Oligohydramnios. When I heard this word in the doctor’s office, I had no idea what it meant. After discussions with doctors and extensive online research, I found out. Oligohydramnios is essentially having too little amniotic fluid surrounding the fetus. What does this condition mean for your pregnancy and the health of your baby? What causes it? These are only some of the issues I will address in this article.
What is Amniotic Fluid, Anyway?
Amniotic fluid fills the sac surrounding your developing baby. Amniotic fluid plays several important roles during pregnancy.
– It cushions and protects your baby while in the womb. If you suffer a fall, for instance, this amniotic fluid will help protect your unborn child.
– It helps regulate temperature in the womb.
– Reduces risk of umbilical cord getting compressed and harming baby by reducing oxygen and nutrient supply.
– Amniotic fluid helps protect against infection.
– Adequate amniotic fluid is necessary for proper movement of fetus while in womb. This movement is important because it helps bones and muscles fully develop.
– Amniotic fluid aids the digestive and respiratory systems develop as your baby swallows and excretes fluid and “inhales” and “exhales” it from his lungsHow Much Amniotic Fluid Do I Need to Have?
Typically, amniotic fluid volume increases until the beginning of the third trimester. Amniotic fluid is usually at its highest at 34 weeks. At this point, most women have about 1 quart of amniotic fluid. After this peak at 34 weeks, amniotic fluid tends to slowly decrease as baby gets larger and larger.
Sometimes women have either too little or too much amniotic fluid. When there is too much amniotic fluid, it is called hydramnios or polyhydramnios. When there is too little amniotic fluid, the condition is called oligohydramnios.
According to the March of Dimes, approximately 8 percent of pregnant women have low levels of amniotic fluid at some point in the pregnancy. This low amniotic fluid, or oligohydramnios, usually occurs in the third trimester of pregnancy. Among women who are still pregnant two weeks past their due date, 12 percent have oligohydramnios.
How Can I Tell if I Have Oligohydramnios?
Your doctor, mid-wife, or other health-care provider may suspect oligohydramnios if you are leaking amniotic fluid, measuring small for your stage of pregnancy, or if you do not feel the expected amount of fetal movement. There are other health conditions that may make the health-care provider more diligent of amniotic fluid level. These conditions include previously having a baby whose growth was restricted; if you have chronic high blood pressure, preeclampsia, diabetes, and lupus; or if you’re past your due date.
To diagnose oligohydramnios, your health-care provider will most likely order an ultrasound. The sonographer will measure the largest pockets of amniotic fluid in four different sections of your uterus and then add them together to determine where you rate on the amniotic fluid index (AFI). A normal measure for the third trimester is between 5 and 25 centimeters (cm). A total of less than 5 cm is considered low. If you measure at levels at around 10, though, you may be monitored for more loss of fluid in the upcoming weeks.
What Causes Oligohydramnios?
This is an excellent question, and one that is often left unanswered. I know I never found out why I developed the condition.
Common causes of oligohydramnios include:
· Leaky or Ruptured Membranes. If there is a tear in your amniotic sac, a small amount of the amniotic fluid will leak. If this is the problem, you may notice that your underwear is wet. Always mention this to your doctor, even if you are embarrassed. When you are pregnant, modesty really goes out the window (and just wait for delivery!).
· Placental Abnormalities. A problem or abnormality with your placenta, such as a partial abruption, keeps it from supplying enough blood and nutrients to the fetus and causes it to stop recycling fluid.
· Carrying Twins or Multiples. Pregnancies of twins and multiples more commonly develop low amniotic fluid.
·(chronic high blood pressure, preeclampsia, diabetes, and lupus, for example) can lead to oligohydramnios.
· Fetal Abnormalities. Perhaps the most feared cause of oligohydramnios is fetal abnormality, or a birth defect. If the kidneys aren’t there or aren’t developing properly (Potter’s syndrome) or the urinary tract is blocked, the baby will not manufacture enough urine to maintain the level of amniotic fluid. A congenital heart defect can also be the cause of oligohydramnios.
I Have Been Diagnosed With Oligohydramnios. Now what?
If you have been diagnosed with oligohydramnios, your health-care provider will monitor you and your amniotic fluid level closely. Your provider needs to make sure your fluid doesn’t drop to dangerously low levels and that the fetus is growing normally.
Oligohydramnios is monitored by frequent ultrasounds, non-stress tests, biophysical profiles, and sometimes Doppler studies. You will be asked to increase your water intake, sometimes reduce physical activity, monitor fetal movement and contact your health-care provider immediately if you notice fetus being less active.
If you are near term and develop oligohydramnios, labor may be induced. If amniotic fluid gets too low, labor may need to be induced even if baby is not yet to term.
Final concerns regarding oligohydramnios involve complications during labor. The primary concern is that the amniotic fluid level will get so low that your baby’s movements or your contractions will compress the umbilical cord.
When you are in labor, your practitioner may insert a catheter through your cervix so that he or she can pump a steady supply of warm saline solution into the amniotic sac to reduce the risk of cord compression. If your baby can’t safely tolerate labor, your health-care provider may recommend a cesarean or c-section. C-sections are more common in women with oligohydramnios than in the general population.
