Pregnancy: Amniotic Fluid Complications - Polyhydramnios and Oligohydramnios
Excess and lack of everything is bad and same is the case with amniotic fluid levels during pregnancy and childbirth. Amniotic fluid is the fluid that surrounds and protects the fetus throughout pregnancy and helps in development of lungs, digestive system, and other vital organs of the baby. From the 12th day of pregnancy, the amniotic fluid increases and goes to about 800 ml at approximately 32 weeks of gestation. From that moment, it remains stable at 800 ml until it begins to decrease from week 40 to approximately 600 ml and remains same until the baby is born. Now polyhydramnios means excess of amniotic fluid around the fetus and oligohydramnios means lack of amniotic fluid.
POLYHYDRAMNIOS - EXCESS OF AMNIOTIC FLUID: Polyhydramnios happens in 2 out of 100 pregnancies and in most cases is nothing more than a normal accumulation of fluid, which disappears spontaneously in half of cases. However, excess fluid sometimes appears very early in pregnancy, around week 16 and may be an indicator of fetal disease.
The origin of polyhydramnios is unknown. It has been found that in twenty percent of cases, the fetus has a defect in the nervous system and gastrointestinal tract and causes polyhydramnios. This disorder can increase fetal lung fluid production. Some known causes of polyhydramnios are anencephaly, achondroplasia, gestational diabetes, or multiple gestations.
Polyhydramnios is detected and diagnosed with the use of ultrasound. When symptoms are mild, it is not a problem but when it is turns in a serious condition, the mother may experience difficulty breathing caused by compression of the lungs and stomach discomfort. In these types of cases, it may become necessary to perform an amniocentesis (transabdominal aspiration of fluid from the amniotic sac) to detect fetal distress and to reduce the amount of excessive amniotic fluid. Also, the gynecologist will check the blood sugar levels of mother to treat diabetes if she has any. In mild cases, no intervention is necessary.
The risks of polyhydramnios include premature rupture of membranes, premature birth, heavy and uncontrolled bleeding of the mother after delivery, umbilical cord problems, and placental abruption. A woman having serious polyhydramnios needs a comprehensively controlled and monitored gestation and labor. To address this and other complications of pregnancy, it becomes really important to have adequate prenatal care and timely followup with the gynecologist.
OLIGOHYDRAMNIOS - LACK OF AMNIOTIC FLUID: Sometimes the amount of amniotic fluid is insufficient for gestational age. This is known as oligohydramnios, which affects 8 out of every 100 pregnancies. One in 8 pregnant women beyond 40 weeks develop oligohydramnios. During the remainder of the pregnancy, the main reasons, which can cause this problem, are fetal abnormalities like rupture of membranes, kidney defects, lung defects, eating disorders, and maternal and placental dysfunction.
The diagnosis of oligohydramnios is also made by ultrasound. The symptoms start when mother notices a small loss of liquid during pregnancy or fails to notice fetal movement. The gynecologist then verifies the amniotic fluid levels with amniocentesis. Depending on the severity and timing of pregnancy in which case the loss of fluid has occurred, the doctor may replace the fluid by mouth or intravenously and even by amnioinfusion during labor. If lack of amniotic fluid occurs in late pregnancy, the normal procedure is to induce labor. Oligohydramnios poses a risk to the fetus that may not be getting enough food, oxygen, and protection. One problem can also be due to the incorrect functioning of the placenta, which can pose significant risks. Though oligohydramnios is not preventable, but examination and detection by an experienced gynecologist at each visit during pregnancy can prevent severe consequences. If a woman gets diagnosed with this problem, the gynecologist will recommend her to eat properly, drink enough water, to not smoke, and take proper rest. You need to immediately consult your doctor if you know you have lack of amniotic fluid and you notice any signs of decreased fetal movement.
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