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Oligohydramnios symptoms. Why does oligohydramnios occur during pregnancy and does it need to be treated? Oligohydramnios during pregnancy: causes and consequences

Oligohydramnios during pregnancy is considered a deviation from the norm of the total volume of amniotic fluid in a smaller direction. This diagnosis is much less common than polyhydramnios, but still occurs. The amount of amniotic fluid should reach at least 100 ml, and by the end of the second trimester 500 ml. With this diagnosis, the fetus experiences a deficiency of nutrients that are required for normal metabolism and play an important role in its development. Oligohydramnios in the second trimester can lead to the formation of pathologies and deformation of the skeletal structure. Often in such a situation, vital organs do not develop, which often leads to deviations in the development of the child.

Oligohydramnios can be detected in the first, second, and third trimesters of pregnancy. But if at the beginning of pregnancy this does not pose a serious danger to the fetus, and at the end of the term they resort to early delivery, which is a cesarean section, then in the second trimester this is a rather dangerous condition. Further treatment or termination of pregnancy will depend on the degree of oligohydramnios and existing pathologies in the fetus.

There is moderate and severe oligohydramnios

In the first case, deviations from the norm are insignificant. However, it is easily treatable if detected in a timely manner. For this purpose, special diets and corrective nutrition are prescribed. If you follow the right lifestyle, the amount of amniotic fluid returns to normal, which does not lead to negative consequences for the fetus. Severe oligohydramnios is characterized by a significant deviation from the norm, which leads to an unfavorable outcome. To avoid unwanted consequences, timely hospitalization and hospital treatment are required.

Symptoms of oligohydramnios

It is impossible to accurately diagnose oligohydramnios on your own. But some signs can be a warning bell.

First of all, these include:

Frequent nausea

Nagging pain in the lower abdomen,

Increased pain sensitivity when the fetus moves,

Dry mouth

Weakness.

Oligohydramnios during pregnancy can be diagnosed by a doctor at an appointment. Often he is guided by deviations from the norms for the corresponding period of pregnancy when measuring the volume of the abdomen and the height of the uterine fundus. Ultrasound will show more accurate results. This examination will determine the amount of amniotic fluid and also diagnose fetal development in appropriate conditions.

Causes of oligohydramnios

There are several reasons that have a direct effect on the reduction of amniotic fluid.

1. Infectious diseases of the mother. These include ARVI, influenza, chronic diseases, inflammation, and genital infections.

2. High blood pressure in a pregnant woman. In this case, the functioning of capillaries and blood vessels is disrupted, which leads to damage to the membranes.

3. Disturbance in the functioning of the fetal urinary system, most often associated with problems in the functioning of the kidneys.

4. Fetal hypoxia, in which blood flow is redistributed, focusing primarily on the blood supply to the heart, central nervous system, and adrenal glands. Thus, the lungs and kidneys become deficient, causing them to stop producing more amniotic fluid.

5. Multiple pregnancy. Uneven development of the placenta cannot be ruled out, which leads to inconsistent and different blood flow for each child.

6. Other causes of oligohydramnios include obesity, metabolism, and diabetes.

Dangers of oligohydramnios

It is oligohydramnios in the second trimester of pregnancy (16–28 weeks) that is considered the most dangerous and unfavorable diagnosis.

1. Complication in fetal development. This may be malnutrition (intrauterine growth retardation), hemiccephaly (insufficient brain development), hypoxia (oxygen deficiency), amniotic bands (fusion of the skin of the fetus), deformation of the limbs or muscles of the fetus.

2. Spontaneous termination of pregnancy (miscarriage).

3. Premature labor.

4. Difficult, protracted labor.

5. Intrauterine fetal death.

Treatment for oligohydramnios

If severe oligohydramnios is diagnosed, the pregnant woman is hospitalized and undergoes a thorough examination (ultrasound, cardiogram, blood and urine tests). In order to determine the course of treatment, it is necessary to correctly identify the cause of oligohydramnios. Only after this are appropriate methods prescribed to eliminate it. Moreover, the entire course takes place under the strict supervision of specialists and the necessary examinations, including ultrasound and Doppler ultrasound. It is also very important to switch to proper nutrition, take vitamins to improve blood supply to the placenta, limit physical activity and physical activity, and bed rest. The most important thing, even with moderate oligohydramnios, is not to resort to self-medication.

