Low Amniotic Fluid (Oligohydramnios) During Pregnancy

What Is Meant By Amniotic Fluid?

Amniotic fluid is the protective, slightly yellowish and clear liquid contained in the amniotic sac which surrounds the unborn baby during pregnancy. Amniotic sac forms inside the uterus twelve days after conception. Amniotic fluid will start to form as soon as the sac formation.

What Is Amniotic Fluid Composed Of?

During former weeks of pregnancy, the fluid consists mainly the water provided by the mother (justifies the increased thirst during the first trimester). But after 20 weeks of pregnancy, fetal urine will be the primary substance of amniotic fluid as the result of the development of kidneys. The urine contributed by the baby is totally non-dangerous for your baby even though he swallows it. It will pass through the digestive system and kidneys and come out as urine. Gradually towards last trimester, the amniotic fluid will be more of fetus urine than water.
Baby floats in amniotic fluid. Amniotic sac will normally break during the time of delivery. This ‘water breaking’ is the one of the first indications that you are approaching delivery.

What Is The Role Of Amniotic Fluid In The Development Of The Baby?

Amniotic fluid has a vital part in supporting the life of your unborn baby. Amniotic fluid will help in:

• Movement of your baby: The amniotic fluid permits free movement of your baby inside the womb. This movement will aid in the development of bone and muscle (muscular- skeletal development)
• Cushioning your baby: The amniotic fluid cushions your baby from being hurt by external blows to the uterus. Even if you fall down. It acts as a liquid shock absorber, dispersing any force that pushes your uterus, including sex
• Lung development of your baby: The fetus will breathe in and breathe out the amniotic fluid and thus it helps in lung development
• Providing lubrication: The amniotic fluid lubricates the child’s growing body parts and keeps the body parts of the baby from growing together (example – webbed fingers and toes)
• Keeping your baby warm: The amniotic fluid helps to keep the temperature consistent around the fetus thus keeping it warm. The even temperature of amniotic fluid will protect the baby from too hot or too cold condition that you are undergoing
• Protecting umbilical cord: The amniotic fluid will help in protecting the umbilical cord from being compressed. Too much compression will cut off the nutrition supply from the mother’s body

What Is The Normal Level Of Amniotic Fluid?

The normal level of amniotic fluid at its fullest is 800ml. this will occur when you are around on 34th week of pregnancy. Towards the last week of pregnancy (full term), due to the growth of fetus the level of amniotic fluid will drop to 600 mL.

What Is Oligohydramnios?

Oligohydramnios is a condition of having too little amniotic fluid than normal level. It can occur at any time. If your tummy or baby appears smaller than the normal size that is expected, a low amniotic fluid condition can be anticipated.
The low level of amniotic fluid can be detected in an ultra sound scan.

What Are The Causes Of Low Amniotic Fluid Levels During Pregnancy?

• Postdate pregnancy: Once you have passed your due date by two weeks or more as the fluid level will decrease by half. In about 12 pregnancies out of 100 that passed 41 weeks becomes complicated because of the low amniotic fluid level
• When you are pregnant with twins: When you have conceived identical twins sharing the same placenta, there are chances of one twin to get more blood through placenta than the other and one who gets more blood produce more amniotic fluid than the other causing amniotic fluid imbalance
• Placental insufficiency: If the placenta gets partially or completely detached from the uterus, (placental abruption), it would be a case of oligohydramnios. When placenta stops providing enough nutrients to the baby, the baby gradually stops recycling the fluid
• Baby with inherited kidney problem: Developmental problems with kidney or urinary tract of your child results in the insufficient urine production. Genetic disorders can also be the cause for affecting the level of amniotic fluid
• Leaking of amniotic sac: Depending on the extend of the tear in the membrane the amniotic fluid gets leaks as tickling or can be a rush out when the membrane ruptures. This will lead to considerable reduction of the amniotic fluid
• Maternal complications: When you undergo complications such as dehydration, problems with blood pressure, lupus, diabetes, hypoxia (a condition in which the tissues suffer oxygen deficiency), and the prehistory of delivering an underweight baby increases the chances of Oligohydramnios
• Medication taken by mother: Some medicines that you take during pregnancy can cause low amniotic fluid conditions. Usually, doctors will not prescribe these medicines unless in some chronic cases

What Are The Risks Of Low Amniotic Fluid During Pregnancy?

The risk factors of low amniotic fluid condition depends on three factors:

• How little fluid you have
• Which stage of pregnancy are you in
• What lead to this condition

Detection Of Oligohydramnios In The First Half Of Pregnancy

The low level of amniotic fluid during the first trimester and first half of the second trimester are rare. But when it happens the chances of still birth and miscarriage increases. Growth retardation may occur and can also affect the lung development.

Detection Of Oligohydramnios In The Second Half Of Pregnancy

When the low amniotic fluid condition appears once you get into your third trimester relatively chances of giving birth to a healthy baby increases. Only closely and continuously monitoring the fluid level and growth rate of the baby is required.
Complications like pre term birth, IUGR (intrauterine growth restriction) – a condition with abnormally low fetal weight are associated with developing oligohydramnios in the second half of pregnancy.

Effect Of Oligohydramnios During Labor

During labor low amniotic fluid level can cause complications such as

• The breech position of baby: As the baby can’t rotate properly because of the insufficient level of amniotic fluid your baby may in the bottom down position during the labor
• Increase the chances of the baby being distressed: When your baby gets distressed during labor meconium, a black substance which is actually his first motion is released, which when he inhaled cause developing breathing problem after birth
• Squashing of the umbilical cord: The umbilical cord may get compressed during labor which creates more complication such as lowering the heart rate of baby, accumulation of carbon di oxide in baby’s blood. When the umbilical cord is compressed for a long time the brain of your baby may get damaged

All these above complication will promote caesarean section.

How Can Low Amniotic Fluid Level During Pregnancy Be Treated?

Your doctor will observe you very closely when you are undergoing oligohydramnios condition. Intravenous fluid therapy is mostly prescribed by the doctor as natural intake of water may not be able to meet the rehydration needed for restoring the fluid.
Amnioinfusion, in which, saline is induced into amniotic sac through a needle placed in the abdominal wall, is found to try in some cases even though it has only a temporary effect as the amniotic fluid level tend to drop in a couple of weeks.
Eat healthy water content food like fresh fruits, keep yourself well hydrated, take plenty of rest, avoid food items that can dehydrate by sending you to urinate more, lie down on your left side etc. are the things that you can do to keep your amniotic fluid level to keep normal.
Avoid consuming foods and drinks that can have dehydrating effect on you. Never take medicines without an approval from your doctor.