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Obstetrics and Gynecology · Obstetrics

Amniotic fluid pathology

Pathologia liquoris amnii

Amniotic fluid pathology includes deviations of amniotic fluid volume from the norm, as well as membrane infection and the formation of amniotic bands. These conditions pose serious complications for the fetus and mother, requiring accurate ultrasound diagnostics and strict adherence to management tactics.

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PolyhydramniosMore than 1.5 L of fluid, AFI > 24 cm, vertical pocket > 8 cm
Frequency of polyhydramniosOccurs in 0.5–1.5% of all pregnancies
Streeter bandsEarly amnion rupture creates fibrous bands leading to amputation
ChorioamnionitisMembrane infection with purulent discharge and fever
3 min readFor medical studentsUpdated Sep 25, 2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Oligohydramnios: management features and risks

The severity of amniotic fluid deficit is assessed along with the condition of the fetus and the presence of concomitant malformations. If oligohydramnios is combined with growth restriction or chronic hypoxia, therapy focuses on placental insufficiency.

  • In labor, when oligohydramnios is detected, amniotomy is mandatory, since a "flat" amniotic sac provokes discoordination or weakness of labor activity.
  • In severe oligohydramnios, physicians expand the indications for Cesarean section due to the high risk of umbilical cord compression.

Polyhydramnios: causes and clinical presentation

Excess amniotic fluid develops due to maternal factors (infections, diabetes mellitus with fetal polyuria) or due to fetal pathologies themselves, including hemolytic disease, non-immune hydrops, or twin-to-twin transfusion syndrome in monochorionic twins.

Symptoms include:

  • Increase in abdominal size, high standing of the uterine fundus, and a tense, elastic consistency.
  • Unstable or malpresentation of the fetus and muffled heart tones.
  • Dyspnea due to high standing of the diaphragm and signs of inferior vena cava compression.
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Complications and tactics in polyhydramnios

Overdistension of the uterus leads to serious consequences during pregnancy, labor, and the postpartum period:

  1. Premature birth and spontaneous abortions in late terms due to cervical shortening.
  2. Premature rupture of membranes with the risk of umbilical cord prolapse and placental abruption (PPROM).
  3. Postpartum hemorrhage due to uterine hypotonia.

In moderate cases, pregnancy is prolonged under observation. In labor, opening of the amniotic sac is performed carefully — laterally and above the internal os, releasing fluid slowly to avoid umbilical cord prolapse. Uterotonic drugs are mandatory for the prevention of hypotonia.

Amniotic bands and chorioamnionitis

Rupture of the amnion in early terms leads to the formation of mesodermal bands (Streeter bands), which can cause severe deformations, amputation of fingers or limbs, and in the 1st trimester — gastroschisis.

Chorioamnionitis is an infectious lesion of the membranes involving anaerobes, staphylococci, or streptococci. The mother suffers from fever, tachycardia, uterine pain, and purulent discharge with a sharp odor. Treatment requires immediate antibiotic therapy with penicillins or cephalosporins in combination with metronidazole.

Class and exam questions

What are the ultrasound criteria for diagnosing polyhydramnios?

The diagnosis is confirmed if the vertical pocket of amniotic fluid exceeds 8 cm, and the total amniotic fluid index is more than 24 cm.

Why is amniotomy indicated in labor for oligohydramnios?

Opening of the amniotic sac is necessary because a "flat" sac in oligohydramnios provokes weakness or discoordination of labor activity.

What complications are characteristic of polyhydramnios during pregnancy?

Premature birth and spontaneous abortions are most frequent. Malpresentation of the fetus, premature rupture of membranes, umbilical cord prolapse, and placental abruption are also possible.

How to properly perform amniotomy in polyhydramnios?

The fetal membranes are opened laterally and above the internal os, fluid is released slowly, and the hand is not removed from the vagina to prevent prolapse of the umbilical cord or fetal arm.

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What else to study on this topic

  • Pathogenesis of maternal diabetes mellitus in polyhydramnios
  • Mechanisms of twin-to-twin transfusion syndrome development
  • Laboratory diagnostics of TORCH infections
  • Features of laser coagulation in TTTS
  • Differential diagnostics of fetal malformations on ultrasound

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Other topics in the "Obstetrics" section

Umbilical cord pathologyPlacental anomaliesChorioamnionitisPostpartum complications
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Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.