Oligohydramnios (oligohydramnios)- pathology of pregnancy, characterized by a decrease in the volume of amniotic fluid inside the membranes. This condition may be a symptom of complications of the gestation period. It is observed with genetic abnormalities, intrauterine infection, violation of the anatomical structure of the placenta and other organs.

Sometimes the lack of amniotic fluid indicates the presence of serious pathologies of pregnancy. After establishing the diagnosis of "oligohydramnios", a woman needs a thorough examination. If necessary, doctors prescribe treatment aimed at replenishing the deficiency of amniotic fluid.

amniotic fluid

Amniotic fluid (amniotic fluid)- a colloidal solution located in the uterine cavity and ensuring the normal development of the baby. It contains nutrients and minerals, vitamins, protective antibodies and hormones. The formation of fetal fluid is associated with the transport of intravascular fluid from the uterine arteries to the cavity of the amniotic bladder.

The formation of the amniotic fluid system is observed in the first days after conception, after the fertilized egg is fixed in the uterine wall. The synthesis of amniotic fluid begins with the formation of the chorion - the primary membrane of the embryo, which is the precursor of the placenta. This event is observed at the beginning of the fourth week of pregnancy.

By the end of the first trimester, the baby's kidneys and lungs begin to perform a filtering function. From this moment on, the body of the unborn child is included in the exchange of amniotic fluid.

Amount of amniotic fluid

The amount of amniotic fluid is not the same in different periods of gestation. In the first trimester, its volume reaches 300-400 milliliters. By the amount of amniotic fluid reaches 700-800 milliliters. Then its quantity continues to grow, by the end of the second trimester the volume of amniotic fluid is about 1.5 liters.

The maximum amount of amniotic fluid is observed at 32-34 weeks, it is 2-2.5 liters. After that, the volume is reduced. By the 36-38th week of the gestation period, its amount decreases to 1700-2100 milliliters. At the end of the 3rd trimester, the volume of amniotic fluid reaches 1-1.5 liters.

After 40 weeks of pregnancy, the amount of amniotic fluid is greatly reduced. When overwearing, its volume can decrease to 500 milliliters.

Amniotic fluid is constantly updated, the circulatory system of the mother's body filters their contents. Complete replacement of amniotic fluid occurs in 3-4 hours.

Functions of amniotic fluid

Amniotic fluid performs several functions:

#1. Nutrition for the unborn child. From about the 12th week of pregnancy, the baby begins to swallow amniotic fluid and digest it. Also in the fetal waters there are minerals and vitamins.

#2. Thermoregulation. The fetal fluid maintains a constant comfortable temperature around the fetus. The normal development of the baby is possible only at 37 degrees Celsius. Lowering the temperature can help slow down the division of cells and tissues. This phenomenon contributes to a delay in the growth and development of the fetus. With an increase in body temperature, enzyme inactivation is observed.

#3. excretory function. After the amniotic fluid is swallowed, the baby's kidneys process it into urine. With it, harmful metabolic products are removed from the child's body.

#4. Mechanical protection. Amniotic fluid is a protective "cushion" between the outside world and the fetus. Various physical factors can injure the child, the waters flavor the shocks and vibrations. Also, amniotic fluid protects the baby's hearing aid from loud sounds.

#5. Infection prevention. Normally, fetal waters are a sterile environment, since microorganisms can cause various pathologies on the part of the unborn child. Amniotic fluid prevents infection from entering the baby through constant renewal.

#6. immune function. Even in the later stages of gestation, the baby's body cannot fully protect itself from the action of negative external factors. The amniotic fluid contains maternal immunoglobulins that protect the unborn child from the development of the infectious process.

#7. Internal environment. The components of the amniotic fluid maintain the normal condition of the baby's skin, protect it from drying out. Also, the water does not hinder the movements of the unborn child, he can move freely in the uterine cavity.

#8. Participation in the birth of a child. Before the baby is born, amniotic fluid begins to put pressure on the cervix, accelerating its opening. After the membranes rupture, the amniotic fluid washes the birth canal, facilitating the passage of the baby's head. Waters stimulate adequate contractile activity of the uterus.

What is oligohydramnios in pregnant women

Causes of oligohydramnios

Quite often, doctors cannot identify the cause of oligohydramnios in a particular woman. Low levels of amniotic fluid may be due to various factors:

#1. Chromosomal abnormalities of the fetus. With some malformations, the amniotic membranes have a pathological structure, so they cannot fully participate in water metabolism. Most often, this condition is observed with abnormalities of the urinary system of the fetus - aplasia or adhesion of the kidney, improper laying of the ureters.

#2. Chronic pathologies in the mother's body. The presence of kidney failure in a woman increases the risk of developing oligohydramnios. With improper filtration of the kidneys, the amniotic fluid cannot normally participate in metabolism. Cardiovascular pathologies also disrupt the formation of amniotic fluid.

#3. infectious process. After the penetration of bacterial or viral microflora into the amniotic membranes, the synthesis of fluid is reduced. Infectious agents provoke changes in the properties of amniotic fluid, there are violations in protein, carbohydrate and fat metabolism. Most often, pathogenic microflora enters the amniotic fluid in an ascending way - in the presence of sexually transmitted diseases. However, some pathogens can enter the fetus through the placenta. This method is characteristic of systemic infections - rubella, influenza, syphilis, etc.

Attention! Quite often, oligohydramnios is not accompanied by symptoms, so the expectant mother should not miss scheduled gynecological examinations, on which he may suspect the presence of a pathology.

#4. Preeclampsia. This pathology is characterized by an increase in blood pressure and a violation of the filtration function of the kidneys. Pre-eclampsia increases the likelihood of developing oligohydramnios due to the loss of protein from the blood. Also, this disease is characterized by edema, in which fluid accumulates in the intercellular space. Due to this, an additional reduction in the amount of amniotic fluid is observed.

#5. Pathology of the placenta. This organ is actively involved in the exchange of amniotic fluid. Premature aging of the placenta, its abruption or presentation can reduce the amount of amniotic fluid.

#6. Bad habits of the mother. The use of nicotine, alcohol, narcotic substances causes pathologies on the part of the renal function of both the mother and the fetus. Poisonous metabolic products slow down the exchange of amniotic fluid.

#7. Carrying twins. Multiple pregnancy increases the load on the urinary system of the mother. Due to this, pathologies of the amount of amniotic fluid are observed.

