Oligoamnios

Description:

The oligoamnios is a reduction of amount of amniotic waters. The volume of amniotic waters depends on duration of gestation. In 10 weeks the volume of waters at normal pregnancy makes 30 ml, in 14 weeks - 100 ml, by 37-38 weeks of pregnancy - 600 to 1500 ml. If waters there are less than 0,5 l – the oligoamnios which meets much less than a hydramnion is diagnosed. Data of ultrasonography help to make the diagnosis, to define a state and amount of amniotic waters.

Oligoamnios symptoms:

Hydramnion forms:
Early - is diagnosed by means of ultrasonography in terms from 16 to 20 weeks of pregnancy, it is caused by functional insolvency of fetal membranes.

Later - reveal after 26 weeks of pregnancy when the oligoamnios comes owing to a hydrorrhea because of a partial prenatal rupture of fetal membranes, meets in 24% of observations.

The prolonged early form at favorable regenerative processes in amnion which promote the termination of the expiration of amniotic waters can pass into late.

Oligoamnios reasons:

Origins of an oligoamnios are found out insufficiently. Usually it is explained by decrease in secretory activity of amnion. Main reasons for an oligoamnios following: infectious and inflammatory extragenital and genital diseases of mother, disturbance of exchange processes (obesity), organic anomalies of an urinary system of a fruit, fetoplacental insufficiency.
Quite often the oligoamnios develops at one of unioval twins. It is explained by uneven distribution between two twins of the blood circulating in the general placenta.

Treatment of the Oligoamnios:

Tactics of conducting pregnancy and the result of childbirth depend on time of emergence and degree of manifestation of an oligoamnios. The worst predictive sign for a fruit is development of an oligoamnios in the II trimester of pregnancy in this connection, it is necessary to resolve timely an issue of expediency of prolongation of pregnancy. At detection of an oligoamnios at the beginning of the III trimester in combination with a fruit arrest of development – prolongation of pregnancy remains problematic.

At the oligoamnios which developed in the III trimester of pregnancy without growth disorder of a fruit the favorable result of childbirth is possible, delivery in 37-38 weeks of pregnancy is justified.

In most cases the oligoamnios develops at a pregnancy perenashivaniye.

Therapy includes treatment of the basic disease which caused an oligoamnios in combination with the medicinal therapy directed to improvement of an uteroplacental blood-groove, metabolism in a placenta, recovery of gas exchange in system a mother-placenta-fruit. Selection of specific medicines is carried out by the doctor. It is regularly necessary to estimate a fruit condition by means of ultrasonography, a kardimonitoring and a dopplerometriya.

At a fruit aggravation of symptoms according to KTG and to indicators of a fruit and placental blood-groove delivery by operation Cesarean section in the emergency order is carried out.

Childbirth at an oligoamnios.
At the full-term pregnancy weakness of patrimonial activity (to 80% of childbirth) happens the most frequent complication of childbirth at an oligoamnios. At childbirth there is an opening of a bag of waters in connection with its insufficient influence on process of disclosure of a neck of uterus.

At an oligoamnios twice more often there are premature birth, than at the usual course of pregnancy. In 20% of cases there comes the acute hypoxia of a fruit. At heavy changes pre-natal death of a fruit therefore the delivery percent by operation of Cesarean section is high is possible (to 40 - 50%).

At a moderate oligoamnios quite often (about 20%) children are born with a hypotrophy of various degree of manifestation. But at the same time the result of pregnancy happens favorable at the prevailing most of women - children are born in satisfactory condition.