In this article you will learn on what basis the diagnosis of “oligohydramnios” is made and how it is dangerous for a woman and her baby. And also what are the causes of this deviation, how oligohydramnios is treated and what measures need to be taken to prevent complications from occurring

• There is such a diagnosis as “oligohydramnios”. This means that the amount of amniotic fluid is less than normal at a certain stage of pregnancy.
• Now, thanks to ultrasound examinations, oligohydramnios is easy to detect, and this diagnosis is made in only 5% of pregnant women
• But, unfortunately, it still exists and this deviation must be treated as early as possible in order to avoid unwanted complications, including defects in the physical development of the fetus

What does oligohydramnios mean during pregnancy?

• Amniotic fluid contains many substances necessary for the baby, such as salts, hormones, oxygen and vitamins. Also, amniotic fluid protects the fetus from many harmful external factors.
• But such a deviation occurs when there is little amniotic fluid and this seriously complicates the healthy bearing of a child
• At different stages, the amount of fluid is different, so, in the last trimester, it should be 0.8-1.5 liters. If the amount of water is less, then we are talking about low water
• There is a division of oligohydramnios into moderate and severe; to determine the severity of the deviation, the degree of fluid deficiency is important

With moderate oligohydramnios, the volume of fluid is slightly less than it should be during a normal pregnancy, and is about 400-700 ml.

Treatment for such oligohydramnios consists of establishing a diet; you need to adhere to a special diet rich in vitamins and minerals, lead a healthy lifestyle, and regularly visit a doctor to monitor the dynamics of the disease and not miss the deterioration of the condition. As a rule, this is enough and moderate oligohydramnios does not harm the fetus.

Severe oligohydramnios during pregnancy

Severe oligohydramnios means a strong deviation from the normal volume of amniotic fluid. In case of severe oligohydramnios, urgent and radical measures must be taken, because This condition is very dangerous for the life and health of the baby.

Treatment is usually carried out in a hospital under the constant supervision of doctors. If you have been diagnosed with this, it can affect your unborn child - due to oligohydramnios, there may be a delay in the development of the fetus, hypoxia, which in turn will lead to problems with the central nervous system, improper formation of the bone skeleton and tissues, and even abortion. pregnancy.

There are only 0.3-0.5% of women suffering from severe oligohydramnios.

Signs of oligohydramnios during pregnancy

The pregnant woman herself usually does not feel that she has such a deviation as oligohydramnios. The only thing that can alert you is the appearance of a sharp pain in the abdomen when the baby pushes. This may indicate a lack of fluid in the amniotic sac.

During an examination, a doctor can identify the likelihood of oligohydramnios by the lag in the following indicators:

• increase in abdominal volume
• uterine fundus measurements

Based on these data, the doctor can make an assumption about a deviation from the norm and must refer the pregnant woman for an ultrasound examination, where an accurate diagnosis will be made.

An ultrasound machine makes it possible to measure the amount of amniotic fluid and determine whether it is enough or not.

If according to an ultrasound you have moderate oligohydramnios, do not rush to be upset, it is better to redo the ultrasound examination in another place, perhaps the doctor is mistaken or the device is not accurate enough, and the results will be different.

Causes of oligohydramnios during pregnancy

All the reasons why oligohydramnios occurs have not been fully studied, but experts identify the following:

1. Leakage of amniotic fluid or, scientifically, amnionic hydrorhea. Leakage of water occurs long before PDR due to rupture of the membranes. Doctors believe that this happens due to infection of the membrane or its premature aging, which leads to its thinning and the appearance of a gap. This deviation is treated with bed rest, while the fluid has time to be restored and its loss does not harm the child
2. Disturbances in the development of the fetal membrane. There are quite a few such disorders and the reasons for their occurrence, too, the most common include genetic disorders and the harmful effects of the environment
3. Infection of the amniotic sac. There are a number of viruses from which the placenta cannot protect the baby and the fetal bladder becomes infected, its proper functioning is disrupted, which leads to oligohydramnios.
4. Postmaturity of the fetus. The placenta and fetal membrane no longer work at full capacity, the baby does not receive the nutrients he needs and the condition of his body worsens, blood circulation in the membranes also becomes difficult, which in turn leads to a decrease in the production of amniotic fluid
5. Underdevelopment of amniotic sac tissue or poor secretory function
6. Pathologies in fetal development. Here doctors identify genetic abnormalities in the development of the face and kidneys
7. Bacterial infections in rare cases can penetrate not only into a woman’s birth canal, but also into the amniotic fluid
8. During multiple pregnancies, there are cases when the blood in the placenta is not distributed correctly and therefore one child does not receive enough of the necessary substances, while the other receives too much of them

What are the dangers of oligohydramnios during pregnancy?

