Incidents 

Low water treatment at home. Low water in pregnant women - the diagnostic significance of the indicator. Normal Amniotic Fluid Index Scores

Every woman dreams that her pregnancy would proceed easily and naturally, so that no one and nothing could distract the expectant mother from pleasant thoughts about her future child. However, in reality, not everything goes so smoothly.

Low water can become one of the serious complications. We will tell you about what it is and how to treat it in this article.


What it is?

In a broad sense, oligohydramnios is called a decrease in the amount of amniotic fluid from the norms characteristic of a particular period of pregnancy. However, in the classical sense of the word, oligohydramnios is considered a small amount of amniotic fluid on the eve of childbirth, at about 39-40 weeks.

When there was no ultrasound, and one could only guess about the amount of water, the lack of water was really determined just before the very birth. Now, thanks to the development of diagnostics, it is possible to identify a tendency to a decrease in water in the fetal bladder is possible from the 16th week.

Water is essential for the normal development of a child. They are also a nature-provided shock absorber, softening shaking, swaying, which the baby could quite significantly feel when walking or other actions of a pregnant woman, if the water did not interfere with this.


Amniotic fluid begins to be produced at about 8 weeks of gestation, and with an increase in gestational age, it also increases in volume. In the 3rd trimester, there is a slight decrease in fluid, because the uterus is already strongly stretched by the grown child.

Many years of studying intrauterine development have allowed doctors and scientists to calculate the normal amounts of amniotic fluid determined for each period. It is not customary to measure them with standard liquid measures - milliliters, for example.

To assess their number, there is a special parameter - the amniotic fluid index. It can be determined in millimeters starting from the 16th week of gestation when undergoing an ultrasound scan.


IAZH standards - table:

Obstetric term, (week)

IAZH (limits of the norm), mm

Obstetric term (week)

IAZH (limits of the norm), mm

Since the amount of water in the fetal bladder is not a constant value, at different periods, the same expectant mother may find lack of water, and after a few weeks it is not detected. This natural phenomenon is called functional dryness. This is the most harmless of all types of this complication.


Usually, with a medical verdict "lack of water", a woman falls into a stupor. Future mothers should be reassured by the following official statistics from the Ministry of Health:

  • oligohydramnios is accompanied by about 4% of all pregnancies;
  • only 0.5-1.2% of such cases have pathological causes;
  • all other women (and from the overwhelming majority) perfectly wear out and give birth to healthy children, since their lack of water was physiological.

Malnutrition pathological is considered to be a persistent insufficient amount of amniotic fluid, which can be registered repeatedly at a variety of times, starting from 16 weeks.


Classification

Low water can be acute if it appeared suddenly under the influence of negative factors, or it can develop gradually and almost imperceptibly, and then it will qualify as chronic.

With acute oligohydramnios, the body of a pregnant woman can react to a viral disease, influenza or ARVI, from which the expectant mother could not protect herself during the period of bearing the baby. This violation is usually temporary and does not mean that the baby has pathologies.

Chronic oligohydramnios is more dangerous. It usually develops due to problems that cannot be called quickly eliminated - mom's diabetes, obesity, as well as child's malformations and prolonged hypoxia. Such a violation will not go away by itself, it definitely needs treatment. Also, the violation can be early if it was detected between 16 and 20 weeks and late if the problem was detected only after 26 weeks.

In the case of early low water, the doctors' forecasts are less optimistic, because the process of the formation of the baby's internal organs and systems has not yet been completed.


Pronounced lack of water at an early stage may be an indicator of gross genetic abnormalities in a baby, and therefore such a "find" on an ultrasound scan needs a detailed study by means of other diagnostic methods. In the later stages, the violation is often functional, quite natural, it can be easily corrected or goes away on its own.

Sometimes the development of such a violation is influenced by the membranes, or rather their integrity:

  • if they are not changed, not injured, then doctors talk about primary oligohydramnios;
  • if the shells are damaged and water leaks, this is a secondary violation.

Primary oligohydramnios occurs in 80% of cases. According to the quantitative indicator of deviations from the norms indicated in the table, moderate and severe low water are distinguished.


Causes

The reasons for the decrease in amniotic fluid, which are so important for the baby, are manifold. It can be malformations of the child, his diseases, pathology of the placenta, as well as diseases of the expectant mother, both acute and chronic.

Some genetic, including chromosomal abnormalities that arose during conception, during the formation of the genetic code, the karyotype of the fetus, proceed precisely against the background of a decrease in the amount of amniotic fluid.

In particular, such defects as abnormal development of the urethra and its valves, as well as abnormal narrowing of the baby's urethra or its complete absence, solidary (on both sides) narrowing of the ureters or anomalies in their structure, lead to the development of oligohydramnios.

Pronounced oligohydramnios is observed in pregnant women in the event that the baby, by a "mistake" of nature, completely lacks the kidneys as such.


Baby polycystic kidney disease (Potter's syndrome) is also an obvious cause of abnormal pregnancy. Among chromosomal abnormalities, oligohydramnios are most often accompanied by Down's syndrome and Turner's disease.

If everything is in order with the baby's genetics, and this was confirmed using other diagnostic methods, then doctors consider the likelihood of infection of the fetus. The most dangerous in terms of the risk of oligohydramnios are cytomegalovirus infection and chlamydia. The lag in the amount of water from the norms often happens with a delay in fetal development.

The main maternal ailment that can lead to oligohydramnios is gestosis. In addition, such a condition can cause venous insufficiency, a tendency to form blood clots, and diseases of the cardiovascular system.


Adversely affect the amount of water and kidney ailments in the expectant mother, and diabetes mellitus. Dehydration can also cause a decrease in amniotic fluid, as well as smoking, which some of the expectant mothers, even in an "interesting position", and can not say goodbye.

Pathologies of the placenta - insufficiency, heart attacks of the "child's place", any anomalies in its development, which occurred during the formation of this temporary organ at the very initial stages, lead to lack of water.

Among other reasons that can lead to such an unpleasant complication of pregnancy are prolongation, in which natural aging of the placenta occurs, trauma to the membrane of the membranes, mothers taking a large number of medications for a long time, as well as fetal death and multiple pregnancies.


Symptoms and Signs

A woman practically cannot determine her oligohydramnios on her own, this is a matter of specialists. Only a few signs can indirectly indicate the likelihood of a decrease in the amount of amniotic fluid.

Usually, in women with oligohydramnios, the size of the abdomen is smaller than it should be in time. It becomes possible to establish a violation thanks to measurements of the height of the day of the standing of the uterus, which are carried out at each scheduled examination in the antenatal clinic.

