Amniotic Fluid Index

Amniotic fluid plays an important role in fetal lung development protection against trauma and infection.

Amniotic fluid index (AFI) is examined in the BPP and reflects the volume of amniotic fluid. The calculation of AFI is as follows: The maternal abdomen is divided into quadrants, and with ultrasound, the maximum vertical pocket of each quadrant is measured in centimeters and added.

Normal Amniotic Fluid Volumes

■ Maximum amniotic fluid is at 28 weeks—800 mL

■ After 28 weeks, amniotic fluid decreases.

Abnormal Amniotic Fluid Volumes

■ Oligohydramnios is < 5 amniotic fluid index.

■ Most common cause: Rupture of membranes.

■ Associated with intrauterine growth retardation (IUGR) in 60% of cases.

■ Polyhydramnios is > 20 amniotic fluid index, or 2 L.

FETAL HEART RATE PATTERNS

Important definitions:

■ Hypoxemia: Decreased oxygen content in blood

■ Hypoxia: Decreased level of oxygen in tissue

■ Acidemia: Increased concentration of hydrogen ions in the blood

■ Acidosis: Increased concentration of hydrogen ions in tissue

■ Asphyxia: Hypoxia with metabolic acidosis

See Table 6-2 for fetal heart rate patterns.

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