• Oligohydramnios during pregnancy can cause quite a few complications. If there is not enough water, the walls of the uterus begin to strongly compress the amniotic sac, which puts unnecessary pressure on the baby
• In this case, the baby will be bent in a position that is uncomfortable and unnatural for him. This development of events leads to curvature of the child’s spine and clubfoot, and the skin can grow together with the fetal membrane
• In addition, Simonartian ligaments may form, which wrap around the fetus and limit its movements, which can even lead to injury.
• If these ligaments become entangled in the umbilical cord, the child will not receive enough nutrients, fetal hypoxia and impaired blood flow may occur, which will lead to developmental delays and possibly even fetal death.
• Amniotic fluid, moreover, protects the baby from the external environment, which can harm him, and its lack will lead to unreliable protection or its absence
• If there is a lack of water, the cervix may open slowly during childbirth, and labor becomes weak. The contractions are painful, but not strong enough. Bleeding may occur after childbirth

If severe oligohydramnios was discovered late and has irreversible developmental disorders of the fetus, doctors insist on early termination of pregnancy.

Moderate oligohydramnios can be said to never have a negative effect on the child, if, of course, the diet and lifestyle of the pregnant woman is adjusted.

Oligohydramnios during pregnancy, what to do?

If your doctor has diagnosed you with oligohydramnios, he will definitely prescribe you treatment and tell you what to do.

First of all, don't worry. A timely diagnosis is 50% of the success of treatment. Follow your doctor's instructions strictly; if you need to go to the hospital, don't even think about it - go to bed, because the health of your unborn baby and, in some cases, even his life depends on it.

How to treat oligohydramnios during pregnancy?

A woman should understand that even with a diagnosis of “moderate oligohydramnios,” she should not self-medicate or ignore it altogether.

The doctor will prescribe additional examinations: general blood and urine tests, tests for infections, fetal CTG (cardiotocography), ultrasound, water smear if there is a suspicion that they are leaking.

Ultrasound for oligohydramnios during pregnancy

These examinations will help to assess the child’s condition and the severity of the deviation. Based on their results, the gynecologist will prescribe the necessary treatment. You should also try to determine the cause of oligohydramnios, this will help you choose the right treatment.

• If the cause of oligohydramnios is obesity and metabolic dysfunction in the body, then you need a proper diet, vitamins and medications that improve blood supply to the placenta. If oligohydramnios is moderate, treatment can be done at home, but if it is severe, then hospitalization is necessary.
• If the cause of oligohydramnios is a viral infection, then antiviral drugs are prescribed and restorative therapy is carried out. The doctor will definitely prescribe a vitamin complex and medications that improve blood microcirculation
• If the reason lies in impaired development of the amniotic sac, doctors try to maintain the pregnancy and prevent infection of the fetus. In this case, treatment is carried out exclusively in a hospital and the woman is prescribed additional examinations to assess the condition of her body and the condition of the fetus.
• In case of post-term pregnancy, doctors puncture the amniotic sac and induce labor with stimulating drugs.
• It is also important to reduce physical activity, reduce physical activity and adherence to bed rest.
• In case of oligohydramnios, doctors direct the woman to do ultrasound and Doppler ultrasound more often in order to monitor the dynamics of the deviation and changes for the better or worse in the mother’s body and the condition of the child
• If the pregnancy is already long and the baby is full-term, the doctor may recommend premature birth, which will be caused by special stimulating drugs

Do not forget to tell your doctor if you have already had this diagnosis in previous pregnancies, and it is better to conduct a couple of additional ultrasound examinations to exclude this abnormality or detect it as early as possible.

Index of oligohydramnios during pregnancy

During an ultrasound examination, a diagnosis of “oligohydramnios” is made based on the amniotic fluid index (AFI), which is calculated by an ultrasound machine. The device measures the amount of water in several places and calculates the IAF.