When the expectant mother begins to feel the movements of her child, with oligohydramnios, they can be quite painful for a woman.

It is impossible to keep silent about such sensations, if the symptom was not diagnosed earlier, it is imperative to inform the doctor about your suspicions, who will prescribe all the diagnostics required in this case.


Diagnostics

The amniotic fluid index is determined by the ultrasound doctor. It measures the distance, free from the baby's limbs and the umbilical cord, between the baby and the anterior abdominal wall, its inner surface. This measurement is called a vertical pocket.

If the result of measurements after a comparative analysis with the tables shows that the amount of water has been reduced, the degree of violation is revealed. With moderate low water, the index is reduced by 10-15% compared to the above norm, and the vertical pocket, which with a normal amount of water is 5-8 cm, is reduced to a size of less than 5 cm.

A pronounced violation is such a violation in which the vertical pocket does not exceed 2 cm, and the amniotic fluid index deviates from the norm downward by 15-20%. To imagine in more detail all of the above, we present a comparative table.


Violations of the amount of amniotic fluid:

Obstetric term, week

Moderate oligohydramnios - amniotic fluid index, mm

Severe oligohydramnios - amniotic fluid index, mm


If an ultrasound specialist indicates in the conclusion that a woman has signs of moderate low water, an obstetrician-gynecologist be sure to send her to doppler and expert ultrasound, in order to more accurately know the state of the child, the placenta and blood flow in the uterine vessels.

When the ultrasound protocol indicates that a pregnant woman has severe oligohydramnios, she is hospitalized for a more thorough examination.

If the reason lies in the congenital abnormalities of the baby, it is recommended to terminate the pregnancy for medical reasons. To agree or not, it is up to the pregnant woman herself to decide. If she refuses, then the child is kept until the very birth, they provide him with the necessary medicinal support.


Possible consequences for the mother

A woman with low water threatens with termination of pregnancy in the late stages, traumatizing both the psyche and the physical health of the reproductive system. If the child dies, there will be no other option. After interruption for a long time, a woman may experience a nervous breakdown and develop secondary infertility.

A small amount of amniotic fluid aggravates the very process of childbirth. Weakness of labor forces often develops, the woman is threatened with a cesarean section. The postpartum period in such women is more difficult, complications are likely.

The pregnancy itself can give the expectant mother a lot of unpleasant sensations: the larger the child becomes, the more difficult it will be for a woman to withstand his movements.

The likelihood of miscarriage during pregnancy with oligohydramnios is high, the risk of premature birth is even higher - it reaches 26%.


Possible consequences for the child

Children born after pregnancy with oligohydramnios are low in weight, weaker than their peers, even if the pregnancy is full-term before the expected date of delivery.

The most severe consequences of prolonged polyhydramnios include various adhesions of the skin of the fetus and the membranes of the amniotic bladder. As a result of such adhesions, all the free space of the uterine cavity can be filled with cords. They can also entangle a baby.

Due to the pressure that the strands will exert on the fetal tissue, irreversible deformities are formed - in babies, limbs are self-amputated or severely bent, there are defects in the face and chest. The baby's appearance is completely disfigured. The frequency of such consequences is low, but this cannot be ruled out.

The likelihood of such outcomes increases if oligohydroamnion is diagnosed early, at 16-20 weeks, and persists throughout pregnancy.


In childbirth, the baby may face other troubles associated with a small amount of amniotic fluid - prolapse of the umbilical cord, premature violation of the integrity of the amnion and, as a result, a long anhydrous period, which can result in hypoxia and infection.

Many women mistakenly believe that lack of water is the cause of the development of diseases such as Down syndrome, as well as other chromosomal abnormalities. The logical connection here is the opposite - with Down syndrome, oligohydramnios often develops, and not vice versa.

Almost always, a protracted oligohydramnios causes a delay in the intrauterine development of the baby. Dangerous in this case is the underdevelopment of the lungs with which mothers give birth to such babies.


However, if help was provided to the baby correctly and in a timely manner, then the child quickly enough then begins to gain weight and soon catches up with his peers in physical development. However, intellectually, the baby can develop late for a long time.

Dangerous from the point of view of the likelihood of complications are also cases of detection of oligohydramnios later, at 30 weeks pregnant, but only on condition that the pathological condition persists for 4-6 weeks or more.

For any negative consequences of low water for a child's health, there is a regularity - the earlier this condition occurs, the more serious the consequences can be.


Treatment

Low water therapy is always comprehensive. And it begins with establishing the exact cause that caused the pathological decrease in the amount of amniotic fluid.

First of all the version with chromosomal abnormalities is being checked. For this, a woman, depending on the period, is sent to one of the methods of invasive prenatal diagnosis.

If oligohydramnios is diagnosed at 16 weeks, a chorionic biopsy can be performed. If the fact of lack of water became known later, the woman can be referred for cordocentesis, amniocentesis.


These procedures will help to obtain samples of amniotic fluid with particles of the baby's epithelium, cord blood from the umbilical cord. An analysis will be carried out in the genetic laboratory, which allows to speak with a high degree of accuracy about the presence or absence of Down syndrome, Cornelia de Lange syndrome and other anomalies associated with a violation of the number of chromosomes in the karyotype and causing oligohydramnios. Such studies are usually carried out is free.

Recently, it has become possible to do a non-invasive prenatal DNA test, which is still expensive. It is absolutely safe for the baby and is based on the isolation of the baby's DNA from the venous blood of the pregnant woman. This test detects chromosomal abnormalities with a probability of 99.9% and is an ideal alternative to invasive tests that can be dangerous for both the pregnant woman and the fetus.

When confirming the cause of oligohydramnios due to chromosomal abnormalities, termination of pregnancy is recommended.


If the additional examination does not show the presence of gross chromosomal abnormalities in the child, then ultrasound specialists of an expert class will look for physical defects. To do this, they will carefully study the baby's urinary system - the ureters, urethra, kidneys. Particular attention will be paid to the health of the placenta. To assess blood flow in the uterine vessels, ultrasound is performed.

The attending physician will refer the woman for blood tests, which can confirm or deny the presence of infections, including sexually transmitted infections.

Blood must be donated for sugar and urine for protein content. The doctor monitors the blood pressure of the expectant mother to exclude gestosis as a cause of oligohydramnios.


If the cause is found, doctors decide how to treat the underlying disease, almost all of them, except for congenital malformations of the fetus and chromosomal pathologies, are amenable to therapy. At the same time, the control over the state of the fetus is enhanced.

Moderate oligohydramnios can be treated at home. in most cases, hospitalization is not required, if the expectant mother follows all the doctor's recommendations.

