The purpose of this review is to examine the evidence that defines normal and abnormal amniotic fluid volumes (AFVs) and current recommendations on the management of abnormalities of AFV. The studies establishing normal actual AFVs and the ultrasound estimates used to identify normal and abnormal AFVs were evaluated. Recommendations from national and international organizations were reviewed for guidance on the definitions and management of abnormal AFVs. A timeline of the development of the thresholds that define abnormal AFVs was created. Recommendations from 13 national and international guidelines were identified, but the definitions and management recommendations for abnormal AFVs varied considerably between groups. An algorithm for the management of oligohydramnios and polyhydramnios was developed. Knowledge gaps and the structure of future studies were examined. Assessment of AFV is performed multiple times per day in antenatal clinics and hospitals. Current recommendations on defining and managing abnormal AFVs differ between national and international organizations. We have proposed algorithms to assist in the management of abnormal AFVs until further studies can be undertaken.
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http://dx.doi.org/10.3390/jcm13164702 | DOI Listing |
J Clin Med
August 2024
Department of Obstetrics & Gynecology, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 518, Little Rock, AR 72205, USA.
Objective: To analyse amniotic fluid volume (AFV), specifically oligohydramnios or polyhydramnios, and associated pregnancy and neonatal outcomes in twin gestations through systematic review and meta-analysis.
Methods: We utilised systematic review methodology to identify items within published and grey literature resources. Prospective and retrospective studies with a control group were included.
Int J Womens Health
August 2021
Department of Obstetrics, Gynecology and Reproductive Sciences of the University of Texas Health Sciences Center at Houston, Houston, TX, USA.
Actual AFV can be determined by a dye-dilution technique or be directly measured at cesarean. This allows investigators to correlate estimated and actual AFVs. Lessons learned by assessing the relationship of estimated to actual AFVs.
View Article and Find Full Text PDFJ Ultrasound Med
February 2020
Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Objectives: To identify abnormal amniotic fluid volumes (AFVs), normal volumes must be determined. Multiple statistical methods are used to define normal amniotic fluid curves; however, quantile regression (QR) is gaining favor. We reanalyzed ultrasound estimates in identifying oligohydramnios, normal fluid, and polyhydramnios using normal volumes calculated by QR.
View Article and Find Full Text PDFJ Ultrasound Med
November 2011
Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, Little Rock, AR 72205 USA.
The amniotic fluid volume (AFV) is regulated by several systems, including the in-tramembranous pathway, fetal production (fetal urine and lung fluid) and uptake (fetal swallowing), and the balance of fluid movement via osmotic gradients. The normal AFV across gestation has not been clearly defined; consequently, abnormal volumes are also poorly defined. Actual AFVs can be measured by dye dilution techniques and directly measured at cesarean delivery; however, these techniques are time-consuming, are invasive, and require laboratory support, and direct measurement can only be done at cesarean delivery.
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