Table of AFI at different stages of pregnancy

In the third trimester:

• if the index is within 5-8 cm, then the amount of water is normal
• if the index is 2-5 cm, then this is “moderate oligohydramnios”
• if the index is below 2 cm, a diagnosis of “severe oligohydramnios” is made

However, it is worth noting that AFI varies depending on the stage of pregnancy:

• at 16 weeks the norm is considered to be from 73 to 201 mm
• at 20 weeks from 86 to 230 mm
• at 25 weeks from 89 to 240 mm
• at 30 weeks from 82 to 258 mm
• at 35 weeks from 70 to 279 mm
• at 40 weeks from 63 to 240 mm

The amount of amniotic fluid changes as the fetus grows, swallows fluid, and urinates. But you shouldn’t worry about the baby’s condition, because... amniotic fluid is renewed every 3 hours, and every 3 days it completely changes.

Nutrition for oligohydramnios during pregnancy

When you have oligohydramnios, you need to eat properly and in a balanced manner:

• try to eat several times a day (more than 5 meals), but in small portions
• products must contain many vitamins and minerals and be nutritious
• choose natural, minimally processed foods
• exclude fast food products from the menu (burgers, hot dogs, etc.)
• reduce the amount of sugar and salt you consume
• eliminate fatty foods from your diet
• try to use less spices and spices
• avoid products containing preservatives, flavors and dyes
• meat, fish and seafood must be well-heated; you should not eat them raw or half-cooked
• refrain from eating blue cheese, unboiled milk and raw eggs
• do not drink strong tea, try to avoid coffee and completely eliminate alcohol
• Instead of sweets and sugar, eat more fruits

Be sure to monitor your weight gain, because... its rapid increase can also lead to oligohydramnios or worsening of an existing deviation.

Tendency to oligohydramnios during pregnancy: how to determine?

A woman may be prone to oligohydramnios during pregnancy in the following cases:

• expectant mother smokes
• multiple pregnancy
• the woman has metabolic disorders in the body
• there are abnormalities in the development of the amniotic sac
• gestosis - toxicosis in late stages
• dehydration due to vomiting or diarrhea
• there is a bacterial or viral infection
• woman suffers from diabetes
• presence of chronic diseases in the expectant mother
• post-term pregnancy
• there are fetal kidney defects
• I had oligohydramnios in previous pregnancies

If you fall into the risk category, the doctor will prescribe additional examinations and tests for you in order to promptly identify deviations from the normal volume of amniotic fluid and begin treatment as early as possible.

Let's summarize and determine the main measures to prevent oligohydramnios:

1. Proper fractional nutrition, products should be as healthy as possible
2. Dieting if you have problems with excess weight
3. Additional intake of complex vitamins
4. Eliminate physical activity and replace it with walking in the fresh air
5. Timely visit to the gynecologist, taking tests, passing the necessary examinations
6. If there are endocrine disorders (diabetes mellitus, for example, or obesity), you need to undergo appropriate treatment

When I was pregnant, I couldn’t get enough of the fact that I had a small belly, as it later turned out on an ultrasound - oligohydramnios. But it was probably moderate, because... The doctor did not prescribe any medications and only said that I would not be allowed to nurse, but my son did not wait long, he was born a little premature - the birth was easy, there were no problems with the child’s health.
Masha, 24 years old.

In fact, doctors exaggerate everything; there is nothing wrong with oligohydramnios. Well, this is understandable, they are playing it safe. But my friend was persuaded to give birth prematurely, she did not agree and carried the child to term. The son was born healthy and on time. It grows and gets stronger.
Diana, 32 years old

In both pregnancies I was diagnosed with “moderate oligohydramnios”, and both times at 30-32 weeks. During the first pregnancy, they did not prescribe treatment; they said that at this stage, moderate is not scary, but in the second, they gave injections. The doctors were different. Both girls are healthy, and this is the most important thing! Christina, 27 years old

VIDEO: Oligohydramnios during pregnancy

Even if, after the next examination, you heard a terrible diagnosis: oligohydramnios, stop panicking! Insufficient amniotic fluid is not a death sentence, but just a symptom. In addition, there are different stages of oligohydramnios and, perhaps, for your body, such indicators are the norm. It's time to figure out what oligohydramnios is during pregnancy, the causes and consequences of which worry you.