#8. Pregnancy reversal. After 41 weeks of the gestation period, the placenta loses its normal structure, it thickens and becomes impermeable to water and various substances. That is why a post-term pregnancy helps to reduce the amount of amniotic fluid.

#9. Obesity, diabetes, hypothyroidism. These factors affect the work of the urinary system of the unborn child and woman. These pathologies reduce the intensity of water metabolism.

Risks for the mother

Oligohydramnios during pregnancy can be a risk factor for pathologies of labor. The lack of fetal fluid contributes to the slow opening of the cervix. This phenomenon causes weakness of contractions and attempts.

The danger of a lack of amniotic fluid lies in its negative effect on the course of gestation. Critical oligohydramnios can be the cause of spontaneous abortion.

Oligohydramnios in late pregnancy is a risk factor for severe bleeding during childbirth. It is associated with insufficient contractile activity of the uterus after the birth of the child.

Risks for the child

The consequences of oligohydramnios for the child's body are the formation of intrauterine fetal hypoxia. Due to the lack of oxygen, the tissues in the baby's body cannot fully develop. Hypoxia leads to fetal growth retardation, as well as pathologies from the central nervous system.

Lack of amniotic fluid can contribute to impaired fetal bone formation. Due to this, the likelihood of anomalies in the structure of the limbs increases. Also, oligohydramnios causes pathologies in the baby's skin, it becomes thin and dry.

Symptoms of oligohydramnios

In clinical practice, doctors distinguish between severe and moderate oligohydramnios. A small deficiency of amniotic fluid is not accompanied by symptoms, it can only be detected with an ultrasound scan.

Severe oligohydramnios may be accompanied by a characteristic clinical picture. The expectant mother notes a deterioration in general well-being, dry mouth, dizziness. It is also possible to develop pain in the lower abdomen, aggravated during the movements of the baby.

Diagnostics

With severe oligohydramnios, there may be a lag in the size of the height of the fundus of the uterus and the circumference of the abdomen. These symptoms are associated with a decrease in the cavity of the organ. However Ultrasound is required to establish an accurate diagnosis.. Expectant mothers at risk should have it every 2-3 weeks.

To calculate the volume of amniotic fluid, doctors have developed a special technology called "determination of the amniotic fluid index." Its principle is to divide the anterior abdominal wall of the expectant mother into 4 parts. The axes of the vertical and horizontal lines pass through the navel.

Using an ultrasound scan, the doctor determines the maximum depth of water in each square of the uterine cavity. The four values ​​are added together, their sum is called the amniotic fluid index.

Specialists have developed special tables that indicate the normal values ​​for the amount of amniotic fluid in each week of pregnancy. The diagnosis of "oligohydramnios" is made when the indicator deviates by 5 percentile or less.

Treatment of oligohydramnios

At the present stage of medicine, there is no drug that could directly restore the exchange of amniotic fluid. That is why the treatment of oligohydramnios is symptomatic.

Expectant mothers are prescribed drugs that improve the blood supply to the placenta. The drugs in this group include Curantil, Actovegin. Medicines stimulate the expansion of the lumen of the placental arteries, improving the leakage of fluid into the fetal membranes.

Also, with oligohydramnios, expectant mothers are shown vitamin therapy. It includes the use of multicomponent preparations with minerals and nicotinic acid. For the treatment of amniotic fluid deficiency, the intake of B vitamins is indicated, these funds improve microcirculation in the placenta.

If the cause of oligohydramnios is infection of the fetal bladder, the expectant mother is shown antibacterial treatment. The choice of drug depends on the type of pathogen, the most commonly used are Ceftriaxone and Ampicillin.

Possible Complications

Deficiency of amniotic fluid can cause pathologies of intrauterine development of the child. Children who grew up with a severe lack of amniotic fluid often lag behind their peers in mental and emotional development. Also, severe oligohydramnios can provoke insufficient mental activity in the future.

Oligohydramnios is a risk factor for pathologies of the nervous system - the child may be lethargic, sleepy, inactive. Also, this pathology increases the likelihood of the birth of premature and low birth weight children.

Prevention methods

Prevention of oligohydramnios consists in careful planning of pregnancy. Before conceiving a future mother, infectious diseases should be cured, the course of chronic pathologies of the kidneys, heart and blood vessels should be normalized.

During pregnancy, a woman is advised to avoid the possibility of contracting infectious diseases - do not stay in places with large crowds of people, do not eat food of dubious quality, avoid communicating with animals. The expectant mother should give up cigarettes and alcohol for the entire period of gestation. Also, a pregnant woman should be selective in sexual relations.

A woman's diet should be rich in vitamins and minerals. She should eat fresh fruits, vegetables and berries, fish, meat, poultry, cereals, dairy products. According to the indications of the expectant mother, it is recommended to take multivitamin and mineral complexes.

During periods of bearing a baby, the expectant mother should avoid emotional stress. Also, a pregnant woman is recommended to lead an active lifestyle - walk, do light gymnastics.

Childbirth with oligohydramnios

Childbirth with a lack of amniotic fluid is accompanied by weakness of uterine contractions and a slow course. That is why a woman is recommended to take contraction stimulants - prostaglandins and oxytocin. If they are ineffective, the woman in labor is shown an emergency caesarean section.

Natural and operative delivery is accompanied by an increased risk of heavy bleeding. As a preventive measure, the expectant mother should undergo a course of iron therapy. With the development of heavy bleeding, doctors inject colloidal solutions, plasma proteins, and erythrocyte mass into the vein.

The female body has all the necessary resources for the full conception of a child, its bearing and successful birth. The mother's womb is an ideal environment where the child is provided with peace, comfort, and safety from aggressive external factors. An important role in protecting the baby from possible negative influences from the outside is played by amniotic fluid, which gives him the opportunity to move freely, develop correctly and take the most comfortable postures. However, sometimes it happens that the amount of this vital fluid is insufficient.

Moderate oligohydramnios during pregnancy - what is it?

Moderate oligohydramnios is one of the pathological conditions that can occur in a woman during pregnancy. The baby in the uterus is surrounded by amniotic fluid, which performs many important functions that ensure the proper development of the baby. The waters warm the fetus, serve as a "safety cushion", a kind of shock absorber that protects against mechanical influences from the outside world and gives it the opportunity to freely move. In addition, amniotic fluid also serves as a source of various nutrients for the baby. They contain protein, trace elements and a lot of vitamins. There is a constant process of swallowing these waters and feces in them, as a result of which a completely sterile environment is formed in which the baby feels comfortable and safe. And if the amount of this fluid is less than normal, this condition is called oligohydramnios.

