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    Premature Delivery

    Here's a complete guide on Oligohydramnios (low amniotic fluid during pregnancy) - Causes, symptoms, signs, and treatment.   

    Written on 14 August 2018

    When a pregnant woman has too little amniotic fluid then this condition is termed Oligohydramnios. Amniotic fluid is a fluid that surrounds the growing baby in the uterus and helps in the development of an unborn child. It acts as a cushion to your baby which allows your baby to move in the womb and prevents the umbilical cord to get pressed. By protecting the baby from any injury, the amniotic fluid performs several crucial functions. During pregnancy, your gynecologist will measure the amount of amniotic fluid through deep pocket measurements. After the AFI (amniotic fluid index) evaluation if the doctor suspects that it is lower than the baby’s gestational age then it affects your health as well as the baby’s health. When the amniotic fluid levels are low in the body of a pregnant woman then it is termed Oligohydramnios and if the fluid is too high then it is termed Polyhydramnios. Oligohydramnios is suspected:

    • When the volume of amniotic fluid is less than 500ml during 32nd-36th week of pregnancy.

    • AFI is less than 5cm.

    • Absence of the fluid pocket 2-3cm (in-depth).

    Oligohydramnios can occur any time during pregnancy however it is most common during the last trimester. If the woman has passed her due date by 2 weeks or more than that then her pregnancy is at high risk because the fluid decreases once the woman crosses her 41 weeks' gestation. If your belly is not growing the way it should during pregnancy then your doctor might ask you to undergo a scan. Here are some common signs and symptoms of low amniotic fluid levels:

    • Fluctuations in blood pressure levels

    • Constant leaking fluid from the vagina

    • You are unable to feel the movement of your baby

    • Both mother and the child are not gaining enough weight

    • The growth of the baby elongates

    Oligohydramnios (low amniotic fluid) is caused by:

    • Water breaking- It happens when the amniotic sac tears off and the fluid flows out. It is natural if it happens around your due date but if it happens before and after your due date then you must immediately seek medical help.

    • Congenital disabilities- Issues with the development of the kidneys or the urinary tract leads to lower levels of amniotic fluid which causes lesser production of urine.

    • Problems with the placenta- The baby may stop recycling the fluid when your placenta is unable to provide enough blood and nutrients to the baby.

    • Post-date pregnancy- Amniotic fluid naturally decreases when the woman crosses her 42nd week during pregnancy.

    • Use of certain medication- Your doctor might strongly recommend you to avoid medicines of high blood pressure or painkillers.

    • Maternal complications like hypertension, diabetes, preeclampsia, chronic hypoxia, etc.

    • Identical twins- The issue of low amniotic fluid occurs when you are carrying identical twins that share the placenta.

    With the help of the following methods, your Obstetrician and Gynecologist can detect oligohydramnios:

    • Ultrasound scans- The fluid is measured in 4 various parts of the uterus and then is put together to evaluate AFI. The kidneys and the bladder of the baby are also assessed to check for any anomalies. Head circumference, abdominal circumference, and femur length are also assessed during an ultrasound scan.

    • AFI (amniotic fluid index)- It is measured through ultrasonography where a doctor can determine the volume of fluid in your uterus.

    • Sterile Speculum Examination- With the help of a speculum (device) a doctor can look inside the vagina and can observe the cervix.

    • Maximum vertical pocket- With the help of ultrasound scan reports a doctor can check the volume of fluid in the thickest part of the uterus excluding the umbilical cord and fetal portion.

    • Blood tests- Maternal serum screening can help in the detection of low fluid. The doctor may also observe any congenital problems in your baby like Down’s syndrome through a blood test.

    • Amniotic wrinkle- It is possible when you are carrying identical twins and doctors have to detect whether both the babies are getting enough amniotic fluid or not.

    Some pregnant women are at a higher risk of Oligohydramnios than others and this includes:

    • Diabetes

    • Obesity

    • High blood pressure during pregnancy

    • Problems with placenta

    • Lupus (an autoimmune disease)

    In mild conditions, the doctor will always advise you to drink plenty of fluids to keep your body hydrated. If Oligohydramnios is diagnosed in the last trimester of pregnancy, then your doctor might do the following treatment for the severe condition:

    • Amnioinfusion

    • Vesico-amniotic shunt

    • Bed rest

    • Fluid injections

    • Maternal hydration

    • Termination of pregnancy

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