![]() ![]() In the first 20 weeks, lung secretions, along with hydrostatic and osmotic transport of maternal plasma through the fetal membranes, make up the majority of amniotic fluid production. The volume of amniotic fluid in the gestational sac is a result of a balance between fluid production and fluid movement out of the sac. The MVP should serve to evaluate oligohydramnios in multifetal pregnancies, as you will not be able to measure all four quadrants for each fetus. With this in mind, some institutions opt to use the MVP in gestations with low AFV and use the AFI in cases of high AFV. The use of the maximum vertical pocket tends to overly diagnose cases of polyhydramnios, while the use of the AFI tends to underdiagnose cases of oligohydramnios. An AFI <5cm is consistent with oligohydramnios. The sum of the four maximum vertical pockets is equal to the AFI. The AFI can be determined after 20 weeks of gestation by dividing the uterus into four quadrants through the umbilicus and determining the MVP in each quadrant. The amniotic fluid index (AFI) is an alternative assessment of AFV. The normal range for MVP is 2-8 cm: a pocket 8 is considered polyhydramnios. The measurement should be made from the 12 o’clock position to the 6 o’clock position. ![]() The sonographer systematically scans the abdomen and obtains an image that demonstrates the maximum vertical pocket - the deepest pocket of amniotic fluid that does not include fetal umbilical cord or body parts. Transabdominal ultrasound evaluation of AFV includes the use of either the maximum vertical pocket (MVP) or the amniotic fluid index (AFI) depending on the institution. Discrepancies should prompt an amniotic fluid assessment by ultrasound. Īmniotic fluid disorders should be included in the differential diagnosis whenever there is a discrepancy between the fundal height measurement and gestational age. This pattern allows for clinical assessment of AFV throughout pregnancy using fundal height measurements and ultrasound evaluation. The AFV then begins to decrease steadily after 40 weeks gestation, leading to reduced volume in post-term gestations. The volume of amniotic fluid changes over gestation, increasing linearly until 34 to 36 weeks gestation, at which point the AFV levels off (approximately 400mL) and remains constant until term. All the best and if you have any questions I'm happy to answer.Oligohydramnios is defined as decreased amniotic fluid volume (AFV) for gestational age. One piece of advice is don't google it, I did and completely stressed myself out. It's stressful having monitoring constantly and having to be prepared to have bubs early but in the end it all worked out for the best. Depending on how low your fluid is (normal being 5-20cm) I would be asking for closer monitoring. ![]() she is doing great now and gaining weight well. They put the low fluid and IUGR down to my placenta not functioning properly, which is why they were monitoring her so closely throughout my pregnancy. She did really well but was smaller than they thought, only 3rd percentile and so they said she had IUGR (growth restricted). The plan was to get me to 37 wks which is when I had my cesarean ( bubs was breech and couldn't turn with the low fluid). Bubs was measuring around the 20th percentile according to the scans. My fluid levels fluctuated between 2.5cm and 6cm but always stayed low. I had to have 2x weekly CTG's to monitor baby and weekly scans to monitor my fluid levels and blood flow to baby, weekly doc appointments and growth scans every 2 wks for the rest of my pregnancy. It was picked up at 30 wks that I had low amniotic fluid I think it was measuring about 5cm. ![]()
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