Low water in pregnant women in the later stages of the consequences. Low water during pregnancy: causes and consequences. Why is low water dangerous? Treatment of oligohydramnios. Nutrition for oligohydramnios during pregnancy

The body of a woman was conceived by nature initially for the birth of a new life in it, its formation with subsequent development and a successful birth. Everything in the female body is debugged so that the baby, as it grows in the mother's tummy, feels comfortable and is maximally protected from the effects of the external environment. Such functions are performed and, in which the baby freely swims and somersaults during pregnancy. And in order for the baby to develop according to the norm and not experience any inconvenience, there should be not a lot of amniotic fluid (namely, this is what amniotic fluid is called) but not a little, but in those quantities that were originally provided by nature.

Amniotic fluid is a necessity, an indispensable fluid to ensure the normal development of the baby. Amniotic fluid is a kind of nutrient medium, consisting of oxygen, vitamins, hormonal compounds, salts. In addition to the "nutritional" function, the amniotic fluid also plays a protective role - amniotic fluid protects the baby from the effects of multiple negative factors and infectious agents. As pregnancy progresses, the amount of amniotic fluid changes - depending on the timing and needs of the baby. And the doctor must monitor these changes, because a decrease (oligohydramnios) or an increase (polyhydramnios) in the amount of amniotic fluid can threaten the development and even the life of a child, cause serious complications.

Oligohydramnios during pregnancy, as the name suggests, is defined as a decrease in the volume of amniotic fluid. Oligohydramnios can be moderate and severe, and moderate oligohydramnios during pregnancy is more common. With moderate oligohydramnios, there is a slight decrease in amniotic fluid, which, of course, is less dangerous than severe oligohydramnios. However, moderate oligohydramnios during pregnancy can cause no less trouble, and complications of pregnancy may well cause, affecting the intrauterine development of the fetus. So, often the result of moderate oligohydramnios during pregnancy is the birth of a small baby. Other consequences of moderate oligoamnios can be curvature of the spine, hip dysplasia.

But you should not panic ahead of time - in most cases, pregnancy with moderate oligohydramnios ends safely, the baby is born in a satisfactory condition. Of course, subject to a timely response to the problem, the correct behavior of the expectant mother, regular visits to the doctor and the implementation of all his recommendations.

Even if a woman at the next time heard the diagnosis of "moderate oligohydramnios during pregnancy", it should not be considered final. So, it is necessary to undergo a second examination - in another clinic and under the guidance of another doctor. Also, the doctor may prescribe vascular doppleography (to exclude a slowdown in the development of the baby) and cardiomonitoring (to assess the general condition of the fetus). If possible, together with the doctor, it is necessary to determine the likely prerequisites that led to moderate oligohydramnios during pregnancy.

The reasons for the development of moderate oligohydramnios have not been fully studied, but the most likely may be: high blood pressure; sexually transmitted infections (even those infectious diseases that the mother suffered before pregnancy and which were not completely cured), chronic inflammatory diseases of the mother (gynecological, urinary). Also, the reasons for the development of moderate oligohydramnios during pregnancy include the problems experienced by the fetus - chronic hypoxia in the baby, disorders and anomalies of its intrauterine development.

The first and most important step in confirming moderate oligohydramnios during pregnancy is to change the lifestyle and eating behavior of the mother. So, a woman with moderate oligohydramnios is simply obliged to eat foods that contain vitamins and minerals in sufficient quantities. A sparing regimen and sufficient rest, avoidance of stressful situations and nervous stress are also shown. And most importantly - regular monitoring by the attending physician, which will avoid deterioration of the condition.

Especially for- Tatyana Argamakova

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 burden 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.

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

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

What does oligohydramnios mean during pregnancy?

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

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

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

Severe oligohydramnios during pregnancy

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

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

Women suffering from severe oligohydramnios, only 0.3-0.5%.

Signs of oligohydramnios during pregnancy

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

The doctor on examination can identify the likelihood of oligohydramnios by lagging behind the following indicators:

growth of the abdomen
fundus measurements

According to these data, the doctor can make an assumption about a deviation from the norm, he must definitely send the pregnant woman for an ultrasound examination, where the diagnosis will be made exactly.