Severe oligohydramnios, if detected early, is also an indication for termination of pregnancy; none of the doctors will dare to make predictions about its outcome. With severe lack of water, diagnosed after 26 weeks, the woman is hospitalized.


Drug treatment

Expectant mothers with severe oligohydramnios are injected intramuscularly with vitamin solutions. In addition, she is given droppers with drugs that improve uteroplacental blood flow. Typically used for this Actovegin. Additionally, doctors recommend taking "Courantil", the dosage and frequency of taking this drug is determined by the doctor.

A pregnant woman may be prescribed broad-spectrum antibiotics to help control the infection, if any. During the period of carrying a baby for these purposes, it is often recommended "Amoxiclav". To improve metabolic processes in a woman's body, drugs such as "Hofitol", as well as multivitamin complexes designed and created specifically for pregnant women.

Simultaneously with taking drugs in a hospital, the baby's condition is checked daily or every other day. A woman is given CTG, if the gestational age is already above 28 weeks, the functionality of the placenta is monitored using ultrasound scan, an ultrasound scan can be performed at any time to assess the amount of water in dynamics.



Any alarming symptoms that may indicate fetal dysfunction can at any time become a decisive reason for doctors to carry out a cesarean section ahead of schedule.

With moderate lack of water, which, according to the doctor, is of a physiological origin, the woman is discharged "Courantil", "

Long walking, playing sports with such a complicated pregnancy are undesirable. Additionally, you will have to limit sex. Overweight, obese pregnant women are advised to go on a special diet in order to exclude even more weight gain.

Nutrition with oligohydramnios should include a large amount of fruits and vegetables, proteins and fats should be balanced, and fast carbohydrates (sweets and pastries) should be avoided altogether.

If there is swelling, you should definitely consult a doctor, to work out together a correct and sufficient drinking regime. With preeclampsia and hypertension, it is important to measure arterial blood pressure twice a day. With a significant increase in it, a woman needs qualified medical care.



Traditional methods of treatment

Alternative medicine is ready to offer pregnant women with moderate low water content a lot of useful and enjoyable recipes and products that, if they do not increase the amount of water, will definitely be able to satisfy the needs of a future mother with a deficiency of amniotic fluid in essential minerals and vitamins.

Folk remedies should not even try to treat severe lack of water. But with minor deviations from the norm, a woman may well use some advice if her doctor has nothing against it.

The need for minerals with oligohydramnios will help restore figs, melons and grapes. It is also good, according to the reviews of expectant mothers, zucchini and fresh tomatoes help.


A real treasure, a natural "pharmacy" for a pregnant woman with a deficiency of amniotic fluid can become chokeberry. A woman can take 50 grams of juice from her or about 100 grams of berries per day.

Another favorite remedy for oligohydramnios is strawberries. They are eaten fresh or brewed with homemade fruit drink to improve the normal functioning of the kidneys. If the pregnancy fell out in the winter and there is nowhere to take strawberries, you can drink weak tea with strawberry jam. If this is not in stock, you can purchase it.


Prophylaxis

Correct and responsible planning of the baby will help to avoid low water during pregnancy. A woman should be examined in advance by doctors of various specialties. who will be able to answer questions about her state of health and the presence or absence of chronic diseases.

Of course, it is not necessary to carry out a full medical examination, but a woman who dreams of a child is simply obliged to visit a cardiologist, therapist and nephrologist. Visits to these specialists will help ensure that the heart, kidneys, and general health will help a woman carry her baby without complications.

If the age of the expectant mother is over 35 years old, it is worth consulting with a geneticist, because the likelihood of conceiving and giving birth to a child with Down's or Patau's syndrome increases in proportion to the mother's age.

It will be correct to do tests for genital and other infections even before conception, and if something like this is found, treat them before the child is conceived.


You should quit smoking before conception, in extreme cases, as soon as it becomes known about the pregnancy. Smoking, and it has been proven, very often acts as a provoking factor of oligohydramnios.

During pregnancy, a woman for preventive purposes it is important not to refuse to undergo mandatory screening tests in the first, second and third trimester, do not give up ultrasound and the delivery of certain tests recommended by the doctor.

Expectant mothers should beware of viral infections, especially during periods of massive incidence of acute respiratory viral infections and influenza, in order to avoid the development of oligohydramnios after an illness. To do this, you should refrain from visiting shopping centers and public transport during seasonal epidemics, observe the rules of personal hygiene.

If the doctor insists on hospitalization, you should not refuse it either, even if the woman herself thinks that she is feeling great and she does not have time to stay in the hospital at all.


This is a decrease in the amount of amniotic fluid to 500 ml or less.

Causes of low water during pregnancy

The reasons for this violation are not well understood. It is believed that oligohydramnios is associated with insufficient formation of amniotic fluid by the membranes or with their increased absorption by the placenta or membranes. Often, lack of water is associated with malformations of the kidneys of the fetus, the form of their complete absence, narrowing of the ureters.

Also of some importance is a violation of blood flow in the placenta-fetus system.

Low water adversely affects the course of pregnancy and fetal development. A small amount of water constrains the movement of the fetus, the forced position bends the spine, torticollis or clubfoot are formed, and other deformities of the skeleton. With a small amount of water, the skin of the fetus touches the membranes, which can form threads (strands) of adhesions of the parts of the fetal body with the membranes. Such strands during fetal movements can entail entanglement with the umbilical cord, squeeze fingers and limbs, sometimes even up to their amputation, cause impaired blood circulation of the fetus when the umbilical cord vessels are compressed.

The diagnosis is made by ultrasound, in dynamics. A pregnant woman with oligohydramnios is hospitalized in a maternity hospital, where treatment is carried out to improve blood flow in the placenta, to improve its nutritional function. Often oligohydramnios is complicated by premature birth, placental abruption.

If oligohydramnios is diagnosed in combination with fetal malformations, then the pregnancy is terminated for medical reasons. With fetal growth retardation, the outcome of pregnancy becomes problematic. In the third trimester, pregnancy is prolonged up to 37 weeks and early delivery is carried out with careful monitoring of the condition of the fetus.

A pronounced oligohydramnios is characterized by a decrease in their number to 100 ml or less (in severe cases, there may even be several milliliters of fluid in the amniotic fluid).

