Little amniotic fluid

What is amniotic fluid and what is it for?

During pregnancy, your baby is embedded in a fluid-filled pouch in your uterus (uterus). This bag is called amniotic sac.

The wall of the amniotic sac consists of two membranes, the chorion and the amnion. These membranes keep your baby safe in this amniotic sac during pregnancy. The membranes will break when your baby is ready for delivery, and the fluid will drain out. This is called bursting of the amniotic sac.

The amniotic fluid has several purposes:

  • It protects your baby from injury if you get a punch in the stomach or your baby's stomach is pressed.
  • It helps your baby develop his lungs and digestive system.
  • It protects your baby from infection.

How much amniotic fluid is normal?

Your baby regularly swallows amniotic fluid and excretes it as urine. This means that the amount of fluid in the amniotic sac usually increases and decreases every day.

The amount of amniotic fluid increases during pregnancy. They start with just a few milliliters. But you have about a liter when you are in the 36th week (Boyd and Carter 2008). From the 38th week, the amount gradually decreases until your child is ready for birth.

If your baby is surrounded by too little amniotic fluid, it's called the oligohydramnios. If too much amniotic fluid is present, it is called the polyhydramnion or hydramnion.

How do I know I have too little amniotic fluid?

Your doctor or midwife may suspect that you have too little amniotic fluid if your baby is smaller than expected. He / she determines this during one of your check-ups.

The state of the amniotic fluid is certainly also controlled if you:

  • already had a baby that was small for the appointment or had a low birth weight
  • have a special medical condition such as butterfly lichen (lupus erythematosus )
  • Blood Pressure Problems

If your doctor has concerns, he / she recommends an ultrasound. The state of the liquid is checked, whereby the whole amniotic sac is looked at. The depth of the largest depots of amniotic fluid in the four sections of the uterus is measured. The results are added together to calculate the amniotic fluid index (AFI). There are proven normal values ​​for every week of pregnancy.Their values ​​are compared with these.

Maybe the deepest depot will be measured with amniotic fluid. A reading of less than 2 cm is considered low (Nabhan and Abdelmoula 2008).

What causes a reduced amount of amniotic fluid?

The most common causes of insufficient amniotic fluid are:
  • a rupture
  • a placental problem
  • medications you are taking
  • your baby has a health problem
  • one of your identical twins is growing not as it should
  • (Boyd and Carter 2008)

Bubble Jump

A rupture of the rupture occurs in a large gush or the liquid slowly drips out because there is a rupture in the amniotic sac. Sometimes you can not tell the difference between a rupture of the bladder and an accidental urination.

If you are not sure if your amniotic sac has burst, contact your midwife or your doctor immediately. If your amniotic sac has burst early, it may cause an infection if labor does not start.

It may be prescribed antibiotics to protect you from infections. They are safe for you and your baby. Depending on the stage of your pregnancy, you may be advised to go into labor. This means that labor is artificially induced. If the birth of your baby is not initiated, you will be watched until labor naturally begins.

A placental problem

A placental problem could be caused by a condition that prevents the placenta from providing your baby with enough blood and nutrients. Such afflictions include butterfly lichen, high blood pressure, preeclampsia and diabetes. If the placenta does not work well, it will affect your baby's growth. Your health and the development of your baby are carefully monitored and the amniotic fluid level is regularly monitored by ultrasound.

Medications you Take

Some medications can cause a lack of amniotic fluid. These are, for example, agents for high blood pressure, which are called ACE inhibitors, but are not usually prescribed during pregnancy. Non-steroidal anti-inflammatory drugs, such as ibuprofen (CKS 2010), can lead to a decrease in the amniotic fluid. Therefore, ibuprofen should no longer be taken from the 28th week of pregnancy, since it then affect the kidney function and thus can lead to changes in the amount of amniotic fluid.

Your baby has a health problem

Your baby does not produce enough urine or it does not get enough. This may be a sign that your doctor has a problem with his kidneys or heart, or that he has a chromosomal abnormality. If this is the case, it is likely to be detected during the ultrasound scan in the middle of pregnancy.

It is always disturbing to hear that the baby has health problems. To give you and your baby the best possible care, you can go to a clinic with a gynecological department. This is where doctors and midwives are specially trained to care for pregnant women who are concerned about the health of their babies (NICE 2006b, NICE 2006c).