Amniotic fluid has a relatively constant composition, and a completely aquatic environment is updated every 3 hours.

The amount of amniotic fluid is affected by many factors: the size and weight of the fetus, the duration of pregnancy, the size of the placenta, the woman's lifestyle, her diet, and much more. Over time, the ratio of the volume of water and the size of the child changes: the baby grows faster than the amount of water arrives. Thus, at a later date, the child becomes more and more crowded. Around 37 weeks, the normal volume of amniotic fluid should be in the range of 1–1.5 liters. When the time comes to give birth, this volume decreases somewhat.

Modern medicine is able to detect pathology in the second and third trimesters

Another name for amniotic fluid is amniotic fluid.

We can talk about moderate oligohydramnios if the volume of amniotic fluid is only slightly less than normal, i.e., it is approximately 500 ml in the later stages of pregnancy. In most cases, moderate oligohydramnios does not pose a serious danger, proceeds favorably and is relatively easily corrected. Modern diagnostic equipment allows you to easily identify this pathology in the second and third trimesters.

Differences between moderate oligohydramnios and pronounced

In addition to moderate, there is also pronounced oligohydramnios. With this pathology, there is a shortage of intrauterine waters much less than the norm, i.e., the volume of fluid is 200 ml or less. If severe oligohydramnios is diagnosed, a pregnant woman needs mandatory hospitalization and inpatient treatment, since this type is much more dangerous for both the woman and the unborn baby.

Sometimes severe oligohydramnios may be an indication for termination of pregnancy, since in some cases it leads to abnormalities in the formation of the child's limbs, facial bones and, in general, deformation of its skeletal system.

amniotic fluid rate

Indicators of the normal volume of amniotic fluid can vary from 600 ml to one and a half liters. As already noted, intrauterine waters are very important for the development and growth of the baby, creating a reliable and safe environment for him. With the course of pregnancy, the volume of water also increases. Here is what the approximate rate of amniotic fluid looks like at different stages of pregnancy:

The rate of amniotic fluid at different stages of pregnancy

Directly to the birth itself, the volume of fluid decreases somewhat and is approximately 800-900 ml. If the pregnancy is delayed, the amount of water may be the same.

Causes

Various reasons contribute to the development of oligohydramnios:

• tendency of a pregnant woman to high blood pressure. It leads to impaired blood flow and function of the placenta;
• abnormal development of the kidneys in the fetus. Unfortunately, in such situations, pregnancy is often subject to termination, since the further prognosis is unfavorable - it is impossible for a child to live without kidneys;
• post-term pregnancy (aging of the placenta). It is advisable to induce labor or perform a caesarean section;
• twin pregnancy. This is due to the discharge of placental blood from one child to the second. Usually, this kind of oligohydramnios does not pose a threat to the fetus;
• untreated, undiagnosed or latent infections. In this situation, analyzes detect pathogenic microflora not only in the birth canal, but also in the fetal waters themselves;
• overweight in a pregnant woman, obesity, impaired metabolism.

Finally, it must be said that in some cases it is not possible to establish the cause.

Oligohydramnios is not an independent disease, but a symptom of a particular disease, therefore, special attention should be paid to identifying the causes of this pathology, since they can pose a real threat to both the future woman in labor and the child.

Symptoms

Most often, moderate oligohydramnios is not accompanied by any typical symptoms that definitely indicate this pathology. It is worth paying attention to pain in the lower abdomen, especially when the baby begins to move. Thus, only a doctor can determine the presence of this pathology. Therefore, regular examination by a gynecologist is mandatory.

Diagnostics

The basis for the diagnosis is the data obtained as a result of observations of the future woman in labor. For its unambiguous confirmation or refutation, ultrasound is prescribed. Signs of low water include:

• rare fetal movements (the mother feels less than ten movements per day);
• the height of the uterine fundus, as well as the circumference of the abdomen, lag behind the average for this period of pregnancy;
• the index of amniotic fluid, detected as a result of ultrasound, is below normal at this stage of pregnancy.

To diagnose oligohydramnios, examination and ultrasound should be performed several times with an interval of 2 weeks

It must be borne in mind that a single examination is not enough. Examinations and ultrasound should be performed several times with an interval of 2 weeks. If in each of these examinations a stable deviation from normal indicators is found, then this is the basis for the diagnosis of oligohydramnios.

But at this time, a woman is informed about the pathology already with a single passage of ultrasound. This can be called not so much a diagnosis as a statement of the presence of an insufficient amount of intrauterine water at the time of the examination. Their shortage is explained by recent colds, stress and other reasons. In this case, fetal CTG or dopplerometry of the vessels of the placenta is prescribed. If the data of these studies show the norm, then there is no reason for concern. The doctor can prescribe a vitamin course, and after a month, send it back for an ultrasound scan. In more than 95% of such cases, this deviation is not detected on a repeat ultrasound examination.

But if a repeated ultrasound procedure again shows oligohydramnios, a detailed examination should be carried out. In this case, it is necessary to donate blood for infections, glucose and anti-Rhesus bodies; measure blood pressure, check hCG and ACE levels, undergo targeted ultrasound to identify possible defects in the development of the child or developmental delays. If necessary, karyotyping and amniocentesis are performed to help detect chromosomal and genetic abnormalities. When the cause of oligohydramnios is established, treatment is prescribed or the question of terminating the pregnancy is considered.

If the results of KGT are normal, the doctor may prescribe a vitamin course, and then again refer to ultrasound

Features of the disease at different stages of pregnancy

The presence of pathology in early pregnancy often indicates significant anomalies in the development of the fetus.

At different times, moderate oligohydramnios proceeds in its own way. In the first trimester, it indicates significant anomalies in the development of the fetus. Sometimes the only way out is to terminate such a pregnancy. However, each case is individual. Thanks to timely diagnosis and treatment, it is possible to normalize the volume of fetal water and the child is born healthy.

In the middle of pregnancy, the picture is different. At the age of 15-27 weeks, the baby needs enough free space in the uterus so that nothing interferes with movement and proper development. And if oligohydramnios is detected at such a time, this means that there is not enough free space, the child experiences tightness and is forced to take unnatural postures. Such conditions can lead to quite serious consequences. There is a risk of clubfoot formation, cranial deformities, etc., which requires active and prolonged treatment by specialists, but in most cases the outcome is favorable.