The reasons for the development of low water are diverse, although, as with polyhydramnios, the reliable reasons are not precisely established and little studied. Most often, this pathology is formed with insufficient development of the amniotic epithelium (inner cystic membrane) or a decrease in its secretory (excretory) function. It is believed that a certain value in the occurrence belongs to the increased ability of the amnion (fetal bladder) to resorption (reabsorption) of amniotic fluid (cases of complete disappearance of amniotic fluid are described in the scientific literature, the amount of which was normal at the beginning of pregnancy). By itself, a decrease in the volume of water does not have pronounced harmful consequences in the case when it does not last long and then gradually recovers to the proper level. However, along with a reduced amount of water, fetal growth retardation syndrome is more common. This is due to the fact that in a hypotrophic (low-weight) fetus, the normal functioning of the kidneys is naturally disrupted, and a decrease in hourly urine output gradually leads to a decrease in the volume of amniotic fluid. Low water is quite common in cases of development of identical twins, which is explained by the uneven distribution of blood circulating in the common placental apparatus between the two twins. These reasons are put forward as the most often assumed, however, along with them, the cause of oligohydramnios may be associated with various extragenital (outside the reproductive system) pathology of the mother (cardiovascular failure, impaired renal and liver function).

When this kind of pathology appears, in most cases complications of pregnancy and the course of childbirth occur, which ends in spontaneous miscarriage, premature birth.

The presence of low water during pregnancy adversely affects the growth and development of the fetus, therefore, this condition belongs to the category of painful conditions and requires a full examination and treatment. Developmental disorders are a consequence of limiting the motor activity of the fetus due to insufficient amniotic fluid. Against this background, congenital clubfoot is most common, in some cases curvature of the spine and deformities of other bones of the skeleton. Often, with low water, adhesions are formed between the skin of the child and the amnion. With a further increase in the size of the fetus, they stretch, and after delivery they take the form of strands and threads. It is not excluded, however, the possibility of the development of such strands against the background of an anomaly in the development of the ectoderm. These formations sometimes cover the torso and limbs of the child, the umbilical cord, which causes disfigurement or even amputation of various parts of the body. Possible fetal death as a result of cord clamping. Possible fetal malformations with low water.

Primary oligohydramnios is characterized by a relatively favorable course, since it is not associated with a violation of the integrity of the amniotic membranes. Traumatic or secondary, a much less common form of this pathology, is characterized by damage to the membranes and a gradual expiration of amniotic fluid during pregnancy. Outpouring of amniotic fluid occurs through the gap formed between the membranes and the inner surface of the uterus. The amount of damage can be different, but, as a rule, its size is small and water flows in small portions for a long time into the abdominal cavity (amnional hydrorhea). The process of the flow of amniotic fluid can be either constant or periodic. In the case when the amniotic epithelium has the potential for synthesis, such an outflow of water is compensated for for some time. Persistent cases of progression of oligohydramnios end in early termination of pregnancy.

A pregnant woman, with a decrease in the amount of water, may notice the appearance of pain in the uterus. The pain is constant, aching, aggravated by fetal movements, with a change in the position of the body of the pregnant woman herself. Initially, with the development of the disease, its signs are slightly expressed, they become noticeable for a woman with the development of severe low water and with the addition of fetal malformations (such children are inactive, the heartbeat is slow).

Diagnosis of oligohydramnios during pregnancy

The main diagnostic criterion of pathology is to determine the discrepancy between the size of the uterus and the true gestational age. For diagnostic purposes, an ultrasound examination can be carried out, which helps to determine the exact amount of water, to clarify the gestational age by the size of the fetus, to identify the presence or absence of fetal malformations, to determine its position in the uterus, and also to perform a medical and genetic examination by chorionic biopsy. This study involves the collection of material (blood from the umbilical cord or other vessels) under ultrasound control for the presence or predisposition to the development of genetic developmental abnormalities.

The course of oligohydramnios during pregnancy

The course of pregnancy with the development of oligohydramnios is characterized by frequent miscarriage - early miscarriages or premature births at a later date.

Labor act in the presence of oligohydramnios also proceeds with various complications. Prolonged labor is most common. The opening of the uterine pharynx is extremely slow. This situation is explained by the lack of proper functioning of the fetal bladder, which normally leads to adequate smoothing of the cervix and the opening of the uterine pharynx. Contractions of the uterus are very painful and do not cause the desired reaction from the side of the fetal movement and, accordingly, the opening of the birth canal.

Consequences of oligohydramnios during pregnancy

One of the most common complications of childbirth with oligohydramnios is premature detachment of the normally located placenta. This situation is dangerous by the development of bleeding, up to the death of the mother and fetus. Vaginal (transvaginal) examination during childbirth reveals the absence of tension of the fetal bladder during contractions (flat fetal bladder), while the membranes adhere tightly to the presenting part of the fetus and only interfere with the normal course of the opening period. Spontaneous rupture or artificial dilution of the membranes helps to accelerate the opening of the uterine pharynx and reduce the overall duration of labor. After opening the membranes, a small amount of turbid amniotic fluid is released (often with an admixture of meconium - fetal feces).

Low water leads to unfavorable pregnancy outcomes, however, the severity of the result depends on the gestational age at which the AFV pathology began. On the other hand, if oligohydramnios is the only finding in the third trimester, the fetal outcome is usually good. Since accurate ultrasound assessment of AFF has its limitations, care should be taken to avoid misusing the diagnosis of amniotic fluid loss to avoid unnecessary use of invasive interventions during pregnancy, such as early induction of labor. Despite this controversy, it is prudent to evaluate ultrasound evidence of decreased amniotic fluid volume to ensure that this is indeed the only finding.

Fetal anomalies / aneuploidy

Congenital malformations and fetal aneuploidy are usually associated with oligohydramnios seen in the second trimester. Most of the fetal abnormalities occur in the genitourinary system; defects in the skeleton, central nervous system and cardiovascular system are also associated with oligohydramnios. It is important to remember that secondary oligohydramnios as a result of renal abnormalities is not detected until 18 weeks of gestation, since up to 14-18 weeks the maternal contribution to the formation of amniotic fluid remains high. A comprehensive ultrasound assessment of the structure of the internal organs of the fetus, especially the kidneys and bladder, is required. Usually, with transabdominal ultrasound, it is possible to accurately diagnose renal agenesis, impaired outflow from the bladder, polycystic kidney dysplasia, and polycystic kidney disease of an infant type. In the absence of both kidneys and fluid in the fetal bladder, renal agenesis is diagnosed. For further examination of the fetus in kidney agenesis, color Doppler ultrasonography is used to determine the location of the renal arteries and to identify the "lying" adrenal glands. Ultrasound picture of multicystic dysplastic kidneys and infantile polycystic kidney disease - enlarged hyperechoic or cystic kidneys. In case of obstruction of the exit from the bladder associated with the syndrome of the posterior valve of the urethra, an enlarged bladder in the form of a keyhole and a significantly enlarged renal pelvis are determined. Due to severe oligohydramnios, accurate antenatal diagnosis of these fetal conditions using transabdominal ultrasound is sometimes difficult.

