Oligohydramnios during pregnancy: causes, consequences and treatment. Oligohydramnios Physiological oligohydramnios

Moderate or severe oligohydramnios during pregnancy is characterized by a small amount of amniotic fluid in the uterus. A qualified doctor will always be able to diagnose low amniotic fluid in pregnant women and explain what it is.

This is the environment surrounding the fetus from the first day of its life. It has a certain biological and chemical composition, temperature regime. Little amniotic fluid occurs on the eve of childbirth or as a result of some pathology.

AFI or amniotic fluid index is a quantitative indicator that allows you to calculate the volume of amniotic fluid during pregnancy. With its help, it will be possible to identify a dangerous pathology in time and take action.

Let's take a closer look at the manifestations and consequences of the disease. We will also find out what moderate and severe oligohydramnios means.

Symptoms and signs

The development of oligohydramnios during pregnancy is characterized by certain symptoms. Among them:

nausea;
aching pain when the child moves;
bad feeling.

Reduced volume of amniotic fluid

The baby's activity brings discomfort, since the lack of amniotic fluid affects their shock-absorbing function. Only a specialist can diagnose the disease. To do this, he will need an ultrasound and gynecological examination.

The doctor focuses on several signs. Among them:

height of the uterine fundus;
low activity of the child;
vaginal leakage.

Abdominal circumference is also assessed. If it does not meet the standards, an additional examination is prescribed. It allows you to establish the severity of the pathology that has arisen for one reason or another, and to identify possible deviations in the development of the fetus.

Causes and consequences

The appearance of oligohydramnios during pregnancy is dangerous. It doesn’t matter if it’s week 30 or week 15. We need to find out what could be causing it and what the pathology leads to.

It is worth noting that a slight deviation is normal and can be observed in pregnant women for 9 months. But not everyone understands why this happens.

The fact is that the child behaves actively in the womb. He drinks amniotic fluid and defecates in it. Therefore, their volume either decreases or increases.

If you do not take this fact into account, the causes of oligohydramnios in pregnant women are often associated with serious diseases. Eg:

fetal malformations. Most often, the problem arises due to a malfunction of the urinary system: underdeveloped kidneys, polycystic disease, narrowing or absence of the urethra;
chromosomal diseases;
infections;
pathologies of the placenta. Placental insufficiency or structural abnormalities;
multiple pregnancy: twins or triplets.

Exciting state

If during the examination it was not revealed what could cause oligohydramnios, then it is characterized by an unknown genesis - idiopathic. Typically, this pathology does not affect pregnancy or childbirth. It may disappear on its own before the birth process begins or in the later stages of pregnancy.

It is worth noting that the disease can cause external problems with the fetus. It does not affect chromosomal abnormalities, but sometimes causes abnormal development of internal organs. However, most often, it is the defects that cause oligohydramnios.

The disease often occurs due to health problems of a pregnant girl. Among them: diabetes mellitus, chronic and acute infections, hypertension, late toxins.

Sometimes the problem occurs when the pregnancy is post-term. Doctors still have not come to a common point of view on the reasons. Perhaps a woman's body becomes so exhausted that it is no longer able to provide the required amount of amniotic fluid.

Infection of the amnion membranes can also cause the disease. Pathogenic microorganisms penetrate the placental protective barrier and infect the fetus, which causes severe oligohydramnios.

Usually the infection comes from the cervical or vaginal cavity. As a result, the placenta ceases to perform its functions and protect the baby. Therefore, it develops with a delay.

Often oligohydramnios occurs due to fetoplacental insufficiency. It appears if the baby does not receive the required amount of blood circulating in the placenta. She is the only source of oxygen for the baby.

Hypoxia occurs - oxygen starvation. This pathology usually either slows down the development of pregnancy or stops it altogether.

It is important to understand what oligohydramnios leads to and what the consequences are if it is recorded. The disease affects both mother and baby.

Anomalies of internal organs.
Premature birth.
Miscarriage.

Thorough check of mother and baby

The worst problems can arise between 15 and 25 weeks of pregnancy. Often the disease at this stage causes serious abnormalities of the baby’s internal organs.

The situation is aggravated by complications with the kidneys. They may be either too large or absent altogether. This causes the death of the child immediately after birth.

Pathology often leads to complications during childbirth. The umbilical cord can wrap around the baby's neck, so he risks dying. Often the baby’s skin fuses with the amniotic membrane. As a result, many thin threads are formed that wrap around the baby and the umbilical cord, which causes tissue necrosis.

Splicing negatively affects blood circulation and causes the development of hypoxia. The result is very deplorable - the death of the fetus.

Due to the small amount of amniotic fluid, miscarriages or early births occur. The contractions are very painful, but ineffective. Against this background, the cervix usually opens slowly, so the birth process is greatly delayed.

In this case, after the opening of the amniotic sac, there is usually little fluid. It is thick and colored by the baby's feces.

The disease causes early placental abruption, which causes bleeding. In addition, due to insufficient dilatation of the cervix, the amniotic sac cannot pass between it and the baby's head. Accordingly, he does not contribute to its disclosure.

Severe oligohydramnios

Severe oligohydramnios occurs when the amount of intrauterine fluid is much less than normal during pregnancy. When this condition is diagnosed, the girl must be hospitalized and treated in a hospital.

Great happiness is to be healthy

The problem cannot be ignored, since it poses a great danger to the woman and her baby. Often severe oligohydramnios forces doctors to terminate the pregnancy or perform a caesarean section. It can deform its skeletal system and lead to abnormalities in the formation of the fetal facial bones and limbs.

It is useless to figure out on your own how to increase the volume of amniotic fluid at 32-33 or 36-37 weeks. This procedure should only be carried out under the close supervision of a specialist. Amnioinfusion is usually used.

Moderate oligohydramnios

Moderate oligohydramnios can occur during pregnancy at 23 weeks or later. There is little amniotic fluid, but enough for the development of a full-fledged child. Typically, the volume of amniotic fluid is approximately 500 ml in late pregnancy.

Most often, you do not have to decide what to do if moderate oligohydramnios is detected. It is easily corrected and does not pose a serious threat to the health of a pregnant girl and her baby.

Baby's first photo

Minor oligohydramnios can be detected at 24 weeks or another period using diagnostic equipment. You need to regularly visit your obstetrician-gynecologist and undergo the required examinations. This will allow timely identification of possible pathology.

Treatment

Oligohydramnios at 40 weeks of pregnancy often develops due to high blood pressure. If it is moderate, it is not worth treating.

It is enough to follow a rest regime, eat right and follow all the instructions of the obstetrician-gynecologist. It is important to limit physical activity and completely eliminate heavy loads.

The situation changes when, at the 24th or 30th week, too little amniotic fluid is detected in pregnant women. This problem requires strict supervision by a specialist. You need to see a doctor in time, otherwise the disease will lead to negative consequences.