What is amniotic fluid?

Your body, like a clock, is tuned to bear and give birth to a child. Not only is the fetus protected by the placenta, it is constantly in the amniotic fluid, which simultaneously serves as food and protects it from external influences of infections. This amniotic fluid contains vitamins and hormones, salts and oxygen necessary for the baby’s growth. All of them enter the child’s body when he swallows liquid.

Unfortunately, not only food can affect amniotic fluid. Infections and viruses easily penetrate the amniotic fluid, which negatively affects the development of the child. As a result, quantitative changes in amniotic fluid and diagnosis, for example, of oligohydramnios.

Oligohydramnios – what is it?

Oligohydramnios is a deviation from the normal amount of amniotic fluid in the direction of its decrease. There is a distinction between moderate and severe oligohydramnios. In the latter case, the amount of amniotic fluid is reduced by 3 or more times.

• The first good news: such a deviation is quite rare, medical indicators range from 0.7 to 5.5%, and even then the highest number characterizes moderate oligohydramnios during pregnancy, which is not considered critical;
• The second positive argument is that in the first and third trimester, oligohydramnios, especially moderate ones, is not a 100% threat to the development of the baby, and it is even possible that the small amount of amniotic fluid you have is of a genetic nature.

Amniotic fluid index table

The amount of amniotic fluid can be determined by the ratio of the volume of the abdomen and the height of the uterus, as well as during an ultrasound examination (read the article on the topic: Is it possible to determine the gestational age by ultrasound?>>>).

Measurements during ultrasound

1. During an ultrasound, the presence of a so-called free pocket is determined. This pocket is nothing more than the distance between your baby and the front wall of your tummy;
2. A specialist may suspect oligohydramnios if this space is less than 2 cm, while the norm is 5 cm;
3. At the same time, the amniotic fluid index will be calculated for you; the principle is the same, but measurements are taken at four different points around the baby. The AFI norm is determined by week, but please note that even within a day the data may fluctuate slightly.

The resulting numbers in mm are checked against the table. Interestingly, the average reaches its peak at week 27 – 156 mm, and at week 42 it drops to 110 mm. The table also shows possible fluctuations, again by week:

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

Thus, oligohydramnios during pregnancy at week 32 is diagnosed when the AFI is below 77 mm. (read the current article: Ultrasound at 32 weeks of pregnancy >>>), while at 22-26 weeks only at 89 and below AFI.

Conventional measurements

You can also talk about oligohydramnios if the size of the uterus and abdominal girth do not correspond to your gestational age, but no one will diagnose you without an additional ultrasound.

Why is oligohydramnios dangerous?

Low hydramnios is a sign that a certain malfunction has occurred in your body. The causes of oligohydramnios during pregnancy, namely whether these disorders are genetic, or whether external factors have affected the functioning of the placenta and the production of amniotic fluid, will be determined by a specialist, but the fact that such a condition can be dangerous is a fact.

Consequences

Check out the list of dangers associated with oligohydramnios during pregnancy.

• There is a 50% risk of premature birth;
• During delivery at term, there is a decrease or absence of labor in 80% of pregnant women;
• The risk of miscarriage increases significantly (up to 50%);
• In a third of pregnant women, oligohydramnios developed as a consequence of an infectious or inflammatory process;
• With a critically low amount of amniotic fluid, the risk of fetal hypoxia is 20%, and hypertrophy or asphyxia is 75%;
• In half of the cases with oligohydramnios, childbirth is carried out by caesarean section.

Causes

You won’t find clear medical parameters in any reference book, but there are certain assumptions:

1. There is a tendency to oligohydramnios during pregnancy due to genetic factors. If your mother or grandmother had small babies with a small belly, you may have the same story;

There is no need to worry when oligohydramnios is moderate and the child feels normal. Another thing is if your relatives, as a result of oligohydramnios during pregnancy, had problematic childbirth, you need to warn your doctor and geneticist about this.

1. If you notice a decrease in abdominal volume ahead of schedule, there is a risk of leakage of amniotic fluid (important article

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 determine 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.