With poor visualization of fetal anatomy at the beginning of the second trimester, transvaginal ultrasound is useful. To improve ultrasound resolution, amnioinfusion was proposed; the advent of MRI made it possible in most cases to non-invasive confirmation of early ultrasound findings. With severe oligohydramnios, it is difficult to perform amniocentesis to assess the karyotype of the fetus. The method of choice is placental biopsy. With the exception of posterior urethral valve syndrome, when in some cases intrauterine surgery can improve the outcome, the fetus is not viable due to pulmonary hypoplasia that develops in these conditions.

Rupture of membranes

The rupture of the membranes is easily determined based on the history and examination. During vaginal examination with sterile mirrors, the accumulation of amniotic fluid is confirmed, the alkaline pH is determined with nitrisin, and the typical phenomenon of arborization is revealed. In case of doubtful history and examination data, other methods are used for diagnosis. If, after amnioinfusion of indigo-carmine in Ringer's solution (100-150 ml), staining of the vaginal tampon occurs, this indicates a premature rupture of the membranes.

The use of methylene blue should be avoided as it can lead to jejunal atresia in the fetus. After 22 weeks of pregnancy, fetal fibronectin is determined in the contents of the posterior fornix, although in uncomplicated pregnancy this test is not very informative. Its definition has been used as a non-invasive method for confirming premature rupture of the membranes with questionable results of anamnesis and clinical examination. The earlier the premature rupture of the membranes occurs, the more cautious the prognosis. A gap with the occurrence of severe oligohydramnios before 24 weeks of gestation carries an additional risk of lung hypoplasia, although not as pronounced as with fetal kidney anomalies. In case of leakage of amniotic fluid after amniocentesis in the second trimester, the prognosis is quite good, the survival rate is more than 90%.

Intrauterine growth retardation

Uteroplacental insufficiency leads to a redistribution of blood flow in the fetus in favor of vital organs. The patient's history and examination data indicate risk factors for intrauterine growth retardation syndrome (FGRS) - drug addiction, chronic hypertension, previous obstetric history, birth weight of children and preeclampsia. With fetal biometrics, fetal weight is below the 10th percentile. FGRP detected at the end of the second and third trimester is characterized by an asymmetry of the biometric parameters of the fetus (inconsistency between the head circumference and the abdominal circumference), whereas with severe FGRP, a symmetric growth retardation is observed in the second trimester.

Ultrasound reveals premature maturation of the placenta (early placental calcification). Additional clues are provided by Doppler examination, which measures the blood flow velocity in the mother and the fetus. Pathological results of Doppler examination of the uterine artery at 18-24 weeks suggest abnormalities in placentation and are of some importance for the prognosis of an unfavorable pregnancy outcome. Doppler examination of the umbilical artery reveals an increase in placental resistance, noted in uteroplacental insufficiency. In the early stages of development of FGRP, Doppler examination of the middle cerebral artery of the fetus reveals the "brain steal syndrome" associated with the redistribution of blood flow. It is expressed in an increase in diastolic blood flow velocity and a decrease in the pulse index. Although there is no separate antenatal study to confirm FGR, pathological dynamic ultrasound results, combined with a history, allow us to calculate the prognosis and choose a rational treatment regimen.

Perinatal morbidity and mortality are inversely related to gestational age at diagnosis. With an early onset of severe FGR, the patient must be examined in detail in order to exclude fetal malformations.

Itrogenic causes

Many iatrogenic causes lead to oligohydramnios. These include fetal procedures - chorionic villus sampling or amniocentesis and various medications. Careful collection of anamnesis allows you to exclude these causes. NSAIDs and angiotensin-converting enzyme inhibitors decrease renal perfusion and lead to oligohydramnios. Fortunately, in most cases, oligohydramnios is reversible when these drugs are discontinued.

Postmaturity

A decrease in the volume of amniotic fluid during post-term pregnancy is a reflection of uteroplacental insufficiency that occurs in late pregnancy. In case of post-term pregnancy, it is recommended to monitor the volume of amniotic fluid and, if signs of oligohydramnios appear, induction of labor is performed. However, it is unclear whether these measures result in improved fetal outcomes.

The classic diagnosis of oligohydramnios is when the volume of amniotic fluid is less than 500 ml before delivery.

Modern medicine says that oligohydramnios can appear and disappear at any stage of pregnancy, starting from the 14th week. Periodic deviation of the amount of amniotic fluid from the maximum permissible values ​​is a functional lack of water. That is, this condition is temporary and caused by external influences or changes in the body.

With a constant lack of fluid and persistent lack of water, we are talking about a pathological process that is dangerous for the expectant mother and her baby.

Causes

The list of factors that can affect a small amount of intrauterine fluid is quite extensive. There are 3 main groups.

Severe chronic diseases and conditions of the expectant mother, among which dominate:

  • autoimmune disorders
  • diseases of the cardiovascular and genitourinary systems,
  • metabolic disorders,
  • tobacco intoxication, gestosis.

Pathological conditions of the placenta:

  • placental muscle infarctions,
  • placental insufficiency
  • sclerosis,
  • necrosis of the placental membrane.

Pathologies in the development of the fetus and its congenital defects:

  • chromosomal abnormalities
  • intrauterine infection,
  • intrafetal hypoxia,
  • developmental lag,
  • narrowing of the urethra,
  • bilateral narrowing of the ureters,
  • many congenital kidney diseases.

Among other reasons for the occurrence of oligohydramnios during pregnancy, it is worth noting:

  • overmaturity of the fetus for more than 42 weeks,
  • frozen pregnancy,
  • premature rupture of the membranes,
  • long-term use of inhibitors.

Symptoms

There are no changes in the well-being of a pregnant woman with moderate lack of water. With severe lack of water, expectant mothers may complain about:

  • nausea
  • dry mouth
  • general weakness and a constant feeling of thirst,
  • pain when the fetus moves after 20 weeks of pregnancy.

If oligohydramnios is functional, that is, caused by a deviation in women's health, then the clinical picture of the underlying disease will appear.

During a gynecological examination, the doctor may detect the following signs of insufficient amniotic fluid:

  • mismatch of the size of the uterus with normal indicators,
  • small abdominal circumference in comparison with the norm of the term,
  • limited fetal mobility.

Diagnosis of oligohydramnios during pregnancy

To confirm the diagnosis, to determine its severity, it is necessary to conduct an ultrasound scan and determine the amniotic fluid index.

To determine the type of oligohydramnios (functional or pathological), the dynamics of diagnosis is necessary. The backlog of readings from the norms for a specific gestational age should last at least three months.