Walks in the open air

Oligohydramnios is characterized by the amniotic fluid index, which is determined during an ultrasound examination. This is the volume of amniotic fluid in which the baby is located. It is measured in millimeters or milliliters.

Duration (week)	Minimum (mm)	Average value (mm)	Maximum(mm)
16	73	121	201
17	77	127	211
18	80	133	220
19	83	137	225
20	86	141	230
21	88	143	233
22	89	145	235
23	90	146	237
24	90	147	238
25	89	147	240
26	89	147	242
27	85	156	245
28	86	146	249
29	84	145	254
30	82	145	258
31	79	144	263
32	77	144	269
33	74	143	274
34	72	142	278
35	70	140	279
36	68	138	279
37	66	135	275
38	65	132	269
39	64	127	255
40	63	123	240
41	63	116	216
42	63	110	192

Treatment methods in the third trimester and other periods depend on the cause of the disease. Usually the doctor prescribes complex therapy.

Vitamins.
Medicines to improve metabolism.
Drugs to normalize the functioning of the placenta.
Medicines for the disease that caused the pathology.

A special diet is often prescribed. Especially when a metabolic disorder is diagnosed.

Amniophysiology is used, which helps prevent problems in fetal development. The specialist places a saline solution into the uterus, which prevents the umbilical cord from drying out and premature placental abruption.

To improve blood circulation in the placenta, Curantil is prescribed. Actovegin, which contributes to the active saturation of the fetal body with oxygen. During treatment, cardiotography is required. It allows you to obtain results about the child’s motor activity, heart rate, and frequency of uterine contractions.

Why is it dangerous?

Oligohydramnios has a bad effect on pregnancy and threatens the child with serious consequences. If you have this disease, you need to minimize the danger so that it does not cause abortion.

Drink the right amount of water

It is necessary to strictly follow the doctor's instructions. If there is a tendency towards oligohydramnios, prevention should be carried out:

observe drinking regime;
eat right, eliminate harmful foods;
sleep more and walk in the fresh air;
undergo regular scheduled examinations with a doctor (free of charge or in a commercial clinic).

How to determine without ultrasound

Determining oligohydramnios or polyhydramnios without ultrasound diagnostics is impossible. Therefore, you should not read various forums and listen to the advice of girlfriends. We are talking about the baby’s health and only a doctor should deal with the problem.

It is important to regularly visit a specialist so that he can monitor the health of a pregnant girl. Ignoring his instructions will have a negative impact on the fetus.

In hospitals, oligohydramnios is detected by measuring the amniotic fluid index using ultrasound machines. Modern technology is high-quality and accurate, so with its help it will be possible to notice pathology in time.

The norms of fluid volume depend on the stage of pregnancy. If you average the indicators and calculate them in ml, you get:

10-22 weeks – 30 ml;
13-14 weeks – 100 ml;
17-20 weeks – 400 ml;
36 week – 1200 ml;
4-5 days before birth – about 600-800 ml.

Vein manifestation restoration

gynecologist, ultrasound doctor, geneticist

Amniotic fluid plays an important role for the normal development of the child in any trimester of pregnancy. Their functions are to supply the baby with nutrients and protect him from mechanical injuries. During childbirth, amniotic fluid promotes rapid dilatation of the cervix. Diagnosed moderate oligohydramnios during pregnancy at any stage, be it 20 or 37 weeks, causes alarm and forces you to look for information about this pathology - what it threatens, how to identify it and what to actually do.

Medical definition

According to the classic definition, a similar conclusion is given to women at 40-41 weeks of pregnancy if the volume of amniotic fluid has decreased to 500 ml or less. This formulation takes into account deviations from the norm only before childbirth. But meanwhile, oligohydramnios can be diagnosed at 20 weeks, 30, and 37; the closer the birth is, the more the placenta “ages” (37, 38, 39 weeks).

Throughout the 9 months of a child's development, the volume of amniotic fluid constantly changes. Its specific values for each week of gestation have become known as a result of numerous studies. At any moment, a situation may arise when the amount of amniotic fluid turns out to be abnormally low. Doctors diagnose and prescribe treatment for oligohydramnios during pregnancy, recording a special indicator - the amniotic fluid index (AFI), which for each week has an average value and normal range, for each week it is different (starting from the 16th week onwards - 20, 30, 34 , 35, 36, 37, 38, 39), and additionally, each ultrasound machine has its own table of these indicators.

Considering the degree of severity, moderate and severe oligohydramnios during pregnancy are distinguished. The first type of disease is much easier to cope with. The condition will return to normal if the expectant mother stops being nervous, starts eating rationally, and pays more attention to her health - just do this and things will get better, and this also applies to the period of 37 - 39 weeks. And the second case is a serious problem for a woman. To eliminate it, you will have to go to the hospital and undergo a course of therapy.

Oligohydramnios in pregnant women is a dynamic condition. Its tendency is unpredictable - it can suddenly appear and disappear at any time. We are talking about a functional deviation if it was present at the 20th week of pregnancy, and disappeared at the 32nd week, and in the last weeks - 37-39 and then the decrease in water levels is considered normal. These are temporary disorders that are not considered a pathology.

A persistent abnormal condition for many weeks, that is, severe oligohydramnios, is a sign of severe abnormalities in the development of the child and the course of pregnancy. According to statistics, the incidence of serious pathology is 0.2-0.3% of all cases. In each of them, abnormalities in the development of the fetus and placenta are visible on ultrasound.

Prevention of oligohydramnios is carried out not during pregnancy - at 34 or 35 weeks, for example, but during the period of planning the birth of a child.

Factors causing pathology

Any pregnant woman can face a similar problem, regardless of age and number of births. When oligohydramnios occurs during pregnancy, the reasons may be the following:

metabolic disorders in the body;
damage to the membranes;
hypertension;
dependence on nicotine in a pregnant woman;
injuries to tissues that protect the aqueous membrane;
multiple pregnancy;
dehydration caused by vomiting or diarrhea;
the effect of bacterial infections and viruses;
gestosis;
genetic abnormalities in child development;
overweight;
diabetes;
post-term pregnancy.

Medicine does not yet know which of the signs of oligohydramnios from the above list play a major role in reducing the volume of amniotic fluid. 90% of expectant mothers suffer from hypertension. Only 4% of these women subsequently experience a severe form of the disease.

In the later stages of pregnancy (starting from 32 weeks), problems arise due to rupture of the bladder. When postmaturity occurs, there is less water as the placenta ages.

Most causes of oligohydramnios during pregnancy can be successfully eliminated with proper treatment. There is no need to panic. Doctors are powerless in the case of genetic abnormalities in the development of the baby, which are detected by ultrasound. Moderate oligohydramnios in other cases can be treated, and a healthy baby is born.