In the third trimester, pathology, as a rule, is already reflected in the process of childbirth. The amniotic sac is flat, therefore, it cannot fulfill the function of opening the cervix. Childbirth will be protracted, with weak contractions, a fairly large percentage of women give birth naturally with oligohydramnios is contraindicated. In this case, a caesarean section is scheduled. Also, pathology can lead to postpartum hemorrhage.

When diagnosing oligohydramnios in late pregnancy, in most cases the outcome of treatment is favorable.

Treatment and diet

Treatment depends on the severity of the pathology and the causes that caused it. As a rule, it takes place on an outpatient basis, hospitalization is not required. Constant monitoring, consultations with a doctor, periodic ultrasound, CTG, dopplerography, prescription of the necessary drugs, strict control of physical activity and stress are prerequisites for a favorable pregnancy outcome. Therapeutic and treatment-and-prophylactic measures are most often complex and aimed at improving metabolic and circulatory processes in the placenta and uterus.

Often, a doctor prescribes vitamin complexes or hormonal preparations that are designed to improve blood circulation and stabilize the placenta.

The most common medications are:

1. Trental. Improves blood microcirculation. It can be prescribed both in the form of tablets and intravenously.
2. Curantyl. The main task of this drug is to protect the placenta from negative and irreversible changes. In addition, it improves blood flow in the "children's place."
3. Actovegin. Usually it is prescribed simultaneously with Curantil to enhance the effect.

Depending on the causes of the appearance of pathology, the doctor may prescribe certain drugs in various variations.

Constant monitoring by a doctor, regular examinations contribute to a favorable course of pregnancy

Folk methods

As for alternative treatment methods, the following recipes will help normalize the volume of amniotic fluid:

1. Birch juice. It is a strong diuretic and an excellent prophylactic. For a decoction, young birch leaves and buds are required. It is necessary to pour boiling water in the amount of one glass of a teaspoon of the kidneys, then put in a thermos to infuse for 4 hours. After that, drink three times a day, one teaspoon. To prepare a decoction of the leaves, you need two teaspoons of raw materials per glass of boiling water, and you need to take a quarter cup 4 times a day.
2. Black chokeberry. This berry reduces blood pressure and saturates the body with vitamins. To forget about problems with blood pressure and vitamin C deficiency for a long time, you should eat 100 grams of chokeberry daily or drink 50 grams of juice a few minutes before a meal.
3. If oligohydramnios is due to overwork, stress or lack of sleep, herbs will help. An infusion of valerian roots can improve sleep and calm the nervous system. It is necessary to brew 1 teaspoon of chopped root in a glass of boiling water and leave overnight. Take half or 1/4 cup. Instead of valerian, motherwort is suitable - a good sedative that relieves spasms. This infusion is prepared in the same way.
4. Lingonberry leaves are another diuretic and anti-inflammatory agent. Two teaspoons of the leaves of this plant are poured into a glass of water and boiled for 15 minutes, then the broth is infused for 30 minutes. Taken 1/4 cup before meals for 15 minutes. If you use it constantly, you can perfectly strengthen the immune system.
5. In the event that oligohydramnios was caused by inflammatory processes of the genitourinary system, such a remedy is used. Two parts of birch leaves and leaves of wild strawberries, peppermint, yarrow and bean leaves are taken; one part of rowan fruits; three parts of the leaves of the string and nettle, rose hips. All this mixture is poured with half a liter of boiling water and infused for 10 hours. Used three times a day for half a glass.

Before taking any folk remedies against oligohydramnios, be sure to consult your doctor.

Diet

To provide the body with the necessary substances and reduce the risk of a small volume of fetal fluid, it is recommended to increase the amount of fruits, vegetables, dairy and potassium-rich foods (melon, raisins, grapes, figs). Currants, watermelon, apples, apricots, gooseberries help improve digestive function, as they contain a lot of fiber. The presence in the daily diet of olives, walnuts, squash and pumpkin dishes, tomatoes, lettuce will also help to enrich the body with all the necessary substances. Fresh strawberries prevent inflammation.

Currant

In addition, kidney stimulation works very well: fresh kefir, the herbal preparations mentioned above, tea with lemon. It is worth giving preference to acidic drinks, while the amount of salt should be reduced to three grams per day. If there are no contraindications, you can also arrange fasting days, during which you can follow a fruit or kefir diet. Strive for a balanced diet throughout your pregnancy.

Childbirth with moderate oligohydramnios

With moderate oligohydramnios, natural childbirth is possible. Often they proceed safely for the woman in labor and the baby, even if there is a breech or pelvic presentation of the fetus, provoked by oligohydramnios. However, sometimes the pathology leads to weakness of labor activity, and the lack of anterior waters (in front of the child's head) - to the stretching of the amniotic membranes on the baby's head.

This phenomenon is called a flat fetal bladder.

In such cases, an artificial rupture of the membranes of the amniotic sac (amniotomy) is indicated to start the process of contractions and allow the child to move towards the exit in the right way.

With moderate oligohydramnios, natural childbirth is also possible, but often the doctor recommends a caesarean section.

In some cases, the doctor may recognize the need to artificially replenish the fetal bladder with saline the day before delivery to reduce the risk of strangulation of the umbilical cord and other complications, and also decide on the need for a caesarean section.

Possible consequences for the woman and the child

In some cases, moderate oligohydramnios is not dangerous, but sometimes it can result in premature birth, weak muscle activity during childbirth. However, if the deviation is left unattended, then even it can cause serious malformations in the development of the baby or even miscarriage, postpartum hemorrhage, premature detachment of the placenta and rupture of the uterine cervix.

What complications can occur in a child? Timely diagnosed and timely eliminated oligohydramnios, as a rule, does not have or has a minimal effect, which can subsequently be corrected (mild hypoxia, reduced immunity, low weight). When advanced, it can lead to various anomalies of intrauterine development, injuries of the joints and spine, infection of the fetus in the womb, and its fading as a result of oxygen starvation.

Timely diagnosis and treatment will help to avoid unpleasant consequences for both the mother and the child.

If moderate oligohydramnios formed at the end of pregnancy, it may not threaten either the mother or the baby. But if the pathology has developed in the early stages, then there is a possibility that then it will go into a pronounced degree and will have disastrous consequences.

Prevention

To date, there are no specific recommendations that would guarantee the absence of oligohydramnios during pregnancy. To minimize the likelihood of a disease, expectant mothers should eat right and balanced, lead a healthy lifestyle and strictly follow all the doctor's instructions.

