Oligohydramnios is when you have low amniotic fluid during pregnancy.Your healthcare provider diagnoses low amniotic fluid using an ultrasound.Oligohydramnios can cause pregnancy complications or be a sign of an underlying health condition.
Introduction: What is Oligohydramnios? Oligohydramnios occurs during pregnancy when your amniotic fluid is lower than expected for your baby’s gestational age. Amniotic fluid is a water-like fluid that surrounds your baby in your uterus. It protects your baby from infection and umbilical cord compression and cushions their movements while they’re in your uterus. Amniotic fluid also helps develop your baby’s digestive and respiratory system,as well as regulates their temperature.Too little amniotic fluid can cause health problems in your baby or be a sign of an underlying condition.These conditions could affect your baby’s development or cause complications during labor and delivery.
1. How common is Oligohydramnios? Low amniotic fluid affects about 4% of people who are pregnant.It’s most common in the last three months of pregnancy.This rate rises to about 12% in people who are past their due date because amniotic fluid levels decrease after 40 weeks of pregnancy.
2. How much amniotic fluid do I have during Pregnancy? It depends on how many weeks pregnant you are.You begin making amniotic fluid about 12 days after conception.The amount of amniotic fluid you produce increases until its peak at 36 weeks of pregnancy. After that,your levels of amniotic fluid start decreasing.
3. Symptoms and causes: What is the most common cause of oligohydramnios? Several factors can contribute to low amniotic fluid,such as:
a. Congenital anomalies that affect your baby’s kidneys or urinary tract.
b. Problems with your placenta.
c. Going more than two weeks past your due date.
d. Hypertension or preeclampsia.
e. Diabetes.
f. Dehydration.
g. Prelabor rupture of the membranes.
h. Twin-to-twin transfusion syndrome.
5. What are the Signs of low amniotic fluid? You may not know you have low amniotic fluid. However,your healthcare Physician may suspect it if:
a. You’re leaking fluid from your vagina.
b. Your uterus measures small.
c. You don’t feel your baby move enough.
d. You’re not gaining enough weight.
e. You’re also at an increased risk for low amniotic fluid if you’ve had low amniotic fluid in prior pregnancies.
6. What are the Complications of Oligohydramnios?
Low amniotic fluid in the first Six months of pregnancy is generally more dangerous. These complications could include:
a. Deformities caused by being compressed in your uterus.
b. Preterm birth.
c. Miscarriage.
d.Stillbirth.
e. Infection if your water has broken early. If you’re diagnosed with oligohydramnios in the last trimester(weeks 28 to 40) of pregnancy, complications could include:
f. Umbilical cord compression.
g. Fetal growth restriction.
h. Respiratory issues or underdeveloped lungs.
i. Increase risk of Cesarean delivery.
j. Need for an early delivery.
k. Increased risk for infection if your water has broken too early.
7. Diagnosis and tests: How is Oligohydramnios diagnosed? If you have any signs of low amniotic fluid, your healthcare physician will measure the amount of amniotic fluid in your uterus using an ultrasound. If the amount of fluid is less than the recommended amount for the gestational age of your fetus, you may have Oligohydramnios. There are two ways to measure amniotic fluid: Amniotic Fluid Index(AFI)or Maximum Vertical Pocket(MPV). Oligohydramnios is typically diagnosed by finding in a routine ultrasound: An ultrasound given to test amniotic fluid level in someone who is at risk
a. An ultrasound given in response to a uterine size that is less than expected for gestational age
b. An ultrasound given in response to a patient who presents with premature rupture of membranes(PROM)
c. Ultrasonic diagnosis of oligohydramnios is performed by obtaining a measurement called the amniotic fluid index (AFI).
d. The assessment of amniotic fluid may be used in conjunction with the biophysical profile (BPP) and non-stress test (NST) as part of an assessment of fetal wellbeing. AFI is calculated by measuring the depth of the amniotic fluid in four sections of the uterus and adding them together. The doctor can take objective measurements using the AFI, and will diagnose oligohydramnios when the amniotic fluid index is less than 5 and the single deepest pocket is less than 2 cm. The doctor can also use a dye-dilution method to quantify the volume of amniotic fluid. The doctor must also look at downward trends in amniotic fluid over time. An AFI less than 5 centimeters indicates oligohydramnios. A borderline AFI of 5-10 centimeters, however, has been associated with many risks, including:
a. Fetal heart rate deceleration
b. Meconium aspiration
c. Low Apgar score
d. Low birth weight
e. NICU admission
Try to remain calm, though most people who are diagnosed with low amniotic fluid go on to have healthy babies. Your healthcare provider will monitor you closely and work with you to determine the safest treatment plan. Attending all prenatal visits and sharing your pregnancy symptoms is the best way to detect potential issues.
Non-reactive non-stress tests, Need for cesarean delivery: Most women with a high-risk pregnancy should have an AFI assessment once a week to monitor for oligohydramnios. Twice-weekly AFI assessments are justified if measurements are between 5 and 10 centimeters at a gestational age of fewer than 41 weeks.Anyone at 41 weeks of gestation or higher should have twice-weekly AFI assessments with a modified BPP. However, the frequency of testing should be based on the clinical circumstances of each person; the more unstable the maternal or fetal condition, the more frequent the testing. Research indicates that all pregnant patients diagnosed with oligohydramnios should undergo a non-stress test (NST) and AFI or BPP once or twice weekly until delivery depending on the maternal and fetal condition, especially in cases in which the cause of the condition is unknown. Oligohydramnios must be identified and managed early to prevent the possibility of permanent brain injury to the baby.
8. Management and treatment: What is the treatment of Oligohydramnios? It depends on how far along you are in your pregnancy and if you’ve been diagnosed with other Pregnancy complications.If you’re close to full term(37 weeks of pregnancy) your healthcare Physician may decide that inducing labor early is the safest option for your baby.
Your healthcare Physician may monitor you more closely with extra prenatal visits, ultrasounds, non-stress tests and a Biophysical profile.
9. Prevention: How can I prevent Oligohydramnios? There isn’t anything you can do to prevent oligohydramnios.Attend all prenatal check-ups and be honest with your healthcare Physician about your symptoms and medical history.Knowing if you’re at risk for low amniotic fluid is your best chance for treating the condition.
10. Outlook/prognosis: Can a baby survive oligohydramnios?
Yes, your baby will likely be born healthy and happy.Low amniotic fluid can be serious, but in most cases,it’s highly treatable.
11. Living with Oligohydramnios; Can drinking water increase amniotic fluid? Maybe some studies show that drinking water can help increase amniotic fluid levels in people who are pregnant.Talk to your healthcare Physician about increasing your water intake as a treatment for Oligohydramnios.
12. When should you consult healthcare physician? Call your healthcare provider if you experience any of the following:
a.Leaking large amounts of amniotic fluid from your vagina.
b.Vaginal bleeding.
c.Cramps or pelvic pain.
d.Contractions.
e.Feeling your baby move less (less fetal movements)
Take away: Low amniotic fluid or Iligohydramnios is a potentially serious condition. It can cause complications with your pregnancy and affect your baby’s growth. Try to remain calm, though most people who are diagnosed with low amniotic fluid go on to have healthy babies. Your healthcare provider will monitor you closely and work with you to determine the safest treatment plan. Attending all prenatal visits and sharing your pregnancy symptoms is the best way to detect potential issues.
(Author is a Medical Officer at J&K Health Department. The views, opinions, facts, assumptions, presumptions and conclusions expressed in this article are those of the author and aren’t necessarily in accord with the views of “Kashmir Horizon”.)