Consequences

It is difficult to predict what the trend of oligohydramnios will be in a given case, because possible complications with low AFI may be:

The shrinking walls of the uterus create additional pressure on the fetus. He has to bend over and sit awkwardly. This situation threatens that the baby’s spine may become curved and develop clubfoot. There is a possibility that the skin will adhere to the fetal membrane. The baby's tissues become dry and wrinkled.
Prolonged close contact between the bladder and children's skin is the cause of the appearance of Simonart's ligaments. The formations wrap around the baby and prevent his movements. If they affect the umbilical cord, blood circulation is disrupted. Consequences: developmental delay. The extreme case is fetal death.
It is known how dangerous oligohydramnios during pregnancy is for the expectant mother. This is a persistent pain in the lower abdomen. It is especially difficult in the 2nd and 3rd trimester. Every movement of the fetus causes discomfort. Sensitivity increases starting from week 36, as the baby is already large.
During labor, the cervix dilates slowly. Contractions are painful, but not productive. The woman in labor may experience bleeding.

The likelihood of negative consequences for the fetus increases when moderate oligohydramnios develops early enough. If we compare problems with fluid at the 20th and 33rd weeks, then in the first case the risk of disfigurement is greater. This statement is true in a situation where the volume of water does not return to normal within 30 days.

Early symptoms

Moderate oligohydramnios is not accompanied by pronounced symptoms and health problems. This is the main difficulty compared to the case if there is severe oligohydramnios. Not every gynecologist will identify the pathology during examination. The doctor may notice a discrepancy between abdominal circumference and gestational age.

An accurate diagnosis is made after several ultrasound procedures. Using technology, the amount of water, the severity of the illness is calculated, and the baby’s condition is analyzed. Sessions are carried out several times over 1 or 2 months.

A woman needs to worry if she is overcome by abdominal pain. Every movement of the fetus causes an exacerbation. And the general condition leaves much to be desired: the pregnant woman feels nausea, weakness, and dry mouth.

Health care

Treatment for oligohydramnios will depend on its type and the cause of its development. If moderate oligohydramnios is the norm, then the treatment will be as follows: the expectant mother will be advised to rest more, watch her diet, take vitamins and periodically consult with a gynecologist. If this is not done, or when the measures taken do not help, the situation worsens, the woman will have to go to the pregnancy pathology department.

When diagnosing a decrease in water, the patient is sent to the hospital for additional studies. It is necessary to undergo an ultrasound, cardiotocography, donate blood and urine to the laboratory. A smear on the fluid will help you find out about leakage of amniotic fluid.

In late pregnancy (37 or more than 38 weeks), an amnioscope can be passed through the cervical canal. The gynecologist will conduct accurate studies of the fluid that will not harm the baby in any way.

If fetal malformations are detected, the woman will be offered to terminate the pregnancy. In case of refusal, treatment will be carried out without changing the technique. The expectant mother will receive the same assistance as if the child has no abnormalities.

If significant abnormalities are observed at 20 weeks, the patient will be asked to consider abortion. This decision has its own reason - the inability to predict the outcome of pregnancy. True, in most cases, by the time the child is born, the situation changes, and people spend their whole lives regretting that they succumbed to the doctor’s persuasion.

The treatment method for oligohydramnios depends on several factors:

the reason due to which it developed;
severity of oligohydramnios;
gestational age.

The most common drug prescribed to pregnant women is Actovegin, due to its ability to maintain the normal condition of the child in many critical situations. The consequences of oligohydramnios are higher in terms of threat to the fetus, depending on when it appeared; the earlier, the more critical. What does this mean? For example, oligohydramnios at the 20th week and at the 30th week differs in that in the first case there is an increased risk of developmental delay and the appearance of deformities. And at 32 weeks and above, oligohydramnios in most cases occurs due to water leakage. Revealed oligohydramnios during the third semester (27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40 weeks) is the basis for the woman being sent to the antenatal department and prescribed a number of procedures: the introduction of vitamins B, C and others, as well as taking Curantil medications, which have a better effect on the blood circulation process in the placenta. Or Actovegin, which ensures the delivery of oxygen to the fetus. The development of oligohydramnios in the first trimester (from 20 to 27 weeks) is unpredictable; even doctors do not undertake to predict the outcome of such a pregnancy and recommend terminating the pregnancy.

AFI is calculated using ultrasound - in a subjective or objective way; the resulting data is compared with a table of amniotic fluid norms for all weeks. For example, at week 16, the normal range of AFI is 73-201 mm. 20 week: 86 - 230 mm; Week 30: 82 - 258; 31: 79–263; 32: 77 – 269; 33: 74 – 274; 34: 72 – 278; 35: 70 – 279; 36: 68 – 279; 37: 66 – 275; 38: 65 – 269; 39: 64 – 255; 40: 63 – 240. Accordingly, the obtained indicators in different weeks, after comparison, indicate polyhydramnios or oligohydramnios.

Meanwhile, there is also an average indicator, which is considered the norm. 20 week – 141 mm; 30 – 145; 31-32 – 144; 33 – 143; 34 – 142; 35 – 140; 36 – 138; 37 – 135; 38 – 132; 39 – 127; 40 – 123.

With a one-time ultrasound examination, a diagnosis of oligohydramnios is not immediately made, since amniotic fluid changes throughout the entire period of pregnancy, its quantitative composition depends on the week of pregnancy and the growth of the child. In addition, each ultrasound machine has its own table.

Not every woman can boast of excellent health, so during pregnancy it is impossible to avoid taking various medications, for example, the same vitamins. Doctors often prescribe Actovegin, which promotes the normal development of the child. Moreover, it can be prescribed at any time, and sometimes Actovegin can be prescribed during pregnancy planning, for example, in case of impaired blood supply.

The dosage form of the drug is selected by the doctor depending on the woman’s condition and the severity of the disease. Actovegin is available in tablets, ointments, ampoules, creams, and gels. During pregnancy, Actovegin should not be taken based on one’s own considerations and after reading reviews, even knowing the standard dosage prescribed by a doctor - Actovegin is not an ordinary analgin that can be taken without a doctor’s instructions. All medications always have side effects and there is a risk of an allergic reaction. Only the attending physician individually calculates the dosage, time and method of using a medicine such as Actovegin. After all, the doctor, based on the condition of the pregnant woman, can prescribe Actovegin in tablets, or can prescribe a course of treatment in the form of injections, and in critical situations, Actovegin can be administered parenterally.

Moderate oligohydramnios is not the worst threat when carrying a little person. The most important thing is to stop being nervous, monitor your health and respond to problems in a timely manner.

Amniotic fluid (amniotic fluid) may vary in volume at different times. This depends on the presence of various diseases and the duration of pregnancy. In this article we will understand the causes and symptoms of oligohydramnios, and also talk about treatment methods, prevention and possible consequences.