Special gymnastics is very useful for pregnant women

It is recommended to undergo scheduled examinations in a timely manner and take the necessary tests, refrain from excessive physical exertion, however, special gymnastics for pregnant women and feasible physical activity will be very useful.

In addition, preventive measures include pregnancy planning, minimizing unprotected sex, avoiding casual sex. It is necessary to prepare for conception in advance: identify and cure all chronic diseases and be sure to register in the antenatal clinic. Following these tips can significantly reduce the risk of oligohydramnios.

Video "Moderate oligohydramnios during pregnancy"

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According to statistics, about 4% of all pregnant women on ultrasound hear the diagnosis of "oligohydramnios". 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? What causes this condition and what consequences does it have?

Appointment of amniotic fluid

Water, or amniotic fluid, surrounds the baby throughout pregnancy. They are in the fetal bladder - a kind of "pouch" in which the fetus is formed 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. Helps create the right environment for the fetus.
2. Contains nutrients and vitamins.
3. Prevent the fusion of the skin of the child and the fetal bladder.
4. Protect from injury.
5. Allow to move. Movement is very important for fetal development.
6. Protect the umbilical cord and placenta from damage as a result of the movements of the child.
7. If there is a sufficient amount of amniotic fluid in the fetal bladder, the baby takes the desired position by the time of birth.
8. Thanks to the waters, it is easier for the mother to transfer the motor activity of the fetus.
9. Water helps open the cervix during childbirth.

Why is there little water?

Oligohydramnios is a decrease in the amount of amniotic fluid. Usually such a 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, and at 30, and at 33 and even at 35 weeks. Why does this condition develop?

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

Congenital malformations of the fetus

• Incorrect formation and development of the urethral valves.
• The complete absence of the urethra or its narrowing.
• Too narrow ureters.
• The complete absence of the muscles of the anterior wall of the abdomen and malfunctions of the urinary system.
• Absence of kidneys.
• Polycystic (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 or 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.
• placenta infarcts.
• Improper development, for example, amnion necrosis or atrophy.

Other factors

• More than 42 weeks of pregnancy.
• Injuries of the amniotic sac.
• Outflow of water.
• The death of the fetus inside the womb.
• Long-term use of drugs that allow you to save 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 on ultrasound, which are performed at 12, 20 and 35-36 weeks.

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

TORCH infections, in addition to oligohydramnios, cause malformations of the child. To avoid problems, you need to be tested for these infections even before conception.

If oligohydramnios is caused by SARS or the common cold, there is no cause for concern. The amount of water will be restored within a month.

Classification

By duration, oligohydramnios during pregnancy can be acute and chronic:

• Acute occurs spontaneously and is called benign. Such oligohydramnios is usually associated with external circumstances, for example, with colds.
• In the second case, oligohydramnios develops hidden, 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 is early or late:

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

According to injuries of the membranes, oligohydramnios is primary and secondary:

• Primary may appear in intact fetal membranes.
• The secondary appears when the fetal membranes are damaged and the water is leaking.

How is it manifested?

It is very difficult to notice oligohydramnios on your own at any time, whether it is 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 pronounced, the baby becomes cramped in the uterus, and each of his movements gives pain in the body of the pregnant woman.

A gynecologist may suspect oligohydramnios if the size of the uterus does not match 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 scan, where a specialist will determine the index of the amniotic fluid (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 unequivocal answer to these questions - it all depends on the timing and reasons.

If the lack of amniotic fluid happened in the middle of pregnancy, in the period from 17 to 27 weeks, the walls of the uterus are squeezed from all sides of the child. It leaves no room for movement and growth.

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

• clubfoot,
• hip dislocation,
• skull deformity.

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

What could be the consequences if oligohydramnios caught up in the later stages, from 35 weeks until the moment of delivery? Childbirth will be fraught with some difficulties. With oligohydramnios, the amniotic sac becomes flat and does not 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.

In women who suffered from oligohydramnios, the risk of bleeding in the postpartum period is much higher.

most dangerous period

The critical period is the period of 30-33 weeks. Low water at 30-33 weeks is noted more often than at other times, and is a consequence of oxygen starvation of the fetus. In this state, all blood is collected 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.

For a period of 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

The 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 the maximum possible period 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 violations in the development of the child, delivery is indicated for a period of 37-38 weeks.

To alleviate the condition of the pregnant woman, doctors eliminate the cause that caused oligohydramnios. They also prescribe drugs to improve blood flow in the placenta. It is important to constantly monitor the baby's condition with the help of ultrasound, CTG (cardiotocography) and dopplerometry.

If the condition of the fetus deteriorates sharply according to CTG, a caesarean 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 the development of the fetus. Also, this condition may 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 maternal organism or disorders in the development of the fetus. It doesn’t matter what the gestational age is: 20, 33, 35 or 40 weeks, in order to avoid serious consequences, all doctor’s prescriptions must be followed.

Oligohydramnios - lack of amniotic fluid. It occurs in 20% of pregnant women. This condition can have serious consequences, it is fraught with complications and deviations from the normal course of pregnancy, and the risk of fetal development pathologies increases. The composition of amniotic fluid is quite diverse. The water inside the fetal egg contains the nutrients necessary for the life and development of the child, oxygen, hormones, salts, vitamins and other substances that ensure the normal course of intrauterine development of the fetus.

Another function of amniotic fluid is protective. The water that is inside the placenta creates a semblance of weightlessness and in this way protects the child from possible damage due to the pressure of the woman's internal organs.

In the event of an impact, it absorbs it, so the consequences for the fetus are minimal. In addition, amniotic fluid protects the baby from infections and other adverse factors. Thus, oligohydramnios during pregnancy is very dangerous, because such a phenomenon is a decrease in the quality of the protective functions of amniotic fluid.

Why does low water occur?

The amount of water inside the placenta varies depending on the needs of the baby and the duration of pregnancy, it is clear that at a period of 20 weeks the volume of water is less than at a period of 37 weeks. By the 38th week of a normal pregnancy, the fluid volume is 1500 ml, and at 39 and 40 weeks it begins to gradually decrease.

Most often, signs of oligohydramnios are detected in the second trimester (by about 20 weeks), but if oligohydramnios is detected for a period of 30-32 weeks, then this can lead to serious problems.