If the results of the repeated ultrasound scan confirm the preservation of low water, then to establish its causes, additional procedures are necessary:

  • blood pressure assessment,
  • blood sampling to determine its composition, the presence of antibodies, markers of developmental defects,
  • targeted ultrasound of children's internal organs to identify pathologies and congenital defects,
  • studies to identify chromosomal and genetic abnormalities of the fetus.

Complications

The consequences of low water depend on the complexity of the pathology and the duration of pregnancy.

In the early stages, pathological low water in pregnant women in most cases ends in miscarriage and premature birth without saving the life of the child.

A decrease in amniotic fluid from the middle of the second trimester can provoke an abnormal position of the fetus, a lag in the development of some organs and systems.

In late pregnancy, oligohydramnios in pregnant women increases the risk of infection in the baby.

Treatment

What can you do

At the initial diagnosis of oligohydramnios, the expectant mother should not worry. It is quite possible that the reason for the decrease in the volume of AFI was a recent infection. In this case, you need to inform the gynecologist about this and undergo the prescribed course of treatment. To assess the effectiveness of treatment, you should undergo a second ultrasound in a month.

If you do not want to carry out unscheduled ultrasounds, then regularly visit your gynecologist to assess your condition by external factors. To monitor the general condition of the child, undergo CTG and dopplerometry of the placental vessels.

If an ultrasound is found, it is recommended to undergo screening tests to identify possible abnormalities in the development of the child. If you find such, you will be offered to terminate the pregnancy. Only the patient herself can make the decision to maintain or terminate the pregnancy.

While maintaining pregnancy, it is worth agreeing to all the procedures and methods of therapy prescribed by the attending physician, who, before the appointment, necessarily assesses the risks to the health and life of the mother and her baby.

Do not self-medicate, do not resort to traditional medicine. Only an experienced specialist, having studied your individual condition, can prescribe a suitable and safe therapy. Therefore, even a diet for oligohydramnios in pregnant women should be agreed with a doctor.

What the doctor does

After an external gynecological examination, the doctor prescribes additional tests and studies to determine the amniotic fluid index and the reasons for the development of this pathology.

If severe oligohydramnios is diagnosed as abnormal for up to 28 weeks, then doctors insist on terminating the pregnancy, since this condition is fraught with the life of the pregnant woman herself.

With a decrease in amniotic fluid in the third trimester, treatment is carried out in stationary conditions. Medical actions are aimed at maintaining pregnancy and preventing infection of the fetus. Therapy is based on the following drugs:

  • B vitamins,
  • medicines to normalize and maintain blood pressure,
  • drugs to maintain normal blood sugar,
  • medicines that improve placental blood circulation.

If necessary, an acceptable treatment of the underlying disease is carried out.

If low water in pregnant women is caused by water leakage, then the patient is prescribed bed rest, a special menu and plenty of drink. Even such a simple treatment requires hospitalization for constant monitoring of the condition of the mother and baby.

In the hospital, CTG and dopplerometry are regularly performed to assess the condition of the placenta and fetus.

Even with hospitalization, doctors try to bring the pregnancy to a natural birth. If indicated, a caesarean section is possible.

Most problems with the placenta are resolved by artificial induction of labor.

Prophylaxis

For the prevention of obstetric pathology, you should carefully prepare for pregnancy. Switch to a healthy lifestyle in advance, undergo examination and, if necessary, cure existing diseases.

Amniotic fluid is the baby's first habitat. It is from her that the child receives the nutrients he needs.

The composition and volume of amniotic fluid have a significant impact on the safety of the fetus and its intrauterine development. For each gestational age, its own boundaries of the normal volume of water have been established. If their number is less than the permissible value, oligohydramnios is diagnosed.

The concept of the norm of the amount of water

The normal amount of intrauterine fluid varies within a fairly wide range. On average, it is 0.6-1.5 liters. A lot depends on their number, since it is this fluid that gives the developing fetus freedom of movement, promotes normal metabolism and provides reliable protection of the umbilical cord from being squeezed.

As noted, the volume of intrauterine fluid increases in accordance with the gestational age. If we consider pregnancy by week, then the volume of intrauterine water changes approximately as follows:

  • At week 10, it is 30 ml.
  • At 13-14 weeks - about 100 ml.
  • At 18-20 weeks, the amount of fluid increases to an average of 400 ml.
  • By the end of the term (starting from 36-37 weeks) - about 1-1, 5 liters.

Closer to the date of birth, the volume of amniotic fluid may decrease to 0.8 liters. The same amount of water is typical for post-term pregnancy.

Based on the above information, when a baby is born, about 1.3-1.8 kg of a mixture of amniotic fluid and placenta comes out of a woman's womb. In this case, the placenta accounts for about 0.5-1 kg, the remaining mass is occupied by water.

Malnutrition: description and forms of the disease

Sometimes, due to certain circumstances, the content of intrauterine water deviates from normal values. In the case of their decrease, we are talking about low water.

There are several classifications of dryness. It can be:

1. Chronic and acute... Chronic dryness is characterized by the absence of severe symptoms. As a rule, the pregnant woman feels normal. Confirmation of the lack of amniotic fluid is possible only by ultrasound.

The acute form is characterized by the presence of a number of unfavorable symptoms, namely: a decrease in the height of the fundus of the uterus, the size of the abdomen, the uterus as a whole; painful sensations when the fetus moves; the appearance of weakness, nausea and general malaise; pain in the lower abdomen.

2. Early and late. The early form develops mainly with functional insufficiency of the membranes and is diagnosed most often at 16-20 weeks of pregnancy.

The late form is determined on average after 25-26 weeks. It can develop against the background of disorders of the endometrium of the uterus and various kinds of secondary diseases, including diabetes mellitus, arterial hypertension and others.

3. Primary and secondary. In case of primary oligohydramnios, the violation of the integrity of the amniotic sac may be absent.

Secondary oligohydramnios always develops with a violation of the integrity of the membranes, which is why the liquid begins to gradually flow out.

Signs and main symptoms of oligohydramnios

The diagnosis is confirmed by ultrasound.

In most situations, the well-being of women with a moderate form of the disease does not seriously deteriorate.

For a pronounced ailment, the presence of:

  • Nausea, general weakness and dryness in the mouth.
  • Also, patients have pain in the lower abdomen, the intensity of which increases with the child's mobility. After the 20th week of pregnancy, the fetus begins to behave much more actively. Against the background of an insufficient amount of amniotic fluid, its depreciation properties are significantly reduced. Because of this, the woman has rather intense pain.