Causes

Did you know? According to statistics, oligohydramnios occurs in 4% of pregnant women.

Oligohydramnios during pregnancy can be moderate or severe. In the first case, the symptoms practically do not make themselves felt. A moderate lack of amniotic fluid is determined only after an ultrasound examination.
If the lack of amniotic fluid in the mother is severe, then there may be following symptoms:

when the fetus moves.
decreases in size (the size of the abdomen decreases, and this can be observed even visually; during an obstetric examination, a decrease in the height of the uterine fundus is noted).
Loss of strength and poor health (nausea, weakness, dry mouth).
Discomfort in the lower abdomen with periodic aching and pulling.

Only a doctor can confirm the lack of amniotic fluid. Therefore, when the first symptoms appear, you should immediately consult a doctor for further examination and treatment.

Possible consequences

Oligohydramnios during pregnancy is a dangerous disease that entails adverse consequences for both mother and child.

For woman

Oligohydramnios during pregnancy poses some danger to the mother. First of all, the woman will feel constant unpleasant nagging pain in the lower abdomen, which constantly intensifies when the child is actively moving. In addition, a lack of amniotic fluid can, in rare cases, lead to miscarriage.

Oligohydramnios in the last weeks of pregnancy leads to complications. Often this manifests itself in the form of weak labor. Weakness occurs because the fluid cannot press against the cervix with sufficient force. As a result, doctors have to use drugs that stimulate labor.

For a child

Oligohydramnios during pregnancy can lead to serious consequences for the child. With a lack of amniotic fluid, the walls of the uterus begin to actively stick to the fetal sac, and this leads to strong pressure on the fetus. As a result, the child bends in the wrong position, which leads to accretion of skin to the fetal membrane.

In addition, due to pressure on the fetus, the child may experience curvature of the spine, disturbances in the development of the skeletal system, disruption of nervous and brain activity, abnormal formation of the limbs, wrinkling and dryness of the skin, hypoxia, and retardation in weight and height.

Important!With oligohydramnios, drinking plenty of fluids (water, juice, milk, etc.), about 2 liters per day, helps.

However, diagnosis using ultrasound should be based on repeated studies.

A one-time ultrasound can only indicate that a woman has some problems during this particular period of pregnancy. They may be associated with previous viral diseases, and subsequently disappear independently and irrevocably. If ultrasound is performed continuously over 1-3 months, and there is always a lack of amniotic fluid, then this indicates the presence of severe oligohydramnios.

Currently, many doctors diagnose oligohydramnios on the basis of a single ultrasound, which in itself can only mean a statement of fact. In this case, active drug treatment is not prescribed. Pregnant women can be prescribed a course of treatment based on harmless complexes.

If ultrasound repeatedly shows severe insufficiency of amniotic fluid, then pregnant women are additionally prescribed Dopplerometry of placental vessels(duplex ultrasound scanning of blood vessels) or Fetal CTG(cardiotocography, which helps evaluate the characteristics of fetal heartbeats). If the results of the two above diagnostic methods are normal, this means that there are no serious abnormalities, and the oligohydramnios was only temporary, functional in nature.
In case of poor data from CTG and Doppler studies, doctors prescribe additional examinations: studies for anti-Rhesus bodies, the presence of infection in the blood, glucose levels, etc. It is imperative to do a targeted ultrasound, which gives a detailed picture of everything that is happening. If possible, karyotyping and amniocentesis are also prescribed. The last two diagnostic methods allow us to identify chromosomal and genetic abnormalities of the child.

Did you know?Down syndrome and trisomy 8 and 13 in the fetus cause oligohydramnios in almost 100% of cases.

Sometimes a gynecologist may suspect that a woman has amnionic hydrorhea (leakage of amniotic fluid). In such cases, water smears are prescribed. In late pregnancy, a lack of amniotic fluid can be detected by amnioscopy, a procedure that is safe for both mother and fetus.

Treatment methods

If you find yourself with any of the symptoms listed above, then you do not need to self-medicate and immediately consult a doctor to prescribe a specific course of treatment for oligohydramnios during pregnancy. Doctors first carry out a full diagnosis and rule out possible fetal malformations. Otherwise, other specialized treatment will be prescribed.
If gynecologists have diagnosed amnionic hydrorhea, then they prescribe to a pregnant woman special preparations and vitamin complexes, which help prevent infection of the child and reduce the tone of the uterus. In addition, in this case, it is necessary to observe bedtime. Doctors often prescribe inpatient treatment under full supervision until labor begins.

Sometimes the cause of a lack of amniotic fluid in pregnant women can be a viral infection. In such cases, antiviral and restorative medications are prescribed. Additionally, vitamin complexes and medications that stimulate blood microcirculation are prescribed.

If the pregnancy is prolonged, an amniotomy is performed (puncture of the bladder) and childbirth is immediately delivered. In addition, there are cases when a pregnant woman has an abnormal development of the membranes, which is why oligohydramnios occurs.

In such cases, prevention of intrauterine infectious lesions and therapy aimed at preserving pregnancy are needed. And do not forget that timely diagnosis of amniotic fluid deficiency and quality treatment lead to a favorable outcome.

Prevention

To prevent oligohydramnios, you can use birch sap, which has a good diuretic effect. To reduce pressure

Oligohydramnios is an insufficient amount of amniotic fluid. This condition is not very common, and its indicators depend on the individual characteristics of the woman’s body. The causes and consequences of oligohydramnios during pregnancy often require medical intervention.

Throughout its development, the unborn child is surrounded by membranes and the placenta. These organs are formed and perform their work exclusively during gestation, which is why they are called pregnancy organs.

Their main function is to create and maintain optimal conditions for the development and formation of the unborn child, and amniotic fluid plays a significant role in this process.

The aqueous membrane, also called the amnion, is a sac that contains the fetus, which is surrounded by amniotic fluid. It adjoins the internal cavity of the uterus and passes to the umbilical cord, and its walls are responsible for the production of amniotic fluid.

By the end of pregnancy, their number can reach from 800 to 1500 ml. This liquid contains hormones, proteins, salts and carbohydrates, without which it is impossible to ensure the full metabolism of the fetus. By the second half of pregnancy it becomes a little cloudy.

The amount of amniotic fluid gradually increases. It expands the walls of the uterus, providing more space for the actively growing fetus. Amniotic fluid is of great importance for the unborn child, creating a unique habitat.

They provide him with the opportunity to move, allow him to develop normally, and protect him from external influences and compression by internal organs. In addition, a water-filled amniotic sac is of great importance in the speed and degree of dilatation of the cervix at the initial stage of labor.

There are different degrees of deviation of fluid volume from normal. In medical practice, moderate (it occurs much more often) and severe degrees are distinguished, and in the second case the decrease can reach 3 times.

