OLIGOHYDRAMNIOS (LOW AMNIOTIC FLUID) Part 2

Last week, we started a topic on Oligohydramnios. We defined Amniotic fluid and Oligohydramnios, explained the causes, signs and symptoms. This week, we will conclude with complications that may arise with low amniotic fluid, diagnosis, prevention, management and treatment.

COMPLICATIONS OF OLIGOHYDRAMNIOS

Amniotic fluid is very important for healthy fetal growth and development so abnormally low fluid levels may be harmful no matter when it occurs. However, the particular risks and potential complications from oligohydramnios vary depending on the trimester in pregnancy  when the condition occurs.

Generally speaking, oligohydramnios during the first six months of pregnancy is more dangerous. These complications could consist of:

• Low amniotic fluid in the first half of pregnancy may result in developmental birth defects caused by pressure compression of the fetus’s organs as they develop inside the womb.
• Deformities: Due to the fetus’s inability to move and stretch due to a very low amniotic fluid level, it may develop contractures or tightness in the joints.

If oligohydramnios is discovered in the third trimester of pregnancy (weeks 28 to 40), complications could include:

• Respiratory issues or underdeveloped lungs: The amniotic fluid is crucial for lung development because it forces the air sacs to open and encourages them to expand. A few lung tissues that cause breathing issues after delivery could be caused by extremely low amniotic fluid levels.
• A very low amniotic fluid level may result in intrauterine growth restriction and umbilical cord constriction, which may cause fetal distress and increase the risk of premature or cesarean delivery.
• If the water breaks too soon, there is an increased risk of infection.

DIAGNOSIS OF OLIGOHYDRAMNIOS

The diagnosis of oligohydramnios should be confirmed by the following:

• Patient history: For conditions linked to oligohydramnios, a thorough maternal and family history, including prior medical history, previous pregnancies or medication use may be used as a screening tool.
• Physical examination: During the examination, the clinician may look for symptoms like urinary incontinence, feeling damp or fluid leakage. A speculum examination or measurement of fundal height may be used to look for decreased fundal size or fluid pooling in the perineum.
• Doppler ultrasound:  This is used to assess the exchange between the placenta and the fetus by measuring the blood flow to the fetal blood vessels.

PREVENTION OF OLIGOHYDRAMNIOS

There is little or nothing that may be done to prevent oligohydramnios. However, attending all prenatal checkups and be honest with the clinician concerning your symptoms and medical history will help  in diagnosis. Listed below are some things that may help prevent Oligohydramnios.

• Do not smoke: Nicotine in cigarettes raises the possibility of PROM (Premature Rupture Of Membrane) or placenta issues. Additionally, nicotine contributes to low birth weight and other health issues for the infant.

• Eat a variety of healthy foods: Fruits, vegetables, low-fat dairy products, lean meats, and beans are examples of healthy foods. You may be able to prevent diabetes and gain a healthy amount of weight during pregnancy by eating healthy foods.

• Take prenatal vitamins as directed: The minimum amount of folic acid in the supplements should be about 400 micrograms. Spina bifida and other birth defects are prevented by folic acid.

• Drink liquids as directed:  Dehydration and high blood pressure may be avoided by drinking more fluids.

• Control diabetes or other medical conditions: Diabetes may harm the unborn child by causing excessive weight gain. Work with the clinician to control blood sugar levels before and during subsequent pregnancy if you have diabetes.

MANAGEMENT AND TREATMENT

There is no long-term treatment for oligohydramnios, but certain procedures could momentarily raise amniotic fluid levels, depending on the fetus’ gestational age.(age of baby).

The gestational age of the fetus determines the course of treatment for oligohydramnios. When the fetus is nearly at full term (37 weeks), the clinician may decide that inducing labor early is best for the baby’s safety. If not up to term the clinician may conduct more frequent prenatal visits. However, there are few factors that may momentarily increase amniotic fluids which include the following:

• Biophysical profile: This procedure monitors the fetus’s movement, muscle tone, heart rate, breathing and the amount of amniotic fluid surrounding the fetus in the uterus.

• A fetal non-stress test: During this test, the fetus’s heart rate and movements are monitored both when it is active and when it is not. The clinician might ask you to perform kick counts. This entails keeping track of how many times an hour you feel the baby move.

• Monitoring: The clinician may schedule a frequent prenatal visit. This may include weekly ultrasounds to check the amount of amniotic fluid.

• Amnioinfusion:  Here, a special fluid (saline solution) is injected into the amniotic sac to replenish any lost or depleted amniotic fluid. When a woman’s membranes have ruptured during labor, amnioinfusion may be administered. Umbilical cord compression may be prevented by the fluid’s ability to relieve pressure on the cord.
• Labor induction or Cesarean delivery: The fetus may need to be delivered in cases where the fetal circulation may be compromised or if the fetal heart rate becomes abnormal in order to prevent birth injuries.

• Supportive therapy: While temporary solutions like fluid intake and bed rest may help increase amniotic fluid, they do not address the underlying cause of oligohydramnios. Typically, oral hydration is advised, but in some situations, intravenous hydration may be required.

• Medications: Antibiotics may be administered to treat oligohydramnios, which are caused by premature membrane rupture, as well as medications like steroids that may help the fetal lungs develop if the placenta is not functioning properly.

• Amniocentesis: This process is used to collect an amniotic fluid sample from the womb. Cells in the fluid can be examined for birth defects and other issues.

CONCLUSION

Oligohydramnios, also known as low amniotic fluid, is a potentially serious condition. It may hinder the development of the unborn child and lead to pregnancy complications. Even though the majority of women who are diagnosed with low amniotic fluid go on to have healthy babies. The clinician will monitor you closely to determine the safest treatment plan. The best way to spot potential problems and reduce more complications is to share pregnancy symptoms and make sure to attend all prenatal appointments.