A problem with identical twins

When identical twins share a placenta, the amniotic fluid level sometimes gets out of balance. This happens when one twin gets more blood through the placenta than the other. The result is that the twin with the extra blood has too much fluid and the other too little (Boyd and Carter, 2008.) If the above problems have been ruled out, it may be impossible to determine why you have low amniotic fluid is that low amniotic fluid levels are much more prevalent in summer, so you may be dehydrated (Feldman et al 2009, Varner et al 2005) Drinking plenty of water can help increase fluid level (NICE 2006a, Hofmeyr and Gülmezoglu 2002). Also, be sure to eat a healthy diet and get plenty of rest.

How does low amniotic fluid affect my baby?

It depends on what causes low stance, such as There is little fluid and how far the pregnancy has progressed Unfortunately, a low level of amniotic fluid in the first trimester and at the beginning of the second trimester may increase the risk of miscarriage Increase birth. However, if low amniotic fluid levels are detected when you are already in the middle of your third trimester, only a careful observation is required.

Your doctors control your baby's amniotic fluid balance and growth. If the amniotic sac has burst, you may be given antibiotics to prevent infection from your baby.

When it comes to birth, low amniotic fluid levels can complicate things. Your baby may, for example, lie down with her butt, that is, have a breech position. It may not have enough room to turn its head down.

If the amniotic sac has burst early, there is a risk of contractions prematurely. When that happens, your physicians weigh the risk against infection when the baby stays in your uterus.

When labor has set in, there's a greater chance that your baby is a little upset. It may, for the first time, have a bowel movement, called a blackish substance, meconium or also called child's breath, which gets into the amniotic fluid. If it inhales the meconium, it can cause breathing problems during childbirth.

Another problem may be that the umbilical cord is accidentally squeezed by your baby during birth.Your baby will be carefully monitored to make sure he's okay. If it gets too hard, you may need to have a caesarean section.

What can I do?

It can be troubling to learn that you have little amniotic fluid. But you can not do much. You can drink a lot, eat healthy and rest a lot. Do not let sleep keep you from pondering. You and your baby are well looked after during your pregnancy. Both are carefully monitored by midwives and physicians to help you get the best possible treatment.

Sources

Boyd RL, Carter BS. 2008.

Polyhydramnios and oligohydramnios. e-medicine. emedicine. Medscape. com [as of November 2013] CKS. 2010. Nonsteroidal anti-inflammatory drugs - prescribing issues - management. // cks. nice. org. uk / [as of November 2013]

Feldman I, Friger M, Wiznitzer A, et al. 2009. Is oligohydramnios more common during the summer season?

Arch Gynecol Obstet 280 (1): 3-6 Hofmeyr GJ, Gülmezoglu AM. 2002. Maternal hydration for increasing amniotic fluid volume in oligohydramnios and normal amniotic fluid volume.

Cochrane Database of Systematic Reviews Issue 1. Art no CD000134. www. mrw. inter science. wiley. com [as of November 2013] Nabhan AF, Abdelmoula YA. 2008. Amniotic fluid index versus single deepest vertical pocket as a screening test.

Cochrane Database of Systematic Reviews Issue 3. Art no CD006593. www. mrw. inter science. wiley. com [as of November 2013] NICE. 2006a.

Therapeutic amnioinfusion for oligohydramnios during pregnancy (excluding labor) National Institute for Health and Clinical Excellence, Clinical Guideline, 37. London: NICE. www. nice. org. uk [pdf file, as of November 2013] NICE. 2006b.

Fetal vesico-amniotic shunt for lower urinary tract outflow obstruction. National Institute for Health and Clinical Excellence. Interventional procedure guideline 202. www. nice. org. uk [pdf-file, November 2013] NICE. 2006c.

Treatment of low urinary tract blockage in an unborn baby using a vesico-amniotic shunt: understanding NICE guidance. National Institute for Health and Clinical Excellence. www. nice. org. uk [as of November 2013] Varner MW, Noble WD, Dombrowski M, et al. 2005. Is there a seasonal variation in the diagnosis of oligohydramnios?

J Matern Fetal Neonatal Med 17 (3): 173-7 Show sources Hide sources

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