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

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

Causes of oligohydramnios during pregnancy

All the reasons due to which oligohydramnios occurs are not fully understood, but experts distinguish the following:

Leakage of amniotic fluid or scientifically - amnionic hydrorrhea. Leakage of water occurs long before the due date due to rupture of the fetal membrane. Doctors believe that this happens due to infection of the membrane or its premature aging, which leads to its thinning and the appearance of a gap. This deviation is treated with bed rest, while the fluid has time to recover and its loss does not harm the child.
Violations in the development of the fetal membrane. There are quite a few such disorders and the reasons for their occurrence, too, the most common include genetic disorders and the harmful effects of the environment.
Infection of the fetal bladder. There are a number of viruses from which the placenta cannot protect the child and infection of the fetal bladder occurs, its proper functioning is disrupted, which leads to oligohydramnios
Overgrowth of the fetus. The placenta and the fetal membrane no longer work at full capacity, the child does not receive the nutrients he needs and the condition of his body worsens, blood circulation in the membranes is also difficult, which in turn leads to a decrease in the production of amniotic fluid
Underdevelopment of the tissues of the fetal bladder or their poor secretory work
Pathologies in the development of the fetus. Here, doctors identify genetic anomalies in the development of the face and kidneys.
Bacterial infections in rare cases are able to penetrate not only into the birth canal of a woman, but also into the amniotic fluid.
With multiple pregnancies, there are cases when blood is not properly distributed in the placenta and therefore one child does not receive the necessary substances, while the other receives too much of them.

What threatens oligohydramnios during pregnancy?

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

If severe oligohydramnios was detected late and has irreversible fetal developmental disorders, doctors insist on early termination of pregnancy.

Moderate oligohydramnios can never have a negative impact on the child, unless, of course, the diet and lifestyle of the pregnant woman is adjusted.

Low water during pregnancy, what to do?

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

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

How to treat oligohydramnios during pregnancy?

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

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

Ultrasound for oligohydramnios during pregnancy

These examinations will help to assess the condition of the child and the severity of the deviation. According to their results, the gynecologist will prescribe the necessary treatment. You also need to try to determine the cause of oligohydramnios, this will help choose the right treatment.

If the cause of oligohydramnios is obesity and metabolic disorders in the body, then you need the right diet, taking vitamins and drugs that improve the blood supply to the placenta. If oligohydramnios is moderate, treatment can be done at home, but if it is severe, then hospitalization is necessary.
If the cause of oligohydramnios was a viral infection, then antiviral drugs are prescribed and general strengthening therapy is carried out. The doctor will definitely prescribe a vitamin complex and medicines that improve blood microcirculation
If the cause lies in the violation of the development of the fetal bladder, doctors try to keep the pregnancy and prevent infection of the fetus. In this case, the treatment is carried out exclusively in the hospital and the woman is prescribed additional examinations to assess the condition of her body and the condition of the fetus.
When overdue, doctors puncture the fetal bladder and induce labor with stimulant drugs
It is also important to reduce physical activity, reduce motor activity and adhere to bed rest.
With oligohydramnios, doctors direct the woman to do ultrasound and dopplerography more often to monitor the dynamics of the deviation and changes for better or worse in the mother's body and the child's condition
If the gestational age is already long and the baby is full-term, then the doctor may recommend premature birth, which will be caused by special stimulant drugs

Be sure to let your doctor know if you've had this condition in previous pregnancies, and it's best to have a couple of extra ultrasounds done to rule it out or detect it as early as possible.

The index of oligohydramnios during pregnancy

An ultrasound examination diagnoses oligohydramnios based on the amniotic fluid index (AFI), which is calculated by an ultrasound machine. The device measures the amount of water in several places and calculates the IAI.

IAI table at different stages of pregnancy

In the third trimester:

if the index is within 5-8 cm, then the amount of water is normal
if the index is 2-5 cm, then this is "moderate oligohydramnios"
with an index below 2 cm, a diagnosis of "pronounced oligohydramnios" is made

However, it is worth noting that the IAI varies depending on the gestational age:

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

The amount of amniotic fluid changes as the fetus grows, swallows the fluid, and urinates. But do not worry about the condition of the baby, because. amniotic fluid is renewed every 3 hours, and every 3 days they are completely changed.

