If you do have low amniotic fluid, there are a number of treatments including delivery that can help keep your little one safe and healthy. Polyhydramnios is another name for having too much amniotic fluid. Discover the causes and learn more about the…. Babies breathe in the womb very differently than they do after birth.
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Health Conditions Discover Plan Connect. Medically reviewed by Debra Sullivan, Ph. How does amniotic fluid work, anyway? What could be causing a low level? Talk to your doctor. Parenthood Pregnancy. How Do Babies Breathe in the Womb? Maintaining a Healthy Pregnancy. Read this next. Reference article, Radiopaedia. URL of Article. Technique the uterus is divided into four imaginary quadrants with the linea nigra and a mediolateral line running through the umbilicus acting as the vertical and the horizontal axes respectively the deepest pocket devoid of an umbilical cord and fetal parts is measured in the vertical dimension measurement of the four pockets is in centimeters the sum of all the four quadrant measurements is the AFI normal AFI values range from 5 to 25 cm Values The normal range for amniotic fluid volumes varies with gestational age.
Am J Obstet Gynecol. Amniotic Fluid Index. J Reprod Med. Obstet Gynecol. Related articles: Pathology: Genitourinary. A doctor may advise more bed rest and decreasing physical activity for women with low amniotic fluid levels. For this treatment, the doctor will introduce a saline solution via the cervix into the amniotic sac to increase fluid levels. If amniotic fluid drops too low during the final stages of pregnancy, doctors may suggest early labor.
Bringing labor forward can help to prevent any potential complications during delivery. While oligohydramnios occurs when a woman has very low levels of amniotic fluid, polyhydramnios is when the fluid levels are extremely high.
Oligohydramnios is a condition where a pregnant woman has too little amniotic fluid. Symptoms and signs of oligohydramnios include:. Oligohydramnios is most common in the last 3 months of pregnancy, known as the third trimester. Polyhydramnios , or hydramnios, is when levels of amniotic fluid are too high. Hydramnios happens if there are problems with amniotic fluid leaving the body, or if the body is creating too much of it.
Untreated polyhydramnios can cause complications for the pregnant woman and the developing fetus. These complications can include early labor or congenital disabilities. A doctor will take a medical history to check for any preexisting conditions and carry out a physical examination. A doctor will use ultrasounds and measure amounts of amniotic fluid to check levels. Once a doctor has checked levels and found any possible causes, they can decide on the best treatment options.
If a pregnant woman has low levels of amniotic fluid towards the end of a healthy pregnancy, they may not need any treatment. A doctor may just carry out additional monitoring to keep a closer eye on levels, including more frequent ultrasounds. If a pregnant woman has a lower level of amniotic fluid than usual, they or their healthcare team can remedy this. Drinking more water is a simple way of increasing amniotic fluid while resting and decreasing physical exercise may also help.
Obtain peak systolic velocity in the middle cerebral artery to rule out fetal anemia. Examine the placenta with color and power Doppler to rule out placental hemangiomas. If it has not been done, screen for diabetes mellitus, because a linear relationship has been reported between AFI and birth weight centiles in a poorly controlled diabetic population. If fetal hydrops is detected , request indirect Coombs to rule out an immune etiology as well as maternal testing to rule out congenital infections.
Also evaluate for signs of cardiac failure eg, triscuspid regurgitation, pulsations in umbilical vein. If polyhydramnios is associated with other conditions, management is based on the underlying condition. Monitor fetal well being Because of the above-mentioned associations between polyhydramnios and adverse obstetric outcome, some experts have suggested institution of fetal testing in the presence of polyhydramnios eg, NST weekly until delivery.
Use caution in interpreting the BPP score in the presence of polyhydramnios, since the 2 points for AFV in these cases are not necessarily reassuring. In addition to monitoring fetal well being, measures can be implemented to reduce the amount of amniotic fluid, including amnioreduction Table 7.
Before 34 weeks, the procedure can be preceded by prophylactic maternal administration of steroids for fetal lung maturity enhancement in case the procedure results in preterm labor and delivery or triggers placental abruption. Although fetal lung maturity tests can be assessed at the time of amnioreduction after 34 weeks, their utility is limited because timing of delivery is mostly affected by the coexisting anomalies with possible need for neonatal corrective surgeries and maternal symptoms.
For mild to moderate polyhydramnios with reassuring fetal testing, there is no need to change standard obstetric management. For severe polyhydramnios, care should be taken at the time of membrane rupture to avoid umbilical cord prolapse or abruption. One solution is to perform an amnioreduction in early labor; alternatively the membranes can be needled to allow gradual spillage of fluid, or can be ruptured at early cervical dilation, because prolapse of a loop of cord is more common as cervical dilation increases.
AFV abnormalities-whether diminished or excessive-should prompt an evaluation for underlying causes. Association and prediction of amniotic fluid measurements for adverse pregnancy outcome: systematic review and meta-analysis.
Sonographic estimation of amniotic fluid volume. Subjective assessment versus pocket measurements. J Ultrasound Med. Ultrasound estimate of amniotic fluid volume: color Doppler overdiagnosis of oligohydramnios. Obstet Gynecol. Amniotic fluid volume estimation and the biophysical profile: a confusion of criteria. Amniotic fluid index and single deepest pocket: weak indicators of abnormal amniotic volumes. How well do the amniotic fluid index and single deepest pocket indices below the 3rd and 5th and above the 95th and 97th percentiles predict oligohydramnios and hydramnios?
Am J Obstet Gynecol. Amniotic fluid index versus single deepest vertical pocket as a screening test for preventing adverse pregnancy outcome. Cochrane Database Syst Rev. Small sac size in the first trimester: a predictor of poor fetal outcome.
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