: if pregnancy with diabetes mellitus caused by excessive amniotic fluid, blood glucose should be suppressed; if maternal and fetal blood group insoluble caused by excessive amniotic fluid, fetal immaturity and edema, or umbilical cord blood shows Hb < 60 g / L, should consider fetal intrauterine transfusion.
4, childbirth treatment: after natural labor, artificial rupture of membranes should be done as early as possible. If uterine contraction is still weak after rupture of membranes, low concentration oxytocin can be given intravenously to enhance uterine contraction, and closely observe the progress of labor. After delivery, the fetus should apply contractions in time to prevent postpartum hemorrhage.
How to manage the cloudy amniotic fluid?
Amniotic fluid turbidity is usually caused by fetal fat or meconium mixed with amniotic fluid, other cases of cholestasis. If it is simply caused by fetal fat caused by mild turbidity, the problem is not big, belong to the normal situation, generally will not cause harm to the fetus, do not need to do special treatment.
If it is caused by meconium muddy amniotic fluid, this situation shows that the fetus may have intrauterine hypoxia, the need to breathe oxygen to supplement oxygen. The latter should be treated immediately, following the advice of a professional doctor for examination or oxygen inhalation, and should be immediately monitored to see if the fetal heart rate is normal to estimate fetal hypoxia. At the same time, the left lying position should be taken and oxygen inhaled to increase the blood supply of placenta and alleviate fetal oxygen supply. If the situation is serious, it is necessary to terminate the pregnancy in advance.
The difference between amniotic fluid depth and amniotic fluid index
The difference between amniotic fluid depth and amniotic fluid index amniotic fluid depth and amniotic fluid index are two different concepts, many pregnant mothers are confused, we look at the difference between amniotic fluid depth and amniotic fluid index.
Amniotic fluid depth: It is the vertical depth of amniotic fluid pool examined by B ultrasound. Generally speaking, the amniotic fluid depth (AFV) 3-7 cm is normal amniotic fluid volume, < 2 cm indicates oligohydramnios, > 8 cm indicates excessive amniotic fluid. It is a medical term and an important indicator of the number of amniotic fluid.
Amniotic fluid index: the uterus is divided into upper left, upper right, lower left and lower right quadrant, four quadrants of the maximum amniotic fluid dark area vertical depth of the sum of amniotic fluid index. The general amniotic fluid index (9-24cm) is normal amniotic fluid volume. If the amniotic fluid index (> 25 cm) was diagnosed as excessive amniotic fluid, the amniotic fluid index (AFI) was 25-35 cm for mild excessive amniotic fluid, 36-45 cm for moderate excessive amniotic fluid, and > 45 cm for severe excessive amniotic fluid. When the amniotic fluid index is less than 5cm, oligohydramnios is less than 8cm.