Amniotic Fluid

Physiology
Secara umum fungsinya adalah (physical space for):
• Dermatomusculoskeletal development
• Permits fetal swallowing (for GI development and fetal breathing for
lung development)
• Protects from physical trauma
• Protects from umbilical cord compression
• Has bacteriacidal properties
Physiology
• Early in pregnancy, similar with extracellular fluid
• frst half of pregnancy, transfer of water and other small
molecules takes place across the amnion—transmembranous
flow, across the fetal vessels on placental surface—intramembranous flow,
and across fetal skin.
• Urine production begins between 8 and 11 weeks (major component until
2nd trimester)
• Water transport until 22 – 25 weeks (keratinization)
•
Physiology
• Amniotic fluid is more hypotonic than fetal and maternal plasma
• Lung fluid produced in late gestation and half are swallowed -> this
allows amniotic fluid reabsorption around 500 mL – 1 L
Volume
• 10 weeks = 30 mL
• 16 weeks = 200 mL
• Mid-3rd trimester = 800 mL

98% are water

Full term = 2800 mL + Placenta = 400 mL
Hydramnios
• The uterus may feel tense, and palpating fetal small parts or auscultating fetal
heart tones may be difficult.
• categorized according to degree. Such categorization has been primarily used in
research studies to stratify risks. Several groups have termed hydramnios as mild
if the AFI is 25 to 29.9 cm, moderate if 30 to 34.9 cm, and severe if 35 cm or more
• Using the single deepest pocket of amnionic
fluid, criteria for mild is 8 to 9.9 cm, moderate is 10 to 11.9 cm,
and severe hydramnios, ≥ 12 cm
• Etiology : Fetal congenital anomalies, diabetes, congenital infection, and RBC
alloimunisation
• Pathphys : complex but concluded as to a high cardiac-output state
Oligohydramnios
• The sonographic diagnosis of oligohydramnios is usually
based on an AFI ≤ 5 cm or on a single deepest pocket of amnionic
fluid ≤ 2 cm
• Etiology : Pregnancies complicated by oligohydramnios include those
in which the amnionic fluid volume has been severely decreased
since the early second trimester and those in which the fluid
volume was normal until near-term or even full-term.