Oligohydramnios

OLIGOHYDRAMNIOS

Q. 1

During an antenatal check up, USG of a 37 weeks pregnant grand primigravida shows amniotic fluid index of 4 cm. 

Assertion: Sonographically, this is a case of oligohydramnios.

Reason: If it is a male fetus, posterior urethral valve could be present.
 

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Q. 1

During an antenatal check up, USG of a 37 weeks pregnant grand primigravida shows amniotic fluid index of 4 cm. 

Assertion: Sonographically, this is a case of oligohydramnios.

Reason: If it is a male fetus, posterior urethral valve could be present.
 

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Ans. A

Explanation:

  • Oligohydramnios is the condition where the liquor amnii is deficient in amount to the extent of less than 200 ml at term.
  • Sonographically, oligohydramnios is defined when the maximum vertical pool of liquor is less than 2 cm or when amniotic fluid index (AFI) is less than 5 cm .
  • LUTO(Lower urinary tract obstruction)on ultrasonography, in a male fetus is almost always due to posterior urethral valves.
  • The classical evidence on ultrasonography of LUTO is the presence of severe oligohydramnios, a grossly distended urinary bladder with increase in bladder wall thickness. The so called “keyhole” sign can be demonstrated if the proximal urethra too is distended.

 


Q. 2

On sonography a multigravida found to have oligohydramnios. Which among the following will be associated with this condition?

 A

Oesophageal atresia

 B

Spina bifida

 C

Cholangioma of placenta

 D

Renal agenesis

Q. 2

On sonography a multigravida found to have oligohydramnios. Which among the following will be associated with this condition?

 A

Oesophageal atresia

 B

Spina bifida

 C

Cholangioma of placenta

 D

Renal agenesis

Ans. D

Explanation:

Congenital Anomalies Associated with Oligohydramnios:
  • Amniotic band syndrome
  • Cardiac: Fallot tetralogy, septal defects
  • Central nervous system: holoprosencephaly, meningocoele, encephalocoele, microcephaly
  • Chromosomal abnormalities: triploidy, trisomy 18, Turner syndrome
  • Cloacal dysgenesis
  • Cystic hygroma
  • Diaphragmatic hernia
  • Genitourinary: renal agenesis, renal dysplasia, urethral obstruction, bladder exstrophy, Meckel-Gruber syndrome, ureteropelvic junction obstruction, prune-belly syndrome
  • Hypothyroidism
  • Skeletal: sirenomelia, sacral agenesis, absent radius, facial clefting
  • TRAP (twin reverse arterial perfusion) sequence
  • Twin-twin transfusion
  • VACTERL (vertebral, anal, cardiac, tracheo-esophageal, renal, limb) association
Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 21. Disorders of Amnionic Fluid Volume. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.

Q. 3

A 25 year old primigravida gave birth an infant who has clubfoot. During her pregnancy period she was diagnosed of having oligohydramnios. She didn’t get a proper care for this problem. She was under certain medications during pregnancy. Which of the following must have caused oligohydramnios in this patient?

 A

Insulin

 B

Enalapril

 C

Ciprofloxacin

 D

None of the above

Q. 3

A 25 year old primigravida gave birth an infant who has clubfoot. During her pregnancy period she was diagnosed of having oligohydramnios. She didn’t get a proper care for this problem. She was under certain medications during pregnancy. Which of the following must have caused oligohydramnios in this patient?

 A

Insulin

 B

Enalapril

 C

Ciprofloxacin

 D

None of the above

Ans. B

Explanation:

Exposure to angiotensin-converting enzyme inhibitors has been associated with oligohydramnios.

Conditions Associated with Oligohydramnios:

  • Fetal
  1. Chromosomal abnormalities
  2. Congenital anomalies
  3. Growth restriction
  4. Demise
  5. Postterm pregnancy
  6. Ruptured membranes
  • Placenta
  1. Abruption
  2. Twin-twin transfusion
  • Maternal
  1. Uteroplacental insufficiency
  2. Hypertension
  3. Preeclampsia
  4. Diabetes
  • Drugs
  1. Prostaglandin synthase inhibitors
  2. Angiotensin-converting enzyme inhibitors
  • Idiopathic

Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 21. Disorders of Amnionic Fluid Volume. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.


Q. 4

Oligohydramnios is seen in ail except:

 A

Renal agenesis

 B

Rh incompatibility

 C

IUGR

 D

Postmaturity

Q. 4

Oligohydramnios is seen in ail except:

 A

Renal agenesis

 B

Rh incompatibility

 C

IUGR

 D

Postmaturity

Ans. B

Explanation:

Rh incompatibility



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