1. Anomalies of internal organs.
2. Premature birth.
3. 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.

1. Vitamins.
2. Medicines to improve metabolism.
3. Drugs to normalize the functioning of the placenta.
4. 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

According to statistics, about 4% of all pregnant women are diagnosed with “oligohydramnios” on ultrasound. The expectant mother begins to worry about how the lack of amniotic fluid will affect the child. And this is a completely normal reaction. After all, oligohydramnios during pregnancy can be a consequence of serious disorders in both the child and the mother. What to do in such a situation? For what reasons does this condition occur and what consequences does it have?

Purpose of amniotic fluid

Water, or amniotic fluid, surrounds the baby throughout the pregnancy. They are located in the amniotic sac - a kind of “sac” in which the fetus forms and develops. By the end of pregnancy, the amount of water is 800-1500 ml. They are constantly updated - approximately once every 3 days.

With each subsequent month, the amount of amniotic fluid increases. At first, the baby moves easily. However, in the last trimester, despite the increase in the amount of amniotic fluid, he becomes cramped.

Amniotic fluid plays an important role:

1. They help create the habitat necessary for the fetus.
2. Contains nutrients and vitamins.
3. Prevents fusion of the baby's skin and the amniotic sac.
4. Protects from injury.
5. Allows you to move. Movement is very important for fetal development.
6. Protect the umbilical cord and placenta from damage as a result of the baby's movements.
7. If there is a sufficient amount of amniotic fluid in the amniotic fluid, the baby will take the desired position at the time of birth.
8. Thanks to the waters, it is easier for the mother to tolerate the motor activity of the fetus.
9. The waters help open the cervix during childbirth.

Why is there not enough water?

Oligohydramnios is a decrease in the amount of amniotic fluid. Typically, this diagnosis is made in the last weeks of pregnancy if the amount of water decreases to 500 ml. In the classic version, oligohydramnios is a deviation from the norm just before childbirth. However, this phenomenon occurs at 20, 30, 33 and even 35 weeks. For what reasons does this condition develop?

Factors that cause oligohydramnios during pregnancy are divided into 5 groups.

Congenital malformations of the fetus

• Improper formation and development of urethral valves.
• Complete absence of the urethra or its narrowing.
• Too narrow ureters.
• Complete absence of the muscles of the anterior abdominal wall and malfunctions of the urinary system.
• Lack of kidneys.
• Polycystic disease (formation of cysts in both kidneys).

Fetal pathologies

• Infection of the fetus with cytomegalovirus, chlamydia, etc.
• Slow development.
• Down syndrome and other chromosomal disorders.

Chronic diseases of the mother

• Diseases of the heart and blood vessels, such as hypertension or venous insufficiency.
• Preeclampsia (toxicosis of the second and third trimester).
• Pyelonephritis, renal failure and other kidney diseases.
• Lupus, arthritis, rheumatism and other diseases from the collagen group.
• Overweight.
• Diabetes.
• Dehydration.
• Smoking.

Problems with the placenta

• Failure.
• Placental infarctions.
• Abnormal development, for example, amnion necrosis or atrophy.

Other factors

• More than 42 weeks of pregnancy.
• Injuries to the amniotic sac.
• Water leakage.
• Death of the fetus inside the womb.
• Long-term use of drugs that allow you to maintain pregnancy and delay childbirth.

It turns out that most causes of oligohydramnios can be prevented. It is impossible to correct only congenital malformations.

However, they can be detected by ultrasound, which is performed at 12, 20 and 35-36 weeks.

Now the most common causes of oligohydramnios in pregnant women are considered to be gestosis, hypertension, diabetes mellitus, colds or ARVI, TORCH infections (toxoplasmosis, rubella, etc.), chronic oxygen starvation of the fetus.

TORCH infections, in addition to oligohydramnios, cause developmental defects in the child. To avoid problems, you need to get tested for these infections before conception.

If oligohydramnios is caused by an acute respiratory viral infection or a common cold, there is no reason to worry. The amount of water will be restored within a month.

Classification

The duration of oligohydramnios during pregnancy can be acute or chronic:

• Acute occurs spontaneously and is called benign. Such oligohydramnios is usually associated with external circumstances, such as colds.
• In the second case, oligohydramnios develops latently, and its causes are difficult to eliminate. A woman must undergo a thorough examination to prescribe therapy. Chronic oligohydramnios will not go away on its own; it can progress.