Oligohydramnios during pregnancy, the causes and consequences of which can be different, is rare: less than 6% of cases. Moreover, moderate oligohydramnios is much more common - a condition that is not considered critical. With rare exceptions, in the first and third trimesters, moderate oligohydramnios does not in any way threaten the unborn child.

What is amniotic fluid and how does it work:

Reasons for development

The exact reasons why there is a lack of amniotic fluid have not yet been established.

Statistics from obstetric practice show that the most common prerequisites for this condition are:

Intoxication of the body with any harmful substances. This happens in cases where the expectant mother has bad habits, or she works in production associated with hazardous substances. You can also encounter toxic substances in your home if you overuse household chemicals in cleaning.
Metabolic disorders, tendency to overweight and obesity. In this case, it is sometimes possible to correct the situation with a properly selected diet.
Dysfunction of the membrane of the amniotic sac.
Multiple pregnancy. Amniotic fluid may not be enough for 1 or more fetuses. This leads to the fact that one of them gets more nutrients and oxygen.
Previous infections of a bacterial nature.
Post-term pregnancy. The placenta, having outlived its allotted time, ages. This leads to its peeling and the inability to fully perform functions.
Late toxicosis.
High blood pressure. Many expectant mothers face this problem, but with oligohydramnios it can be more pronounced.
Anomalies in the development of internal organs of a child
Diseases of the genitourinary system - both acute and chronic.
Violation of the integrity of the fetal membrane and the resulting leakage of water.

Severe oligohydramnios is often associated with intrauterine malformations, the most common of which are anomalies in the development of the skull and kidney formation. In such situations, the diagnosis is usually established after the 10th week of pregnancy, and additional studies of the fetal condition are required.

The second most common cause of oligohydramnios is viruses that can penetrate the placental barrier.

This could be a regular flu or ARVI, which the expectant mother suffered from during the period after conception.

Quite often, obese women, as well as acquired and congenital diabetes, suffer from oligohydramnios.

In this case, oligohydramnios may begin already in the first trimester.

Somewhat less frequently, infectious agents penetrate the membranes from the vagina. Having a negative impact on the amnion, these diseases lead to disruption of metabolism and production of fetal fluid.

There are no steps that can be taken to 100% prevent this pathology.

But expectant mothers are advised to avoid excessive physical activity, preferring measured walks in the fresh air, eat right and undergo routine examinations and studies without delay, and follow the instructions of a specialist.

Why is oligohydramnios dangerous?

The amount of amniotic fluid produced is directly determined by the functional capacity of the placenta, on which the growth and development of the unborn child depends.

Oligohydramnios during pregnancy, the causes and consequences of which can be different. Disturbances associated with this pathology affect the functioning of the placenta and can lead to premature birth, miscarriage, and fetal hypoxia.

In about half of the cases, women with this diagnosis require a caesarean section.

If the problem appeared in the second trimester, and critical fetal defects or a slowdown in its development are diagnosed, the doctor may offer the option of terminating the pregnancy. If there are no developmental defects, drug correction of placental insufficiency is performed.

Symptoms
In addition to ultrasound examination, the problem can be recognized by the following signs:
painful and severely uncomfortable sensations during normal fetal movements until the end of the second trimester;
persistent feeling of dryness of the oral mucosa;
abdominal girth is too small, does not correspond to the period;

If oligohydramnios is mild, the listed symptoms sometimes do not manifest themselves at all, but the problem can be identified as a result of an examination. You should not resort to self-medication and try to diagnose the pathology yourself, without the help of a specialist.

Classification

Depending on the stage at which this pathology occurs, there are two types:

Before the 10th week, early oligohydramnios may appear, which in many cases is associated with problems in the formation of membranes.
In the II-III trimesters, a late form of oligohydramnios is diagnosed, which is most often associated with associated complications and pathological conditions, including those associated with the functioning of the organs of pregnancy.

Of great importance is how pronounced the reduction in fluid level is. If the decrease is insignificant, then objective external symptoms may be absent. If the deficiency reaches 700 ml, we are talking about severe oligohydramnios.

Diagnosis of oligohydramnios during pregnancy

The diagnosis is based on examination of the woman and analysis of her complaints. In addition, the doctor prescribes a number of tests and studies. Usually, pathology can be suspected as a result of a routine examination. The specialist pays special attention to the discrepancy between the normal height of the uterine fundus and the volume of the abdomen.

Of great importance is a thorough history taking, which will allow us to identify with maximum accuracy the root cause of this condition, on which the treatment tactics depend.

To exclude the possibility of an infectious factor, laboratory tests of blood and urine are prescribed. A smear is taken to identify pathogenic microflora, which allows you to refute or confirm the suspicion that the child is infected. The final diagnosis is made using ultrasound. Sometimes a CTG is performed to clarify the child’s well-being.

Ultrasound helps to make a final diagnosis if oligohydramnios is suspected and thereby prevent undesirable consequences, as well as partially eliminate the causes of such pregnancy pathology.

If the patient was diagnosed with the same pathology in previous pregnancies, there is a high probability that it is genetic in nature and has a connection with the individual characteristics of the body.

This fact is of great importance when collecting anamnesis, as it often allows one to exclude serious health problems of the expectant mother. Information about whether family members had similar problems is also important.

Treatment of oligohydramnios during pregnancy

Therapy is determined by the form and degree of oligohydramnios, as well as the general health of both the fetus and the patient herself. If the pathology manifests itself moderately and there are no obvious symptoms, a wait-and-see approach is used in the second trimester. Therapy is carried out on an outpatient basis.

A severe form of oligohydramnios associated with uterine hypertonicity requires hospitalization. Treatment in a hospital setting is also indicated when pathology is diagnosed at 34 weeks of pregnancy and later. Even one of these criteria is usually a sufficient reason for the expectant mother to be admitted to the clinic until birth.

Regardless of the form of oligohydramnios, its treatment should begin with the correct organization of the woman’s lifestyle.

It is important to protect her from stress and overwork, and to avoid physical activity. In some cases, bed rest is indicated.

Drug therapy

Drug therapy involves the use of drugs that stabilize uteroplacental blood flow. Medicines that normalize the functions of the placenta, as well as vitamin and mineral complexes, are actively used. If uterine hypertonicity is diagnosed, the prescription of tocolytics is indicated.

The direct impact on the causative factor is of great importance. If we are talking about infection, the doctor prescribes antiviral or antibacterial agents. At the same time, concomitant diseases that can affect the insufficient production of amniotic fluid are treated.

Women with oligohydramnios require close monitoring by an obstetrician-gynecologist.. The main efforts are directed towards the full formation and development of the child, and the continuation of pregnancy management until the planned date of birth.

If conservative therapy does not bring the expected results, and the level of amniotic fluid continues to decrease, leading to deterioration of the fetus, premature delivery may be required.