Among the main signs of low water diagnosed in the process of gynecological examination and ultrasound examination, it can be noted

  • lag in the size of the uterus from the normal for the current period of pregnancy.
  • There is also a decrease in the circumference of the abdomen and limitation of the child's mobility.

The diagnosis is confirmed by an ultrasound examination. It also allows you to determine the volume of intrauterine water and the severity of low water, if any. Most often, a woman first undergoes an ultrasound scan, and then is sent for a more detailed gynecological examination.

With a deficiency of amniotic fluid, spontaneous miscarriage or premature birth can occur. During the period of contractions, the woman will feel very severe pain. The cervix opens more slowly.

Labor activity in most situations is protracted. After opening the amniotic fluid, a small amount of viscous fluid is found, colored by the baby's emptying.

The danger of low water for women and children

Low water leads to a number of complications. With an insufficient volume of amniotic fluid, the walls of the uterus begin to put pressure on the fetal sac and, as a result, on the child. As a result, he has to bend in an abnormal position, which can lead to a number of side effects, including:

  • fusion of the skin with the amniotic sac;
  • clubfoot;
  • various kinds of spinal anomalies.
  • baby's skin becomes dry and wrinkled.

Low water also adversely affects pregnancy. As noted, patients feel pain, especially when the child becomes more active.

Pregnancy can be terminated due to a lack of fluid. The risk of miscarriage is especially high in the 1st trimester.

Regardless of the type of disease, there are complications during childbirth. The most common is the weakness of the process, expressed in insufficiently strong attempts and minor contractions.

The listed problems appear due to the low pressure of the amniotic sac. Due to its reduced size, it is not able to affect the speed and degree of cervical dilatation.

If the pregnancy is premature, childbirth is most often performed with a caesarean section.

In addition, the doctor may prescribe special medications that stimulate contractions. The drugs are usually prescribed for more than 35 weeks.

With a favorable outcome, the woman manages to give birth on her own.

The main causes of low water

Many different reasons lead to the appearance of the disease, including;

  • pathology of the urinary system;
  • genetic predisposition to the disorders in question;
  • high blood pressure;
  • exacerbation of chronic diseases during pregnancy;
  • bacterial infections;
  • multiple pregnancy;
  • overburdening. Having served its purpose, the placenta is rapidly aging, stratifying and losing its function. With the development of oligohydramnios against the background of prolongation, doctors, as a rule, provoke artificial childbirth;
  • metabolic disorder;
  • overweight;
  • incompatibility of the Rh factor of the blood of the mother and the child;
  • placental insufficiency;
  • various diseases of the placenta;
  • diabetes;
  • pathology or insufficient development of the secretory epithelium.

Diagnostics of low water

Amniotic water is the first environment for a child's life, therefore it is very important that the composition and, of course, the amount of fluid are acceptable for the full development of the baby.

It is the normal volume of water that is one of the most important indications that the child is developing correctly.

To determine the amount of fluid, a woman, as already noted, undergoes an ultrasound examination. Based on the results of the survey, a conclusion is drawn up, which, among other things, indicates amniotic fluid index... This indicator characterizes the volume of water present in the amniotic fluid. At each stage of pregnancy, the fluid rate is individual. Thanks to this indicator, the doctor can draw conclusions about the nature of the development of pregnancy.

Amniotic fluid volume, as well as its composition, change almost weekly. In addition to the mean, there is a rather significant difference in the permissible values ​​of the amniotic fluid index.

It is important to understand that these fluctuations are quite significant, so even if you have it far from the established norm, this is not necessarily a cause for concern and anxiety.

In general, you can study the normal indicators of amniotic fluid and permissible deviations from the norm at each stage of pregnancy in the following table:

Pregnant women are often interested in: why amniotic fluid becomes more or less? The reason is that the fetus develops, and as it grows, it swallows intrauterine water, and then removes it from the body along with urine. You don't have to worry about the baby's condition: the intrauterine waters are renewed at intervals of 3-4 hours, and they completely change every 3-4 days.

As noted, oligohydramnios is a decrease in the volume of amniotic fluid below an acceptable level, and it can be moderate or severe. The moderate form is diagnosed much more often.

Moderate low water is characterized by a relatively small decrease in the volume of intrauterine water. This form is less dangerous in comparison with pronounced lack of water. But moderate lack of water during pregnancy can deliver no less worries and troubles. And all sorts of complications can also appear, not having the best effect on the condition of the fetus.

For example, the result of the deviation in question is quite often the birth of a small baby. Also frequent consequences are hip dysplasia, various kinds of spinal pathology.

But you don't need to start worrying right away - in the vast majority of situations, pregnancy with the considered form of oligohydramnios passes and ends safely and the baby is born in a relatively good condition.

A woman only needs to react in time to the problem that has arisen, behave appropriately, visit a doctor and follow all his advice.

If during the next ultrasound examination a moderate form of oligohydramnios was diagnosed, no one will consider it as a final conclusion. It is imperative to be examined again... It is better to do this in a different office and with a different doctor.

Also, the doctor will try to determine the reasons against which oligohydramnios began to develop. The exact reasons for the appearance of such an anomaly are not fully established, but most often they lead to such a problem:

  • infections of the genitourinary system. Even those ailments that the patient suffered without being pregnant can lead to the occurrence of oligohydramnios;
  • high blood pressure;
  • chronic inflammatory processes in the body.

Various problems experienced by the developing child directly can lead to the occurrence of moderate lack of water. For example, often the problem appears due to chronic hypoxia and other anomalies of intrauterine development.

Usually, when a moderate form of oligohydramnios is detected, doctors recommend that a pregnant woman adjust her diet and, in general, the nature of life. Such patients are recommended to eat foods high in minerals and vitamins.

It is also recommended to have a normal regular rest and, in general, a gentle regime without stress, stress, etc. And most importantly, you need to be regularly monitored by a doctor in charge of pregnancy in order to timely detect deterioration, if any, and take appropriate measures.

Severe oligohydramnios in pregnant women: basic information and recommendations

The main symptom is lower abdominal pain

A pronounced type of oligohydramnios is more dangerous for a mother and her unborn child than a moderate one. The woman is worried about discomfort in the abdomen (mainly in the lower part), there is nausea and general malaise. The fetus very often develops hypoxia - a condition caused by an insufficient amount of supplied oxygen. Hypoxia is dangerous for the whole body of the baby as a whole and, to the greatest extent, for the nervous system.

Against the background of prolonged and pronounced lack of water, simonart ligaments are formed, entwining the baby. They interfere with the mobility of the fetus, and sometimes lead to extremely serious injuries. If the simonart ligaments are wrapped around the umbilical cord, there is a violation of the blood flow in the vessels. The result can be unpredictable - from developmental delays to the death of the baby.