Nutrition for oligohydramnios during pregnancy

You need to eat with oligohydramnios correctly and balanced:

try to eat several times a day (more than 5 meals), but in small portions
foods should contain many vitamins and minerals, be nutritious
choose natural products with minimal processing
exclude fast food items from the menu (hamburgers, hot dogs, etc.)
reduce the amount of sugar and salt you eat
eliminate fatty foods from your diet
try to reduce the use of spices and spices
avoid products containing preservatives, flavors and dyes
meat, fish and seafood should be well cooked, they should not be eaten raw or semi-finished
refrain from eating blue cheese, unboiled milk and raw eggs
do not drink strong tea, try to do without coffee and completely eliminate alcohol
eat more fruit instead of sweets and sugar

Be sure to keep an eye on weight gain, because. a rapid set of it can also lead to oligohydramnios or worsening of an already existing deviation.

Tendency to oligohydramnios during pregnancy: how to determine?

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

mother-to-be smokes
multiple pregnancy
the woman has metabolic disorders in the body
there are abnormalities in the development of the fetal bladder
preeclampsia - late toxicosis
dehydration due to vomiting or diarrhea
have a bacterial or viral infection
woman suffering from diabetes
the presence of chronic diseases in the expectant mother
prolongation of pregnancy
fetal kidney defects
had oligohydramnios in previous pregnancies

If you fall into the risk category, the doctor will prescribe you additional examinations and tests in order to detect deviations from the normal volume of amniotic fluid in time and start treatment as soon as possible.

Let's summarize and define the main measures for the prevention of oligohydramnios:

Proper fractional nutrition, products should be as useful as possible
Dieting if you have problems with being overweight
Additional intake of complex vitamins
Exclusion of physical activity, replace them with walking in the fresh air
Timely visits to a gynecologist, passing tests, passing the necessary examinations
If there are endocrine disorders (diabetes mellitus, for example, or obesity), you need to undergo appropriate treatment

When I was pregnant, everyone could not get enough of the fact that I had a small stomach, as it turned out later on an ultrasound scan - oligohydramnios. But, probably, it was moderate, because. the doctor did not prescribe any medications and only said that they would not allow me to walk, but my son did not wait long, he was born a little ahead of schedule - the birth was easy, there were no problems with the child's health.
Masha, 24 years old.

In fact, doctors exaggerate everything, there is nothing wrong with oligohydramnios. Well, this is understandable, they are reinsured. But here my girlfriend was persuaded to give birth prematurely, she did not agree and informed the child. My son was born healthy and on time. Grows and strengthens.
Diana, 32 years old

In both pregnancies, I was given "moderate oligohydramnios", and both times at 30-32 weeks. In the first pregnancy, no treatment was prescribed, they said that at such a period moderate is not scary, but in the second they gave injections. The doctors were different. Both girls are healthy, and this is the most important thing! Christina, 27 years old

VIDEO: oligohydramnios during pregnancy

Amniotic fluid plays an important role in the normal development of the baby in any trimester of pregnancy. Their functions are to supply the baby with nutrients, protect him from mechanical injuries. During childbirth, the amniotic fluid promotes the early opening of the cervix. Diagnosed with moderate oligohydramnios during pregnancy at any time, whether it be 20 or 37 weeks, is alarming and makes you look for information about this pathology - what it threatens, how to determine it and what to actually do.

medical definition

According to the classical definition, a similar conclusion is given to women at 40-41 weeks of gestation, if the volume of amniotic fluid has decreased to 500 ml or less. This formulation takes into account the deviation from the norm only before childbirth. But meanwhile, oligohydramnios can be delivered at 20 weeks and at 30, and at 37, the closer the birth, the more the placenta “ages” (37, 38, 39 weeks).

Throughout the 9 months of a child's development, the volume of amniotic fluid is constantly changing. Its specific values for each week of gestation have become known as a result of numerous studies. At any time, a situation may arise when the amount of amniotic fluid is abnormally low. Doctors diagnose and prescribe treatment for oligohydramnios during pregnancy, fixing a special indicator - the amniotic fluid index (AFI), which for each week has an average and normal range, for each week it has its own (from 16 weeks onwards - 20, 30, 34 , 35, 36, 37, 38, 39), and additionally each ultrasound device has its own table of these indicators.

Given the severity, there are moderate and severe oligohydramnios during pregnancy. The first type of disease is much easier to deal with. The condition will return to normal if the expectant mother stops being nervous, starts to eat rationally, pays more attention to her health - it is enough to do this and things will get better, and this also applies to the terms at 37 - 39 weeks. And the second case is a serious problem for a woman. To eliminate it, you will have to go to the hospital and undergo a course of therapy.

