Premature Babies

Babies born before the start of 37th week of pregnancy

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What causes low amniotic fluid during pregnancy

The amniotic fluid is part of the baby’s life support system. It protects your baby and aids in the development of muscles, limbs, lungs and digestive system. Amniotic fluid is produced soon after the amniotic sac forms at about 12 days after conception.  It is first made up of water that is provided by the mother, and then around 20 weeks fetal urine becomes the primary substance. As the baby grows he or she will move and tumble in the womb with the help of the amniotic fluid. In the second trimester the baby will begin to breathe and swallow the amniotic fluid. In some cases the amniotic fluid may measure too low or too high.  If the measurement of amniotic fluid is too low it is called oligohydramnios.  If the measurement of amniotic fluid is too high it is called polyhydramnios. What is oligohydramnios? Oligohydramnios is the condition of having too little amniotic fluid.  Doctors can measure the amount of fluid through a few different methods, most commonly through amniotic fluid index (AFI) evaluation or deep pocket measurements. If an AFI shows a fluid level of less than 5 centimeters (or less than the 5th percentile), the absence of a fluid pocket 2-3 cm in depth, or a fluid volume of less than 500mL at 32-36 weeks gestation, then a diagnosis of oligohydramnios would be suspected. About 8% of pregnant women can have low levels of amniotic fluid, with about 4% being diagnosed with oligohydramnios. It can occur at any time during pregnancy, but it is most common during the last trimester.  If a woman is past her due date by two weeks or more, she may be at risk for low amniotic fluid levels since fluids can decrease by half once she reaches 42 weeks gestation. Oligohydramnios can cause complications in about 12% of pregnancies that go past 41 weeks. What causes low amniotic fluid? Birth defects – Problems with the development of the kidneys or urinary tract which could cause little urine production, leading to low levels of amniotic fluid. Placental problems – If the placenta is not providing enough blood and nutrients to the baby, then the baby may stop recycling fluid. Leaking or rupture of membranes –This may be a gush of fluid or a slow constant trickle of fluid. This is due to a tear in the membrane. Premature rupture of membranes (PROM) can also result in low amniotic fluid levels. Post Date Pregnancy– A post date pregnancy (one that goes over 42 weeks) can have low levels of amniotic fluid, which could be a result of declining placental function. Maternal Complications– Factors such as maternal dehydration, hypertension, preeclampsia, diabetes, and chronic hypoxia can have an effect on amniotic fluid levels. What are the risks of having low amniotic fluid? The risks associated with oligohydramnios often depend on the gestation of the pregnancy. The amniotic fluid is essential for the development of muscles, limbs, lungs, and the digestive system. In the second trimester, the baby begins to breathe and swallow the fluid to help their lungs grow and mature. The amniotic fluid also helps the baby develop muscles and limbs by providing plenty of room to move around. If oligohydramnios is detected in the first half of pregnancy, the complications can be more serious and include: Compression of fetal organs resulting in birth defects Increased chance of miscarriage or stillbirth If oligohydramnios is detected in the second half of pregnancy, complications can include: Intrauterine Growth Restriction (IUGR) Preterm birth Labor complications such as cord compression, meconium stained fluid and cesarean delivery What treatments are available if I am experiencing low amniotic fluid? The treatment for low levels of amniotic fluid is based on gestational age. If you are not full term yet, your doctor will monitor you and your levels very closely. Tests such as non-stress and contraction stress test may be done to monitor your baby’s activity. If you are close to full term, then delivery is usually what most doctors recommend in situations of low amniotic fluid levels. Other treatments that may be used include: Amnio-infusion during labor through an intrauterine catheter.  This added fluid helps with padding around the umbilical cord during delivery and is reported to help lower the chances of a cesarean delivery. Injection of fluid prior to delivery through amniocentesis.  The condition of oligohydramnios is reported to often return within one week of this procedure, but it can aid in helping doctors visualize fetal anatomy and make a diagnosis. Maternal re-hydration with oral fluids or IV fluids has shown to help increase amniotic fluid levels. content source

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Potential complications of twin pregnancy