There is a high probability of primary weakness of labor, fetal hypoxia and the development of complications during childbirth. If conservative therapy leads to positive results, a planned caesarean section is performed upon reaching 38 weeks of pregnancy.

Folk remedies

Oligohydramnios during pregnancy, the causes and consequences of which cannot always be established with high accuracy, is practically untreatable. Complete restoration of the normal amount of amniotic fluid by medicinal methods is impossible. But some simple folk methods can have a positive effect on the course of pregnancy with diagnosed oligohydramnios.

Consumption of chokeberry fresh. It is enough to consume 100 g of berries before meals every day.
If oligohydramnios was caused by inflammatory diseases of the genitourinary system, you can use a decoction of: strawberry leaves, birch leaves, yarrow, peppermint, rowan and rose hips, nettle leaves and string. The finished decoction is consumed 3 times a day, half a glass.
Treatment with a decoction of lingonberry leaves has an anti-inflammatory and diuretic effect. It should be consumed a quarter glass before meals.
If the lack of amniotic fluid is associated with an increase in the blood pressure of the expectant mother, consuming corn grits will help correct the situation. It is most convenient to mix it with a small amount of warm water.

Any folk recipes using herbs and herbs can cause an allergic reaction in the expectant mother and child, so you should be careful when using them.

Diet

If oligohydramnios is associated with metabolic problems and a woman’s excess weight, a properly selected diet will help stabilize the situation, about which it is recommended to consult a specialist.

The causes and consequences of oligohydramnios during pregnancy can be very serious, so a proper diet can be not only one of the measures to combat this condition, but also a good way to prevent it.

Possible complications and consequences of oligohydramnios

Oligohydramnios during pregnancy, the causes and consequences of which are different, is primarily dangerous because the fetus is not protected by a sufficient amount of amniotic fluid from external influences.

This can lead to a number of complications:

An increase in the number of contacts between the fetus and the amniotic sac. This sometimes causes them to grow together.
The mother's internal organs may begin to squeeze the unborn child. This leads to clubfoot, curvature of the spine, disorders of skeletal formation, hip dysplasia, and malformations of the skull.
Impaired fetal mobility associated with a lack of amniotic fluid leads to developmental delays. There may be problems with growth and development of the nervous system.
Increased risk of having an underweight baby. The probability of this pathology is less than 10% with a moderate form of oligohydramnios and more than 75% with a severe form.
Drying of the skin of the unborn child.
Oxygen starvation of the fetus.
Deficiency of nutrients supplied with amniotic fluid.

In addition, oligohydramnios affects the course of pregnancy, childbirth and the postpartum period:

In most cases, the listed consequences relate to a pronounced degree of oligohydramnios. The moderate form rarely causes significant complications, but requires observation by a specialist. Oligohydramnios can occur at almost any stage of pregnancy, and its main symptom, which the woman herself can recognize, is a relatively slow increase in abdominal volume for the current period.

Oligohydramnios carries certain risks, but is one of the most serious pathologies that occur in pregnant women.

With moderate oligohydramnios, the likelihood of fetal pathologies is extremely low, especially if the expectant mother follows the doctor’s recommendations and follows the treatment plan.

Despite the fact that the causes of oligohydramnios during pregnancy may not be obvious and do not always lead to serious consequences, during the process of bearing a child it is important to pay attention to any changes in health status and unusual symptoms.

If you mention them during a routine examination, this can help to diagnose oligohydramnios in a timely manner and provide the expectant mother with appropriate qualified assistance.

Article format: Svetlana Ovsyanikova

Video on the topic: oligohydramnios and polyhydramnios during pregnancy: causes and consequences

Causes of oligohydramnios during pregnancy, possible risks:

Polyhydramnios during pregnancy: causes and consequences:

Update: October 2018

Amniotic fluid is the fluid that surrounds the fetus throughout pregnancy. It contains minerals, urea, glucose, proteins, fats and carbohydrates. Among the components of water there are a large number of hormones, immune factors, and bactericidal substances. As the gestation period increases, the water accumulates hairs and skin scales of the fetus.

Why amniotic fluid is needed?

Amniotic fluid plays a very important role in maintaining the life of a small person. In fact, this is the only habitat of the fetus that performs the following tasks:

prevents mechanical damage to the fetus
creates a favorable space so that the fetus can move unhindered
protects the umbilical cord from compression during childbirth
actively participates in fetal metabolism
stimulates the development of the lungs (due to the movement of fluid in them in two directions)
has antimicrobial and properties

How is amniotic fluid formed?

Amniotic fluid accompanies the fetus throughout almost the entire pregnancy. In the first trimester, when the embryo's organs are just forming, some of the mother's blood penetrates the fetal membranes, forming a small level of fluid. This level can be seen as early as 3 weeks of pregnancy. There is an opinion that the baby’s blood plasma can also “leak” through his skin in the shortest possible time.

In the second trimester, the main source of amniotic fluid is the fetus itself. Urine and fluid secreted by the lungs enter the space surrounding it.

From there it can be swallowed by the fetus, and part of it is absorbed directly into the mother’s blood. For example, during full-term pregnancy, the fetal lungs secrete up to 400 ml of fluid per day, the volume of urine per day can reach 1 liter.

Ingestion of water begins from 18-20 weeks of pregnancy, by 40 weeks the fetus swallows up to 500 ml of water per day (see). Within 3 hours, the amniotic fluid is completely renewed.

The total amount of amniotic fluid depends on the balance of these two processes (formation and excretion of fluid).

What is oligohydramnios?

Oligohydramnios is a decrease in the level of amniotic fluid to 0.3-0.5 l during full-term pregnancy. About 0.3–5.5% of all pregnancies are accompanied by oligohydramnios of varying severity.

Causes of oligohydramnios

The main cause of oligohydramnios during pregnancy is considered to be impaired functioning of the fetal kidneys. But there are many more factors that affect the balance of amniotic fluid:

Fetal malformations
- posterior urethral valves
- absent or narrowed urethra
- bilateral obstruction of the ureters and other parts of the urinary tract
- undercut belly syndrome
- absence of two kidneys
- bilateral cystic renal dysplasia
- polycystic kidney disease (infantile form)
- cloaca abnormalities

Fetal chromosomal abnormalities
Disorders of the placenta (placental development abnormalities)
Post-term pregnancy
Antenatal fetal death
Squeezed twin syndrome in multiple pregnancies
Oligohydramnios caused by the use of prostaglandin synthetase inhibitors
Oligohydramnios due to prenatal water leakage
Causeless (idiopathic) oligohydramnios

Absence of both kidneys

The malformation, more common in boys, is characterized by the complete absence of both kidneys and severe oligohydramnios. This condition is lethal, that is, the fetus dies in utero or immediately after birth. The causes of the pathology are also considered to be chromosomal abnormalities and exposure to unfavorable factors (maternal diabetes, smoking and cocaine use, rubella virus infection).