If for a period of 30 - 32 weeks the amniotic fluid is less than 1000 ml, then we are talking about oligohydramnios. Depending on the amount of fluid deficiency in the placenta, severe or moderate oligohydramnios during pregnancy is diagnosed. Ultrasound is most commonly used for diagnosis.

Sometimes moderate oligohydramnios during pregnancy is the result of malnutrition. In such a situation, a pregnant woman does not need treatment, it is enough to establish a regimen and diet. Usually, doctors prescribe a sparing regimen in such a situation, which includes eating a variety of foods rich in vitamins and minerals. In parallel with the diet, it is important to periodically be examined by a doctor.

If the ultrasound showed severe oligohydramnios, then serious measures will be required, including drug treatment. In such a situation, the woman will be placed in a day hospital for preservation. The more pronounced oligohydramnios, the more serious the consequences for the baby can be. Severe oligohydramnios threatens the development of the following pathologies:

• deformities of the child's skeletal system,
• asphyxia, which can lead to a violation of the nervous system and adversely affect the activity of the brain,
• abnormal development of the limbs in the fetus.

A pregnant woman should know that a decrease in the volume of amniotic fluid at a later date (37, 38, 39 weeks) is not read by pathology. This is a natural process of preparing for childbirth, which in most cases occurs at 39 or 40 weeks.

Symptoms of oligohydramnios

The most dangerous thing in this state is that there are no obvious signs of oligohydramnios. Physically, the woman feels great and her well-being has no deviations from the norm. Only sometimes, at the moment of fetal movement, a woman can feel pain in the lower abdomen, but this is an unreliable symptom.

Only a specialist can accurately determine whether a pregnant woman has oligohydramnios. So, an experienced doctor can diagnose pathology in the case of:

• lagging behind in size or inconsistency in the height of the uterine fundus,
• its serious discrepancy with the terms of pregnancy,
• insufficient size of the abdomen for this period.

If such symptoms are detected, the doctor may come to the conclusion that oligohydramnios is detected in a pregnant woman. Every doctor knows what threatens oligohydramnios if it is not treated. The risk of giving birth to a baby with developmental pathologies is very high, especially with severe oligohydramnios.

In order to refute or, conversely, confirm this diagnosis, it is necessary to conduct an ultrasound scan, on the basis of which the diagnosis is made. Ultrasound examination will accurately determine the amount of fluid inside the placenta, and when confirming the diagnosis, the doctor will assess the severity and condition of the fetus using ultrasound. If you suspect the presence of oligohydramnios, a pregnant woman should be examined by a gynecologist.

They can diagnose oligohydramnios at 20, 30 and 37 weeks. Although oligohydramnios in the classical sense can only be diagnosed at 39 or 40 weeks, if the volume of fluid has decreased to 500 ml or less.

However, the classical definition is outdated; in modern medicine, we can talk about oligohydramnios starting from the 20th week. The closer the term of delivery (37, 38, 39 weeks), the more the placenta ages and the more often oligohydramnios is detected.

Causes of oligohydramnios

If a doctor diagnoses oligohydramnios during pregnancy, the causes of this condition may be different. Experts to this day cannot come to a common opinion about why oligohydramnios occurs. From a long list of causes, scientists have pinpointed the following:

• Decreased function of the secretion of the membrane that forms the fetal egg, insufficient or abnormal development of the epithelium covering this membrane. If a pregnant woman does not know what is dangerous for oligohydramnios during pregnancy, then this is even better. Most of all, it is not diagnosis that causes difficulties for doctors, but “false symptoms” that arise as a result of the excitation of the woman’s nervous system.
• Abnormal fetal development. Other variants of abnormal development include hereditary anomalies in the development of the face and kidneys. It is possible to clarify this between 20 and 30 weeks, when the second mandatory ultrasound examination has already been carried out.
• High blood pressure in pregnancy. Naturally, throughout the entire period of pregnancy, the pressure will be increased, but its jumps will be insignificant. If the jumps in blood pressure are too high, then this can cause oligohydramnios. In the case of hypertension, there may be a delay in the development of the fetus, a slowdown in its growth or fading. Especially often this happens after 20 weeks.

• Another cause of oligohydramnios is all kinds of bacterial infections that have been transferred to a pregnant woman and not cured qualitatively. Sometimes the danger is hidden in infections that a woman had long before pregnancy. In such a situation, pathogenic microflora with the help of analyzes is detected both in the birth canal and in the amniotic fluid. The manifestation of such a danger can be detected at 20 weeks of pregnancy, when, under the influence of hormones, the infection begins to progress, in parallel with this, oligohydramnios develops. For a period of 30 weeks, oligohydramnios becomes pronounced.
• Oligohydramnios is often observed in the case of multiple pregnancies. The cause of this disease in such a situation may be the uneven distribution of blood flow in the placenta. In this case, one child gets more oxygen and nutrients than the other. This situation can lead to the death of a weaker embryo, so stationary monitoring is necessary.

• Another reason for oligohydramnios is overexposure. At 36 or 37 weeks, the baby is already fully formed and can appear at any time. Sometimes women carry a baby for more than 40 weeks, but it is important to know that starting from 38 weeks, oligohydramnios can develop. The reason for this is the "shelf life" of the placenta, which has already served its due time and is beginning to age. Sometimes obvious aging of the placenta is noted as early as 37 weeks. As a result, it peels off and fails to perform its functions. Under such circumstances, doctors raise the question of caesarean section or induction of labor by piercing the placenta. Do not be afraid if doctors offer to do surgery for a period of 37 or 38 weeks. By this period, the child is already completely ready for the birth.

• Oligohydramnios can develop gradually, starting from the first week of pregnancy, and be detected at a period of 12 or after 20 weeks during an ultrasound scan. The reason for it may be obesity of a pregnant woman as a result of serious metabolic disorders. In such a situation, it is important to know how pronounced it is, and how seriously it affected the development of the fetus. If oligohydramnios has not yet had time to become pronounced and become critical, then you can save the child. To do this, the pregnant woman is placed in a hospital, where she will be under the supervision of doctors throughout the entire period of gestation. With such a pathology, you need to introduce a strict diet and find out the causes of obesity. Even with the best option, the baby will be born no later than 37 or, in extreme cases, 38 weeks. This is due to the death of the placenta. In this case, a caesarean section is necessary.