So, are you going to welcome double happiness? Congratulations on the twins! If double blessings are on your way and you are worried about the complications in your pregnancy, then it’s time for you to relax and educate yourself with all the possible twin pregnancy complications with this easy-to-understand guide- Common Complications Associated with Twin Pregnancy 1. Preterm labor When the delivery happens before 37 completed weeks of pregnancy, it is called as preterm delivery. When you carry an additional fetus in your womb, the gestation period decreases. The premature rupture of the ovarian membranes results in preterm labor.   Premature babies do not develop properly. They do not achieve a normal healthy weight before they are born. Low-birth-weight babies may be incapable of fighting infections. These babies often need special care in a NICU.   2. Miscarriage risks As compared to singletons, a twin pregnancy carries a higher risk of facing a miscarriage. But it is impossible to say how much higher the risk is, as most early miscarriages are not identified. Most of the miscarriages occur in the first trimester of the pregnancy. Sometimes one baby is lost but it does not have an adverse effect on the development of the second baby. Many early twin pregnancies are not discovered so this occurrence is more common in nature. Feeling sad and down is natural under these circumstances. But you do not have any control over it. Talk to your doctor to guide and support you better during this difficult time. 3. Intrauterine Growth Restriction (IUGR) One of the most common complications with a twin pregnancy is the growth issue. The growth rate of the twins begins to slow down at 29 to 32 weeks. IUGR occurs during the same phase when placenta cannot handle any more growth of the twins. IUGR is a condition in which a baby is smaller than is expected to be. Your body starts succumbing to the growth process as both the babies compete to obtain a sufficient amount of nutrients. Contact your gynecologist, as she may guide you by performing an ultrasound and measuring the size of your abdomen. 4. Placental Abruption If the placenta detaches itself from the uterine wall before the time of delivery, it may lead to serious complications. Though it affects only 1 % of pregnant women, but chances of this condition are higher in twin pregnancies. In the case of a twin pregnancy, abruption may occur just after the first baby is delivered vaginally. Usually, C-section is advised to deliver the other baby. 5. Preeclampsia and High blood pressure The chances of developing Preeclampsia are higher when you are expecting twins. High blood pressure can also be one of the complications that can pose serious threats to you and the unborn babies. Preeclampsia is a pregnancy complication marked by protein in the urine, high blood pressure, liver or kidney abnormalities. But with adequate parental care, it is possible to reduce the risk of developing a serious problem from preeclampsia. 6. Anemia Due to increased blood flow, iron level drops which cause anemia. Your doctor will prescribe you a suitable iron supplement to cope up with this condition. When you are suffering from anemia, your body feels drained and tired. This complication is more common in multiple pregnancies. Regular checkups are must to keep a track of anemia levels. 7. Heart Failure It is also observed that 13% of the women who are expecting twin pregnancies suffer from the danger of heart failure. They are more likely to have the risk of heart failure as compared to a singleton. 8. Gestational Diabetes This is one of the most common problems that occur in twin pregnancies. The resistance to insulin production increases due to the presence of two placentas. And it leads to a sudden increase in blood sugar level. Greater placenta size or elevated levels of the placental hormones are also some of the reasons that lead to gestational diabetes. 9. Birth Defects Twin pregnancies can also have the risk of developing congenital abnormalities in the newborn twins. Heart abnormalities, gastrointestinal disorders, and neural tube defects are some of the common birth defects usually experienced in case of twin pregnancy. 10. Obstetric Cholestasis This rare condition affects the liver. Many studies have revealed that Obstetric cholestasis is caused by pregnancy hormones estrogen and progesterone. Twin or multiple pregnancies produce a higher level of hormones that why it is more common in such kind of pregnancies. The most common symptom is extreme itching without rashes. Contact your doctor immediately if you experience something like this. Prevention of complications This is the most common question that people often have and we truly understand this. Twin pregnancies have little to do with your lifestyle or behavior. But an early confirmation that you are expecting twins may help you in a big way. This will help your doctor to detect, monitor or treat complications that may arise. It is highly recommended to make a note of these important points- Mothers who carry more than 1 fetus need more proteins, calories, iron, and nutrients. So, you need to have a healthy diet. Proper hydration is highly recommended.  Be aware of all the warning signs associated with pre-eclampsia and other pregnancy complications that need immediate attention More frequent prenatal visits help the doctor to monitor and treat the condition timely and effectively. Seek doctor’s advice on doing some gentle exercises during your pregnancy and also attend all antenatal appointments. Smoking is injurious to health and it is deadly during pregnancy. If you really want to do something for your babies, quit this bad habit now! Passive smoking may also create problems so ask your family members and visitors to smoke outside and make your home a smoke free zone. Feature Image Source

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