Oligohydramnios in pregnant women is a dynamic condition. Its tendency is unpredictable - it can suddenly appear and also disappear at any time. We are talking about a functional deviation if it was at the 20th week of pregnancy, and disappeared at the 32nd week, and in the last weeks - 37-39 and then the decrease in water is considered normal. These are temporary disorders that are not considered pathological.

A persistent abnormal condition for many weeks, that is, severe oligohydramnios, is a sign of severe deviations in the development of the child and the course of pregnancy. According to statistics, the incidence of serious pathology is 0.2-0.3% of all cases. In each of them, violations in the development of the fetus and placenta are visible on ultrasound.

Prevention of oligohydramnios is not carried out during pregnancy - at 34 or 35 weeks, for example, but during the planning period for the birth of a child.

Factors causing pathology

Any pregnant woman can face a similar problem, regardless of age and number of births. When oligohydramnios is observed during pregnancy, the reasons may be the following:

violations of metabolic processes in the body;
damage to the fetal bladder;
hypertension;
dependence on nicotine in a pregnant woman;
injuries to tissues that protect the aquatic membrane;
multiple pregnancy;
dehydration caused by vomiting or diarrhea;
the action of bacterial infections and viruses;
preeclampsia;
genetic abnormalities in the development of the child;
overweight;
diabetes;
prolongation of pregnancy.

Medicine does not yet know which of the signs of oligohydramnios from the above list play a major role in reducing the volume of amniotic fluid. 90% of expectant mothers suffer from hypertension. Only 4% of these women subsequently experience a severe form of the disease.

In the later stages of bearing a child (starting from 32 weeks), problems arise due to a tear in the bladder. When overwearing, there is less water, as the placenta ages.

Most of the causes of oligohydramnios during pregnancy are successfully eliminated with proper treatment. There is no need to panic. Doctors are powerless with genetic abnormalities in the development of the baby, which are detected by ultrasound. Moderate oligohydramnios in other cases can be treated, and a healthy baby is born.

Consequences

It is difficult to predict what will be the tendency of oligohydramnios in this or that case, because possible complications with an underestimated IAI can be:

The contracting walls of the uterus create additional pressure on the fetus. He has to bend over, make himself uncomfortable. This situation threatens that the baby's spine may be bent, clubfoot may develop. There is a possibility that the skin will grow to the fetal membrane. The tissues of the child dry out and wrinkle.
Prolonged close contact of the bladder and children's skin is the cause of the appearance of simonart ligaments. Formations wrap around the baby, impede his movements. If they affect the umbilical cord, blood circulation is disturbed. Consequences - developmental delay. The extreme case is fetal death.
It is known that oligohydramnios is dangerous during pregnancy directly for the expectant mother. This is a non-releasing pain in the lower abdomen. It is especially difficult in the 2nd and 3rd trimesters. Every movement of the fetus causes discomfort. Sensitivity increases starting at 36 weeks, as the baby is already large.
During childbirth, the cervix dilates slowly. Contractions are painful but not productive. The mother may bleed.

The likelihood of negative consequences for the fetus increases when moderate oligohydramnios has developed early enough. If we compare problems with fluid at the 20th and 33rd week, then in the first case the risk of disfigurement is greater. This statement is true in a situation where the volume of water does not return to normal within 30 days.

Early symptoms

Moderate oligohydramnios is not accompanied by pronounced signs and health problems. This is the main difficulty in comparison with the case if there is pronounced oligohydramnios. Not every gynecologist will determine the pathology during the examination. The doctor may notice a discrepancy between the circumference of the abdomen and the gestational age.

An accurate diagnosis is made after several ultrasound procedures. With the help of technology, the amount of water, the severity of the disease are calculated, the condition of the baby is analyzed. Sessions are carried out several times over 1 or 2 months.

A woman needs to worry if she is overcome by abdominal pain. Each movement of the fetus causes an exacerbation. And the general condition leaves much to be desired: the pregnant woman feels nausea, weakness, dry mouth.

Health care

Treatment for oligohydramnios will depend on its type and cause. If moderate oligohydramnios is the norm, then they will be treated in this way: the expectant mother will be advised to rest more, monitor nutrition, take vitamins and periodically consult a gynecologist. If this is not done, or when the measures taken do not help, the situation worsens, the woman will have to go to the department of pathology of pregnant women.