Examinations and analyzes for oligohydramnios

Before starting treatment, the doctor needs to establish what led to the pathology and make a diagnosis. First of all, it is important to clarify the cause that resulted from the insufficiency of amniotic fluid and the severity of oligohydramnios. In this case, you need to go through a series of tests and studies:

1. ultrasound and dopplerography, as a result of which you can:

• determine the amount of water in the fetal egg;
• clarify the degree of developmental delay of the child;
• assess the quality of blood flow in the uterine arteries of a pregnant woman, as well as in the umbilical cord and cerebral artery of the fetus.

1. urinalysis, complete blood count, smear for possible infections and other sexually transmitted diseases. These tests will exclude the possibility of infection of the fetus, as a result of which oligohydramnios develops;
2. CTG in order to determine the well-being and condition of the fetus.

In addition, it is extremely important to conduct an oral survey of a pregnant woman. The more honest her answers are, the faster it will be possible to find out the cause of oligohydramnios. It is important to clarify whether she abused any products, whether she drank alcohol, whether the pregnant woman smokes. The sooner the cause of oligohydramnios is established, the sooner it will be possible to start treatment, which means saving the child.

If oligohydramnios is diagnosed at an early stage, then the pregnant woman will need to undergo additional examinations throughout the entire gestation period to identify the amniotic fluid index (AFI). For each week, starting from 16, you need to determine the AFI. The frequency of determination is 20, 30, 32, 34, 35, 36, 37, 38, 39 and 40 weeks of pregnancy (provided that delivery by caesarean section does not occur at 37 weeks).

Treatment of oligohydramnios

Methods of treatment of this disease can be different. It all depends on the severity of oligohydramnios, the causes of its occurrence and the timing of pregnancy. For example, in the case of metabolic disorders and obesity for a period of 30 or 32 weeks, a woman is prescribed medication that normalizes the activity of the placenta.

Also, the doctor will make a special diet. If the gestational age is 33 or 34 weeks or more, then complex treatment is prescribed, which includes taking drugs that improve the metabolism in the placenta, vitamins, and drugs for the main cause of the disease.

Treatment can take place in two versions: outpatient - with a moderate degree of oligohydramnios, or in a hospital - if the degree of oligohydramnios is pronounced. Outpatient treatment includes:

• restriction of motor activity,
• maintaining a gentle regime,
• exclusion of heavy physical exertion,
• taking drugs prescribed by a doctor,
• periodic visits to the antenatal clinic.

Usually outpatient treatment is prescribed if the woman is in the second trimester of pregnancy. A woman is admitted to the hospital if:

• if oligohydramnios has a pronounced degree;
• if the amount of amniotic fluid is slightly below normal, but the tone of the uterus is detected;
• oligohydramnios at 34 - 35 weeks of gestation and later.

In the case of diagnosing oligohydramnios, the doctor may prescribe a weekly ultrasound, starting at 34 or 35 weeks, fetal CTG and dopplerography. Such measures are extremely important in order to control pathology. Then, if something goes wrong, it will be possible to take the necessary measures in time.

If oligohydramnios is severe and the severity of the pathology threatens the health of the child, then the doctor is obliged to take action and perform a caesarean section. Preterm birth in this case is possible only with a gestational age of 33 weeks or more.

However, whenever possible, doctors try to do everything to keep the pregnancy up to a period of at least 35 weeks, since the fetus is considered to be fully ripe only by the end of 36 weeks. But this does not mean that you need to abandon the operation for a period of 34 or 35 weeks, since with oligohydramnios the fetus can be severely affected.

The condition of a woman with oligohydramnios

Oligohydramnios has serious consequences and has a negative impact on the course of pregnancy, resulting in painful sensations, this is especially pronounced during the period of active fetal movement. In addition, a small amount of amniotic fluid can lead to abortion. The risk of miscarriage is especially high in the first trimester of pregnancy.

Regardless of the form of oligohydramnios (moderate or severe), there is a complication of the course of childbirth. This can manifest itself in the weakness of the birth process - minor contractions and weak attempts.

This occurs as a result of the low pressure of the fetal bladder, which, due to its small size, is not able to influence the rate of preparation of the birth canals and the opening of the cervix. At a period of less than 34 weeks, a caesarean section will have to be performed.

In such a situation, it may be necessary to inject special drugs that stimulate contractions. This is especially important for a period of more than 35 weeks. In this case, the woman will be able to give birth herself.

Prevention of oligohydramnios

Since the consequences of oligohydramnios can be serious and difficult to treat, preventive measures must be taken. They consist in proper nutrition and in compliance with all medical recommendations. It is important to pass examinations and take tests on time. It is forbidden to lift weights.

The baby, while in the womb, is protected not only by the placenta, but also by the amniotic fluid. This liquid is a source of vitamins, hormones, salts, and oxygen for the child. However, in some cases, harmful microorganisms can penetrate into the amniotic fluid, which is reflected in its quantity - and can cause the development, for example, of oligohydramnios.

Causes of oligohydramnios during pregnancy - who is at risk?

Hearing such a diagnosis at the next examination, you should not panic!

Low water is different in severity:

• In some cases, treatment procedures are limited to diet and vitamin therapy.
• Modern medicine corrects more complex conditions with the help of therapeutic measures.

The pathological condition under consideration is a consequence of the deformation of the villi of the aquatic membrane - or their inability to produce a sufficient amount of amniotic fluid.

There are several reasons that can provoke this phenomenon:

1. Anomalies in the development of the fetus

These include:

• Absence of both kidneys. A similar defect can be observed during ultrasound. Shadows in the region of the kidneys and bladder will not be observed. This condition leads to death at the time of bearing a child, or immediately after his birth. Bad habits of the mother, some infections, work in hazardous industries, as well as chromosomal ailments can cause the absence of two kidneys in the fetus.
• Formation of valves in the urethra, which leads to stretching of the bladder and enlargement of the kidneys. Diagnosed only in boys.
• Enlargement of the kidneys with the formation of cavities in them. Such a defect often makes itself felt in the 3rd trimester of pregnancy, and has an unfavorable prognosis for the life of the child. This defect is hereditary in nature, so parents must undergo karyotyping without fail.
• Cropped Belly Syndrome. It combines many defects in the structure of the urinary system, testicles, as well as the muscle tissue of the peritoneum. In some cases, this all negatively affects the development of the lungs. This pathology is extremely rare in practice, and if it is detected, doctors recommend terminating the pregnancy.
• Too small urethra- or its complete absence.
• Errors in the structure of the cloaca. Such a defect affects the digestive tract and the genitourinary system. Fluid accumulates in the abdominal cavity and cysts form. In some cases, the bladder and intestines are not covered by the skin.
• Occlusion of the lumen of both ureters.