When performing an ultrasound, the doctor notes a low level of amniotic fluid, the absence of a shadow of the kidneys and bladder. It is important to note that if the bladder is visible, then the fetus still has at least one kidney. And with unilateral agenesis (absence of a kidney), the condition of the fetus usually does not suffer, the quality of life of such a child is practically no different from other children.

Infantile form of polycystic kidney disease

A hereditary disease, the main symptom of which is huge kidneys with cystic deformation (in the form of large cavities). The disease is usually detected in the second half of pregnancy using ultrasound; an additional sign is severe oligohydramnios. The prognosis of the disease is quite poor; most children do not survive the first year. If a pathology is detected, it is necessary to undergo full karyotyping (determining the number and shape of chromosomes), since the risk of recurrence of polycystic kidney disease in future children is 1:4.

Posterior urethral valve syndrome

Pathology of male fetuses, in which valves form in the urethra. These growths interfere with the flow of urine from the bladder. Over time it stretches. As the disease progresses, the kidneys also enlarge. Therefore, ultrasound examinations of such babies reveal large kidneys, a distended bladder, and oligohydramnios. The prognosis depends on the onset of the disease and the degree of development of the lungs (very often they are underdeveloped).

Prune-belly syndrome

A rather rare congenital malformation of a child, combining three main features:

absence or underdevelopment of the muscles of the anterior abdominal wall
disorder of the structure of the urinary system in the form of a large bladder
undescended testicles into the scrotum

In the case of a severe form of the syndrome, other anomalies may be added to these signs: dilation of the ureters, renal dysplasia and dilation of the renal pelvis. Sometimes this syndrome is combined with Potter's syndrome, when the child's kidneys are affected due to blockage of the urinary tract, the lungs do not develop, and a state of oligohydramnios occurs.

The syndrome is diagnosed already at the end of the second trimester, when an ultrasound reveals a huge fetal bladder. The prognosis of this disease is unfavorable, especially if oligohydramnios develops (in this case, termination of pregnancy is suggested). If a mild form is diagnosed, then observation and surgical intrauterine treatment are possible, although in this case the child’s chances of surviving the first year are very low.

Abnormalities of the cloaca

Anomalies of the cloaca are a rare combination of defects of the genitourinary system and the digestive tract of the fetus. Violations occur at the stage when these two systems are still combined into one.

Ultrasound reveals fluid and cysts in the child’s abdomen, absence or abnormal development of kidneys, and defects of the duodenum. Often the bladder and bowels are located outside the abdomen and are not covered by skin. With such pathologies, screening may indicate an increased level of AFP.

Often the pathology leads to the death of the child, but modern surgical methods make the chances of life for such babies quite high.

General features of malformations of the fetal urinary system:

Most of these defects are accompanied by a reduced amount of amniotic fluid (due to the small volume of urine excreted)
Severe oligohydramnios in pregnant women or anhydramnios (complete absence of water) are an unfavorable prognostic sign. In such cases, underdevelopment of the lungs is often observed - the main cause of death in newborns with such defects.
Some defects can be treated surgically (bypass surgery) during pregnancy.
There is an isolated enlargement of the kidneys, not accompanied by oligohydramnios, which goes away on its own during pregnancy.

Fetal chromosomal abnormalities

Most chromosomal diseases occur with polyhydramnios or a normal amount of water. In some cases (if the syndrome is associated with disorders in the urinary system), there may be a decrease in the level of amniotic fluid. The main diagnostic value is the second trimester and other ultrasound signs of chromosomal pathologies.

Intrauterine infections

In 30-40% of cases of severe oligohydramnios, infection of the membranes occurs. When transmitting infection from mother to fetus, it is the placenta and fetal membranes that serve as an intermediary. Their inflammatory changes lead to placental insufficiency, decreased water levels and delayed development of the child. A complete absence of water is often observed during infection in the 1st trimester, resulting in congenital malformations of the fetus.

Fetoplacental insufficiency

Insufficient blood supply to the fetus by the placenta can occur for many reasons:

genetic disorders of the placental bed
infections
gestosis
diabetes mellitus and other chronic maternal diseases
impaired ovarian function and many other factors

But the result is always the same: gradual (and sometimes sudden) oxygen starvation of the fetus. The most sensitive organ to hypoxia is the brain. Nature has invented a way to protect it by redistributing blood throughout the fetal vessels. As a result, other organs begin to receive less oxygen. These include the kidneys and lungs, which are directly responsible for the amount of amniotic fluid. Therefore, with placental insufficiency, oligohydramnios is a common occurrence.

Post-term pregnancy

The exact causes of oligohydramnios during post-term pregnancy are still unclear. A possible reason is the inability of the maternal body to satisfy the needs of an overripe fetus, which leads to fetoplacental insufficiency and, as a consequence, oligohydramnios.

Antenatal fetal death

Intrauterine death of a child is almost always accompanied by oligohydramnios. Firstly, acute placental insufficiency most often leads to death. Secondly, immediately after the death of the fetus, its kidneys and lungs stop producing amniotic fluid. Therefore, the decrease in the level of amniotic fluid can be very sharp, and the volume of the abdomen can decrease significantly.

Squeezed twin syndrome

In case of multiple pregnancy with twins, that is, as a result of fertilization of one egg, which subsequently splits, the number of complications is quite high. One of the most dangerous and common pathologies is fetafetal blood transfusion syndrome.

Almost 70% of identical twins share a placenta, that is, they are monochorionic monozygotic twins. It often happens that additional vessels are formed in the thickness of this placenta, connecting the twins. If at the same time the part of the placenta that supplies blood to one child (donor) begins to work worse, then most of the blood goes to the second twin (recipient). As a result, the recipient begins to produce more urine and becomes polyhydramnios. And the donor does not receive enough blood and oxygen, begins to lag in growth and develops oligohydramnios.

Without treatment, this pathology leads first to the death of the donor from oxygen starvation, and then to the recipient from severe swelling and intoxication. But modern methods can significantly reduce the mortality and morbidity of such twins:

coagulation of additional vessels using laser
Caesarean section as soon as possible after the death of the donor fetus (to save the life of the recipient fetus)
in the short term, if the donor dies, the umbilical cord is closed (so that decay products and hormones do not reach the living fetus)

Iatrogenic oligohydramnios (caused by indomethacin)

Urine production by the fetus, and therefore the level of amniotic fluid, is controlled by many hormones and substances. These substances include prostaglandins, which regulate the diameter of the renal arteries. Drugs that suppress the synthesis of prostaglandins reduce renal blood flow and the amount of urine excreted by the child, which threatens the kidneys.

Indomethacin is a common drug with this effect, used to reduce the amount of amniotic fluid and prolong pregnancy. It must be used with extreme caution, as it can lead to fetal renal failure.

