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Normal amniotic pressure throughout gestation.

N M Fisk1, D Ronderos-Dumit, Y Tannirandorn

  • 1Royal Postgraduate Medical School, Institute of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, London.

British Journal of Obstetrics and Gynaecology
|January 1, 1992
PubMed
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Amniotic pressure (AP) increases with pregnancy duration but is not linked to amniotic fluid volume. This study establishes a reference range for AP, aiding in procedures like amnioinfusion.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Physiology

Background:

  • Amniotic pressure (AP) is a physiological parameter within the gravid uterus.
  • Understanding AP dynamics is crucial for managing pregnancy complications.
  • Previous characterizations of AP in relation to amniotic fluid volume have been limited.

Purpose of the Study:

  • To characterize amniotic pressure (AP) in pregnancies with normal amniotic fluid volume.
  • To establish a reference range for AP across gestation.
  • To investigate factors influencing AP, independent of amniotic fluid volume.

Main Methods:

  • Observational, cross-sectional study in a tertiary referral hospital.
  • Inclusion of 194 pregnancies (232 occasions) between 7 and 38 weeks gestation undergoing transamniotic procedures.

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  • Manometry readings obtained via fluid-filled lines, referenced to maternal abdomen, with AP measured in mm Hg and corrected for gestational age (z scores).

    • Main Results:

    • Amniotic pressure (AP) demonstrated a significant increase with advancing gestation, plateauing in the mid-trimester (P < 0.001).
    • AP z scores were not influenced by amniotic fluid volume indices (deepest vertical pool, amniotic fluid index), twin gestation, or maternal/fetal characteristics.
    • No correlation was found between AP and subsequent spontaneous preterm delivery.

    Conclusions:

    • Amniotic pressure is not primarily determined by intrauterine volume.
    • AP may be influenced by gestation-specific anatomical and hormonal factors affecting uterine musculature.
    • A reference range for AP has been developed for clinical applications such as amnioinfusion and amnioreduction.