The main symptom of a woman is pain in the lower abdomen. They become especially pronounced by the end of the term, when the child is already quite large. Due to lack of water, labor is often weakened, which becomes a prerequisite for a caesarean section.

Otherwise, if severe lack of water is detected, medical recommendations should be followed. The course of treatment is selected individually, taking into account the patient's condition and the characteristics of her problem.

Treatment of oligohydramnios

Various methods are used to treat the disease in question. The specific treatment option is selected taking into account the intensity of the severity of the disease, the reasons for its appearance, as well as the duration. For example, if obesity and metabolic disorders led to the appearance of oligohydramnios within 1-2 trimesters, the doctor will prescribe the woman an individual diet and drugs to normalize the function of the placenta.

If low water is detected after 31 weeks, complex therapy is most often prescribed, including drugs to normalize metabolism, vitamins, as well as medicines to eliminate the main cause of the disease.

If a moderate degree of illness is found, outpatient treatment is prescribed. Patients with a pronounced nature of the disease are treated permanently.

For outpatient therapy, it is prescribed:

  • limitation of activity;
  • sparing regime;
  • elimination of heavy loads;
  • taking medications (prescribed by a doctor);
  • regular doctor visits.

As a rule, outpatient treatment is resorted to in the 2nd trimester.

Inpatient treatment is used in the following situations:

  • when diagnosing a pronounced degree of the disease;
  • with a significant deficiency of intrauterine fluid;
  • if oligohydramnios is detected after the 31st week.

The doctor may recommend the patient to have a weekly ultrasound scan and dopplegrafia. It is also often recommended to do a CTG of the fetus. The listed activities allow you to control the disease and respond in a timely manner to the deterioration of the condition.

If the intensity of the severity of oligohydramnios threatens the health and life of the baby, the doctor may take extreme measures - terminate the pregnancy or resort to caesarean section. The possibility of early delivery is considered only in the case of patients at 33 weeks and later.

There are no specific prophylactic recommendations that allow 100% to eliminate the risk of developing oligohydramnios. Pregnant women are advised to eat a healthy diet and follow all doctor's recommendations.

It is also necessary to regularly take tests and undergo the required examinations. You should refrain from lifting weights and other serious physical activity. Respond to uncharacteristic changes in your body in a timely manner, follow the doctor's advice and be healthy!

The amniotic fluid performs many important functions for the successful development of pregnancy and the fetus. The most important of them is nutritious, because they contain the substances necessary for the baby: vitamins, hormones, salts, biologically active substances, proteins, fats, carbohydrates.

The amniotic fluid is a natural living environment for the baby, in which optimal conditions for its existence are constantly preserved and maintained: temperature regime, qualitative composition, sterility. Water allows the fetus to move easily and naturally, protects it from external influences, including mechanical ones. Therefore, any violations in their quality or quantity can be fraught with many dangers.

The amount of amniotic fluid during pregnancy is constantly changing with an increase in duration. But there are certain norms for a particular week. If the volume of water does not reach these standards, doctors talk about the development of low water.

This condition is considered pathological and requires compulsory treatment. There is low water during pregnancy infrequently: according to statistics, in about 3-4 cases out of 100. But women on forums very often discuss the issue of how to treat low water during pregnancy. Mainly because the information available on the Internet promises disappointing forecasts for the development of this pathology.

Even an experienced gynecologist is able to suspect the development of pathology when examining a pregnant woman. His guesses can be confirmed by the complaints of the expectant mother about overly active and painful movements of the child, abdominal pain, dry mouth, weakness. However, as a rule, a pregnant woman does not feel any subjective signs, because the mentioned symptoms are observed already with a pronounced violation.

An accurate diagnosis can be made only after undergoing an ultrasound examination, which will show the amount and condition of the amniotic fluid. If oligohydramnios is diagnosed during pregnancy, then mom will be sent for additional examinations: Doppler ultrasonography will determine the state of blood flow in the vessels of the placenta and umbilical cord, and CTG will show the general condition of the fetus based on the data of its heartbeat. After these examinations, it will be possible to judge the degree of low water and fetal damage.

A slight decrease in the amount of amniotic fluid at the end of pregnancy is physiological and does not pose any threats. Also, in most cases, low water is not dangerous, which manifests itself in one of the two fetuses when carrying twins. Fear should cause a violation that occurs in the process of bearing a child (from 12 weeks onwards). However, medical appointments will depend not only on the period at which the pathology was found, but also on the degree of its manifestation.

Moderate decrease in amniotic fluid volume does not require hospitalization and is usually treated on an outpatient basis. According to the indications of a pregnant woman, medications that improve blood circulation in the placenta (Actovegin, Curantil), as well as vitamin preparations, can be prescribed. Treatment of oligohydramnios during pregnancy is aimed mainly at eliminating the causes that caused it. Among the most common are infectious and chronic diseases, endocrine disorders, late gestosis, pathologies in fetal development. That is, there may be a need to take appropriate medications that are approved for use during the period of gestation.

However, something will also depend on the expectant mother. The diet must be balanced by including healthy foods. Physical activity is minimized, any physical activity is completely excluded.

Treatment of oligohydramnios during pregnancy with folk remedies is impossible, but traditional medicine recipes, with the approval of a doctor, may well be used to eliminate the causes that caused it (such as high blood pressure, cystitis, pyelonephritis and other conditions).

Low water in the very early stages is usually of little danger. But as pregnancy progresses, the threat increases, with the highest risk being up to 28 weeks. If, as a result of examinations, it turns out that the consequences for the fetus were tragic (incompatible with life), then for medical reasons the pregnancy may be terminated.

Severe oligohydramnios with high risks, developing up to 32 weeks, is treated in a hospital. The woman is undergoing drug therapy and is under close medical supervision, regularly undergoes ultrasound. Also, the condition of the fetus is constantly monitored.

If the treatment of oligohydramnios in a hospital does not give positive results, and the further course of pregnancy becomes dangerous for the baby's life, doctors decide on an early delivery by Caesarean section.

However, in most cases, oligohydramnios, with proper therapy, does not interfere with the normal ending and successful resolution of pregnancy. Many women leave feedback on the forums that, despite the disappointing diagnosis, the pregnancy ended well, and the baby was born absolutely healthy!

It should only be understood that such a diagnosis should not be neglected. As well as unnecessarily worrying about this: if only because nervous experiences will not change the situation for the better, but they may worsen. In addition, pronounced oligohydramnios during pregnancy is quite rare, and moderately easy to correct and almost never carries great danger.

Especially for - Larisa Nezabudkina