Video: Polyhydramnios and oligohydramnios

2. Intrauterine infections

Harmful agents penetrate the placenta and membranes of the fetus through the genitals of the expectant mother, thereby provoking inflammation.

Such conditions in the first weeks of pregnancy can cause a complete absence of amniotic fluid.

3. Poor blood supply to the baby due to violations in the structure of the placenta

The following events can lead to this:

• Infection.
• late toxicosis.
• Malfunctions of the ovaries.
• Chronic ailments in a pregnant woman (including diabetes mellitus).

4. Fetal death

The main reason for this is, as a rule, fetoplacental insufficiency.

Amniotic fluid is produced in a smaller amount due to the stoppage of the kidneys and lungs.

Outwardly, this is manifested by a decrease in the abdomen in a pregnant woman.

5. Obesity

6. Multiple pregnancy - in cases where additional blood vessels begin to form in the common placenta

This provokes malfunctions in the functioning of the placenta: one twin secretes more urine against the background of active blood supply, the second develops hypoxia.

7. Taking certain medications

In particular, this applies to Indomethacin, the main purpose of which is to reduce renal blood flow.

8. Rupture of membranes a few weeks before delivery

During which there is a leakage of amniotic fluid.

This phenomenon may occur due to the following factors:

• Diagnosis of isthmic-cervical insufficiency in a future mother.
• Too narrow pelvis and / or incorrect position of the baby.
• Inflammatory processes in the fetal membranes.
• Invasive interventions: cordocentesis, amniocentesis, etc.
• Polyhydramnios.

Types, severity of oligohydramnios and timing of pregnancy

In the medical literature, the considered pathological phenomenon is classified according to two main features:

1. Based on the timing of pregnancy:

• Previously oligohydramnios up to 20 weeks. The culprit is often the poor condition of the membranes.
• Later oligohydramnios. It makes itself felt after the 20th week and, as a rule, is provoked by errors in the functioning of the placenta.

2. Depending on the degree of decrease in the level of amniotic fluid:

• Moderate low water. The volume of liquid ranges from 400 to 700 ml. This practically does not affect the condition of the fetus, and therapeutic measures are limited to diet.
• Expressed. The level of amniotic fluid does not exceed 400 ml (with a normal 1000-1500 ml at 38 weeks). In such cases, the woman is hospitalized and provided with qualified medical care. Severe oligohydramnios has a very negative effect on lung function, and can cause fetal death.

Signs and symptoms of oligohydramnios during pregnancy - diagnosis of oligohydramnios

Moderate oligohydramnios practically does not manifest itself in any way, and it affects the development of the fetus.

If oligohydramnios is severe, the following symptoms occur:

1. Loss of energy, dizziness. The pregnant woman also complains of nausea, and in some cases vomiting is present.
2. Aching pain when moving the baby.
3. Dry mouth.
4. Small belly: after the 4th month it is almost invisible. In addition, the height of the fundus of the uterus does not meet the standards.

Alarming symptoms, if this is not the last week of pregnancy, is the appearance of watery discharge from the vagina. This indicates leakage of amniotic fluid.

Another bad sign is a decrease in fetal mobility.

Diagnostic measures include the following procedures:

• Examination at the gynecologist. The specified specialist at each visit measures the volume of the abdomen for the expectant mother, as well as the height of the uterine fundus. These indicators should increase as the gestational age increases. The doctor is also interested in the mobility of the fetus.
• Ultrasound diagnostics. Guaranteed method for determining oligohydramnios. During the study, it is possible to establish the exact volume of amniotic fluid, assess the level of fetal development and structural features of the placenta, and identify degenerative conditions that caused oligohydramnios.
• Laboratory research. As mentioned above, the considered pathological condition can be triggered by various infections. Testing of urine, blood, and vaginal swabs favors the detection of harmful agents.
• Cardiotocography. It is prescribed by a doctor if necessary, starting from the third trimester, to determine the individual health of the fetus, the general condition of the pregnant woman, as well as the tone of her uterus.
• Doppler. It is carried out with severe oligohydramnios in order to study the state of the placenta. When diagnosing placental insufficiency, this type of examination is carried out every 14-20 days.

Possible complications of pregnancy and childbirth with oligohydramnios - the main dangers and risks for mother and child

Severe forms of oligohydramnios often lead to miscarriages or premature births (in 50% of cases).

Other negatives include:

1. Prolonged labor with slow opening of the cervix. It is also possible the complete absence of labor activity. After childbirth, severe bleeding may open. Often, to solve this problem, they resort to a caesarean section.
2. Squeezing the umbilical cord during childbirth, which is fraught with the development of acute oxygen deficiency or the death of the baby.
3. The formation of amniotic cords that wrap around the limbs and provoke their deformation. The possibility of their amputation is also not ruled out.

Is it possible to cure oligohydramnios in pregnant women - treatment of oligohydramnios and the choice of labor tactics

When a future mother is found to have low water, first of all, the cause of this phenomenon is determined. To do this, conduct a comprehensive examination.

If oligohydramnios is the only symptom, therapeutic measures in the first two trimesters of pregnancy are limited vitamin therapy and protein-vegetable diet. At the same time, the patient needs to minimize physical activity, relax more, and avoid stressful situations.

When diagnosing oligohydramnios at the 34th week of pregnancy, or when this pathology is combined with uterine hypertonicity, a woman is hospitalized - and her condition is monitored until the baby is born.

In the event that the diagnosis revealed a primary ailment, the main goal of treatment will be its elimination.

In this regard, the following measures can be taken:

• Surgical procedures for congenital anomalies. In case of their inappropriateness, it is recommended to terminate the pregnancy.
• Antibiotic therapy to eliminate intrauterine infection. Before prescribing a particular drug, a pregnant woman should undergo a series of laboratory tests.
• Expectant management or abortion in case of chromosomal defects. Here it is very important for the doctor to find out the level of fetal viability.
• hormone therapy, as well as the prevention of infection in case of rupture of the fruit membranes.
• Taking vascular medications up to the 20th week in the diagnosis of placental insufficiency. After this period, the expectant mother is regularly monitored. If the fetus is significantly behind in its development, a decision is made on early delivery. It is desirable to carry out a similar procedure after the 33rd week.
• Vascular shunting of the placenta in the syndrome of "squeezed twin". The recipient fetus is pumped out excess amniotic fluid.