1、单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,Abnormal amniotic fluid volume,1,Review,2,3,Function of amniotic fluid,A valuable source for analysis of fetal tissues and fluids,；,Cushion(,缓和）,the fetus against severe injury,；,Provide a medium in which the fetus can move easily,；,A source of fetal nutrition;,In early pregnancy,essential for fetal lung development,Inhibits bacterial growth,4,Amniotic fluid origin,maternal serum dialysed,secreted by amniotic membrane(,羊膜）,fetal urine,（胎儿尿液）,The aver
2、age volume is 800 mL,Amniotic fluid absorb,fetal,membrane,fetal skin,fetus swallows about 400ml of amniotic fluid a day in the final stage of pregnancy,umbilical,cord,5,Polyhydramnios,6,Definition,The volume of amniotic fluid increases beyond,2000ml,during pregnancy,7,Etiology,1.Fetal anomalies,（,18%-40%,）,1),neural tube defects,-50%,：,exposed meninges,（脑脊膜）,open spina bifida(,开放性脊柱裂）,oesophageal atresia,(,食道闭锁）,duodenal atresia,（十二直肠闭锁）,8,9,Etiology,2),chromosomal abnormalities:18-trisome,，,21-
3、trisome,（唐氏综合征），,13-trisome,：,cause absence of fetal swallowing reflex,3),hydrops fetalis(,胎儿水肿）：,Incompatibility of mother and fetus group;infection in uterine,10,21-trisome,（唐氏综合征）,Etiology,12,Maternal factors:diabetes,cardiac or renal disease,acute hepatitis,Placenta factor:large placenta,Multiple pregnancy:excessive blood and urination,Specific polyhydramnios(30%),Clinical manifestation,Acute polyhydramnios,Seldom seen,appear generally at 20-24 weeks,Series of oppressing,（压迫）,symptoms,13,Chr
4、onic polyhydramnios,Uterus is larger than expected gestational age,Fetal parts is difficult to be palpated(normally palpable from 26-28weeks),Auscultation:fetal heart sound unclearly,far away,14,Clinical manifestation,Ancillary examination,Ultrasonic examination,Amniotic fluid index-AFI18cm,Amniotic fluid volume-AFV8cm,AFP(alpha fetoprotein),anencephalus,（无脑儿）,spina bifida,15,Ancillary examination,Blood sugar:,especially the chronic polyhydrymnios,Blood groups:,hydrops,16,Diagnosis,Sonography-th
5、e most important,Hydatidiform mole,Twin pregnancy,Fetal macrosomia,（巨大儿）,17,Prognosis,Hypertensive disorder,C,omplicating pregnancy,Premature delivery,Placental abruption,Prolapse of umbilical cord,Perinatal mortality is 7 times than normal,18,Treatment,Normal fetus,reduce the amniotic fluid attention:500ml/h,dont exceed 1500ml one time,indometacin administration:reduces fetal renal excreting,19,20,Treatment,Malformed fetus,terminate pregnancy,21,Oligohydramnios,22,Definition,Amniotic fluid volu
6、me is less than,300ml,at the,last,pregnancy term,Incidence,0.4-4%,23,Etiology,1.Fetus defect of urinary system,kidney:no kidney,agenesis,ureter,urethra,obstruction,24,2.Placenta problem,post term pregnancy,hypertensive disorder,FGR(fetal growth restriction),25,Etiology,3.Maternal factor,:,dehydration,(,脱水）,blood,deficiency,4.Amnion disorder,：,rupture,26,Etiology,Clinical presentation,Uterus smaller than expected gestational age,Abdominal pain when fetus moving,Severe pain in labor,27,Prognosis,Defect of fetus,Pulmonary hypoxia,Fetal distress or neonatal asphyxia,（窒息）,28,Diagnosis,Clinical symptoms,Sonography AFI,External electronic monitoring:late deceleration,8cm alert,5cm certainty,29,Treatment,Preterm gestation,infuse physiological solution into uterus cavity,enough liquid supply to mother,improve placental infusion,30,term gestation,delivery,cesarean section,31,Treatment,Fetal,abnormal,Terminate pregnancy:,amniocentesis,羊膜腔穿刺,32,Treatment,
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