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1. AMNIOTIC FLUID Presented by – Suresh Choudhary BSC Nursing 4 th year

2. Introduction Amniotic fluid is the protective liquid contained in the amniotic sac surrounding the fetus. It is essential for fetal growth, development, and protection.

3. Definition Amniotic fluid is a clear, slightly yellowish liquid within the amniotic sac. It surrounds the developing fetus in the uterus and provides a stable environment.

4. Origin of Amniotic Fluid Early pregnancy: Derived mainly from maternal plasma. Later stages: Fetal urine and lung secretions become the primary sources.

5. Composition Amniotic fluid contains: - 98–99% water - Electrolytes - Proteins - Carbohydrates - Lipids - Hormones - Fetal cells - Waste products

6. Functions of Amniotic Fluid (1) 1. Provides cushioning and protection against trauma 2. Maintains constant temperature around the fetus 3. Allows free movement for musculoskeletal development

7. Functions of Amniotic Fluid (2) 4. Prevents adhesions of fetal parts 5. Facilitates lung development by enabling fetal breathing movements 6. Acts as a barrier to infection

8. Volume Changes Amniotic fluid volume varies with gestational age: - 10 weeks: ~30 mL - 20 weeks: ~300 mL - 28 weeks: ~700 mL - 34 weeks: 800–1000 mL (peak) - Term: ~600–800 mL

9. Assessment of Amniotic Fluid Amniotic fluid is assessed by: - Clinical examination - Ultrasound imaging - Amniotic Fluid Index (AFI) - Single deepest vertical pocket measurement

10. Amniotic Fluid Index (AFI) AFI is measured using ultrasound by dividing the uterus into 4 quadrants. The vertical depth of the largest fluid pocket in each quadrant is summed. Normal range: 5–25 cm.

11. Normal & Abnormal Ranges Normal AFI: 5–25 cm Oligohydramnios: AFI < 5 cm Polyhydramnios: AFI > 25 cm Borderline: AFI 5–8 cm

12. Oligohydramnios Definition: Abnormally low volume of amniotic fluid. Causes: Renal agenesis, intrauterine growth restriction (IUGR), ruptured membranes. Complications: Pulmonary hypoplasia, limb deformities, cord compression.

13. Polyhydramnios Definition: Excess amniotic fluid volume. Causes: Maternal diabetes, multiple pregnancy, gastrointestinal tract malformations. Complications: Preterm labor, malpresentations, cord prolapse.

14. Amniotic Fluid Color Normal: Clear to pale yellow. Yellow: Hemolytic disease (bilirubin). Green: Meconium-stained fluid (fetal distress). Red: Intrauterine bleeding. Cloudy: Infection.

15. Amniotic Fluid pH Normal pH: 7.0–7.5 pH < 7: Suggests fetal acidosis pH > 7.5: Suggests infection or ruptured membranes

16. Amniocentesis A diagnostic procedure where a needle is inserted into the uterus to withdraw amniotic fluid. Uses: Genetic testing, infection studies, fetal lung maturity assessment.

17. Clinical Importance Amniotic fluid analysis helps in: - Assessing fetal well-being - Detecting congenital anomalies - Monitoring high-risk pregnancies - Diagnosing intrauterine infections

18. Amniotic Fluid Embolism A rare but serious complication where amniotic fluid enters maternal circulation. Symptoms: Sudden respiratory distress, hypotension, coagulopathy. High maternal and fetal mortality.

19. Disorders Related to Amniotic Fluid 1. Premature rupture of membranes (PROM) 2. Fetal distress due to abnormal fluid 3. Congenital anomalies linked to fluid abnormalities

20. Recent Advances 1. 3D/4D ultrasound for accurate volume measurement. 2. Proteomic and genomic analysis for early anomaly detection. 3. Non-invasive prenatal testing (NIPT) using amniotic fluid.

21. Conclusion Amniotic fluid plays a vital role in fetal growth, development, and protection. Regular monitoring ensures better pregnancy outcomes. Timely diagnosis and management of fluid abnormalities are crucial.