Leakage of amniotic fluid

Classic, followed by rupture of amniotic fluid. Often the membranes rupture before contractions. In a full-term pregnancy, labor begins after this, and its course differs little from the classic version. Completely different outcomes and prognosis occur if the membranes rupture before 36 weeks of pregnancy.

Causes of premature rupture of membranes

incompetence of the cervix (isthmic-cervical insufficiency)
membrane infection
polyhydramnios
abnormal fetal position and narrow pelvis
medical procedures (amniocentesis, cordocentesis and others)

If the membranes rupture from below, then more often a complete rupture of water and subsequent birth occurs. If the rupture is located from above, then water can leak gradually, practically without reducing the overall level of amniotic fluid. Therefore, the combination of even moderate oligohydramnios with suspicious liquid discharge from the vagina can be dangerous for the health of the mother and child; it is advisable to conduct additional research. Using test strips, you can detect amniotic fluid in the vagina and prescribe treatment. Depending on the duration of pregnancy, the condition of the fetus and mother, blood and urine tests, pregnancy extension or labor induction will be carried out.

Idiopathic oligohydramnios

Oligohydramnios, not accompanied by any of the above pathologies, is considered idiopathic, that is, causeless. Most often, the amniotic index is slightly reduced, and the condition of the mother and fetus is stable. As the period increases, the amount of water may return to normal, or it may remain small until birth, without affecting the baby’s health.

Symptoms of oligohydramnios

the volume of the abdomen and the height of the uterine fundus lag behind the timing of pregnancy
low fetal motor activity
liquid vaginal discharge (due to rupture of membranes)

At each visit to the antenatal clinic, the pregnant woman’s abdominal volume is measured, which can indirectly reflect the amount of water. By the end of full-term pregnancy, it reaches 90-100 cm, but the value can vary if the woman is obese.

The main way to diagnose oligohydramnios is to determine the amniotic index using ultrasound.

How is the amount of amniotic fluid determined by ultrasound?

The main way to determine the level of amniotic fluid is to conduct an ultrasound examination. There are several techniques that allow you to estimate the volume of amniotic fluid with great accuracy.

Measuring a vertical pocket

If the largest of the pockets in two planes does not exceed 1 cm, then a diagnosis of oligohydramnios can be made.

Determination of amniotic fluid index

During this method, the entire cavity of the pregnant uterus is divided into 4 parts using two perpendicular lines passing through the navel. The maximum diameter of the liquid volume is then measured in each quadrant. By summing the data obtained in all quadrants, the amniotic fluid index is obtained.

To evaluate the results for each stage of pregnancy, special centile tables have been created, according to which doctors write a conclusion. If the index value is less than the 5th percentile, then a diagnosis of oligohydramnios can be made. Although oligohydramnios has practical significance only when the index is less than 2.5 percentile.

If you need to assess the level of amniotic fluid in the first half of pregnancy, then the uterus is divided into two quadrants with a vertical line.

Gestational age	Amniotic fluid index, cm
Gestational age	5th percentile	50th percentile	95th percentile
14 weeks	2,8	5,0	8,6
16 weeks	3,6	5,8	9,6
18 weeks	4,6	6,8	11,1
20 weeks	5,5	8,0	12,9
22 weeks	6,3	9,3	14,9
24 weeks	7,0	10,7	16,9
26 weeks	7,5	12,0	18,7
28 weeks	7,6	13,0	19,9
30 weeks	7,5	13,6	20,6
32 weeks	7,1	13,6	20,4
34 weeks	6,4	12,9	19,4
36 weeks	5,6	11,8	17,9
38 weeks	4,7	10,3	15,9
40 weeks	3,7	8,6	13,9

Why is oligohydramnios dangerous during pregnancy?

The appearance of amniotic cords. If the amount of amniotic fluid is sharply reduced, adhesions may occur between the fetal skin and the amniotic membrane. They can entangle or pull parts of the fetus, which leads to deformation or even amputation of limbs.
Impaired labor (due to a flat membrane). Contractions may be too weak and irregular.
Compression of the umbilical cord during childbirth, up to acute hypoxia and fetal death.
Disturbed position of the fetus in the uterus.

How to treat oligohydramnios?

The main principle of treating oligohydramnios during pregnancy is pathogenetic. This means that a decrease in the level of amniotic fluid itself cannot be cured; the cause of this condition must be found. To do this, ultrasound includes a gynecological examination, monitoring of fetal heartbeats, genetic screenings, and tests.

If there are no additional signs other than oligohydramnios, then nothing needs to be treated. Monitoring the condition of mother and child is required. There is information that mothers may experience oligohydramnios. Some pregnant women with edema begin to arrange “fasting” days with limited fluid intake, which is extremely undesirable. Adequate fluids per day are necessary to maintain balance in the body.

If additional signs of trouble are detected, the primary disease must be treated:

For congenital fetal defects– surgical treatment (if appropriate) or termination of pregnancy. A wait-and-see approach is possible.
For chromosomal abnormalities– assessment of the child’s viability, after which – termination of pregnancy or expectant management
For intrauterine infection– antiviral or antibacterial treatment (if necessary), monitoring the child’s condition. Before treating such diseases, you need to carry out all the necessary tests.
For placental insufficiency– treatment with vascular drugs up to 20 weeks (Curantil), after 20 weeks – expectant management. If fetal development is severely delayed, the pregnant woman should give birth as early as possible (preferably after 33 weeks)
In post-term pregnancy– induction of labor or expectant management (if the fetus is in normal condition)
Complications of multiple pregnancy– treatment by shunting the blood vessels of the placenta, pumping out excess amniotic fluid from the recipient fetus. If the donor fetus dies, they usually try to deliver the pregnant woman as early as possible to preserve the life of the recipient fetus.
When fruit membranes rupture– induction of labor or expectant management. The main task is to prevent infection of the fetus and allow the lungs to develop (with the help of hormone therapy).

How is childbirth carried out with severe oligohydramnios?

If an ultrasound reveals significant oligohydramnios, then doctors perform an early opening of the amniotic sac. The fact is that with a small volume of amniotic fluid, the bubble takes on a flat shape. As a result, it not only does not stimulate labor, but can even disrupt it. Therefore, it is better to open such a fetal bladder.

If oligohydramnios is extremely severe, then, if indicated, a caesarean section may be used.

Prevention of oligohydramnios

You can reduce the risks of oligohydramnios (but not make them zero) by properly preparing for pregnancy and following all doctor’s recommendations:

Take 400 mcg of folate per day
Get tested for HIV, syphilis and TORCH complex
If a woman did not have chickenpox or rubella as a child, get vaccinated against rubella and chickenpox before pregnancy.
To refuse from bad habits
Control diabetes, hypertension and other chronic diseases
Avoid taking medications without consulting a doctor during pregnancy