According to the time of development, oligohydramnios can be early or late:

• Early oligohydramnios is considered the most dangerous. It usually appears between 16 and 20 weeks. During this period, the child develops most actively. Therefore, it is worth undergoing a detailed examination and starting treatment immediately.
• Late oligohydramnios appears mainly in the third trimester. May be a consequence of abnormalities in fetal development.

Based on injuries to the membranes, oligohydramnios can be primary or secondary:

• Primary may appear in intact membranes.
• Secondary appears when the membranes are damaged and water leaks.

How does it manifest?

It is very difficult to notice oligohydramnios on your own at any stage, be it 20, 33 or 35 weeks of pregnancy. For a woman to suspect something, there must be critically little water. With moderate oligohydramnios, the expectant mother does not experience any symptoms.

If oligohydramnios is severe, the baby becomes cramped in the uterus, and his every movement is reflected in pain in the pregnant woman’s body.

A gynecologist may suspect oligohydramnios if the size of the uterus does not correspond to the gestational age or parts of the baby’s body are easily palpable. At the slightest suspicion, a pregnant woman will be sent for an ultrasound, where a specialist will determine the amniotic fluid index (measured in millimeters).

What is the danger?

Does oligohydramnios always have a negative effect on the child and mother? What could be the consequences of this condition? It is difficult to give an unambiguous answer to these questions - it all depends on the timing and reasons.

If a lack of amniotic fluid occurs in the middle of pregnancy, between 17 and 27 weeks, the baby is squeezed from all sides by the walls of the uterus. There is no room left for him to move and grow.

As a result, some deviations in its development may appear:

• clubfoot,
• dislocated hips,
• deformation of the skull.

If you consult a doctor in time, these defects can be eliminated.

What could be the consequences if oligohydramnios occurs in the later stages, from 35 weeks to the time of birth? Childbirth will involve some difficulties. With oligohydramnios, the amniotic sac becomes flat and does not in any way contribute to the opening of the cervix. As a result, the birth process is delayed. In most cases, doctors decide to perform a caesarean section.

Women who suffer from oligohydramnios have a much higher risk of bleeding in the postpartum period.

The most dangerous period

The critical period is considered to be 30-33 weeks. Oligohydramnios occurs more often at 30-33 weeks than at other periods and is a consequence of oxygen starvation of the fetus. In this condition, all the blood collects in the brain and heart. The lungs and kidneys are starving. The process of producing amniotic fluid, for which these organs are responsible, is disrupted.

At 30-33 weeks, the amniotic fluid index ranges from 74 to 274 mm.

Doctors call this period critical: oligohydramnios can lead to serious consequences and even provoke the death of a child.

How is it treated

Management of pregnancy and childbirth, as well as possible therapy, depend on the trimester in which oligohydramnios occurred and how severe it is. The most risky is the second trimester. In case of danger, doctors try to prolong the pregnancy for as long as possible so that the baby has time to develop and become viable. This process is called prolongation.

If oligohydramnios is detected in the third trimester, it will be difficult to prolong the pregnancy. In the absence of disturbances in the development of the child, delivery is indicated at a period of 37-38 weeks.

To alleviate the condition of a pregnant woman, doctors eliminate the cause of oligohydramnios. They also prescribe medications to improve blood flow in the placenta. It is important to constantly monitor the baby’s condition using ultrasound, CTG (cardiotocography) and Doppler.

If the fetal condition worsens sharply according to CTG data, a cesarean section is performed.

Reverse situation

Sometimes a woman develops a condition that is completely opposite to oligohydramnios - moderate polyhydramnios during pregnancy. This is an increased level of amniotic fluid.

As with oligohydramnios, the causes of polyhydramnios are chronic diseases and problems in fetal development. This condition can also be a consequence of pregnancy with twins, triplets, etc.

Even moderate polyhydramnios during pregnancy can seriously complicate childbirth and postpartum recovery. In addition, it is very dangerous for the child.

So, oligohydramnios and polyhydramnios during pregnancy occur due to diseases of the mother’s body or disorders in the development of the fetus. It doesn’t matter what stage of pregnancy you are: 20, 33, 35 or 40 weeks, in order to avoid serious consequences, you need to follow all doctor’s orders.