When diagnosing a decrease in water, the patient is sent to the hospital for additional studies. It is necessary to undergo ultrasound, cardiotocography, donate blood and urine to the laboratory. A swab on the water will help to find out about the leakage of amniotic fluid.

In late pregnancy (37 and more than 38 weeks), an amnioscope can pass through the cervical canal. The gynecologist will conduct accurate examinations of the fluid that will not harm the baby in any way.

If fetal malformations are detected, the woman will be offered to terminate the pregnancy. In case of refusal, they will be treated without changing the methodology. The expectant mother will be provided with the same assistance as in the absence of abnormalities in the child.

If serious abnormalities are observed at 20 weeks, the patient will be asked to consider abortion. This decision has its own reason - the inability to predict the outcome of pregnancy. True, in most cases, by the birth of a child, the situation changes, and people regret all their lives that they succumbed to the persuasion of a doctor.

The method of treatment of oligohydramnios depends on several factors:

the reason for which it developed;
the severity of oligohydramnios;
gestational age.

The most common drug prescribed for pregnant women is Actovegin, due to its ability to maintain the normal state of the child in many critical situations. The consequences of oligohydramnios are higher in terms of the degree of threat to the fetus, depending on when it appeared, the earlier, the more critical. What does this mean? For example, oligohydramnios at the 20th week and at the 30th differs in that in the first case, the risk of developmental delay and the appearance of deformities is increased. And at 32 weeks and above, oligohydramnios in most cases is due to water leakage. Identified oligohydramnios during the third semester (27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40 weeks) is the basis for the fact that the woman is sent to the antenatal department and prescribed a number of procedures: the introduction of vitamins B, C and others, as well as taking Curantyl preparations, which has the best effect on the process of blood circulation in the placenta. Or Actovegin, which provides oxygen delivery to the fetus. The development of oligohydramnios in the first trimester (from 20 to 27 weeks) is unpredictable based on the results, even doctors do not undertake to predict the outcome of such a pregnancy and recommend terminating the pregnancy.

IAI is calculated using ultrasound - in a subjective or objective way, the data that are obtained as a result are compared with the table of amniotic fluid norms for all weeks. For example, at week 16, the range of the limits of the IAI norm is 73-201 mm. 20 week: 86 - 230 mm; 30 week: 82 - 258; 31:79–263; 32:77-269; 33:74-274; 34:72-278; 35:70-279; 36:68-279; 37:66-275; 38:65-269; 39: 64 - 255; 40: 63 - 240. Accordingly, the obtained indicators in different weeks, after comparison, indicate polyhydramnios or oligohydramnios.

Meanwhile, there is an average indicator, which is considered the norm. 20 week - 141 mm; 30 - 145; 31-32 - 144; 33 - 143; 34 - 142; 35 - 140; 36 - 138; 37 - 135; 38 - 132; 39 - 127; 40-123.

With a one-time ultrasound examination, oligohydramnios is not immediately diagnosed, since the amniotic fluid changes throughout the entire pregnancy, their quantitative composition depends on the week of pregnancy and the growth of the child. In addition, each ultrasound machine has its own table.

Not every woman can boast of excellent health, therefore, during pregnancy, one cannot avoid taking various drugs, for example, the same vitamins. A frequent appointment of doctors is actovegin, which contributes to the normal development of the child. Moreover, it can be prescribed at any time, and sometimes actovegin can be prescribed even at the planning stage of pregnancy, for example, with impaired blood supply.

The dosage form of the drug is chosen by the doctor depending on the condition of the woman and how severe the disease is. Actovegin is produced in tablets, ointments, ampoules, cream, gel. During pregnancy, Actovegin should not be taken on the basis of one's own considerations and having read reviews, even knowing the standard dosage prescribed by the doctor - Actovegin is not an ordinary analgin that you can drink without a doctor's instructions. Always and all medicines have side effects and there is a risk of an allergic reaction. Only the attending physician individually calculates the dosage, time and method of using a medicine such as Actovegin. After all, the doctor, based on the condition of the pregnant woman, may prescribe Actovegin in tablets, or may prescribe a course of treatment in the form of injections, and in critical situations Actovegin may be administered parenterally.

Moderate oligohydramnios is not the worst threat when carrying a little man. The most important thing is to stop being nervous, monitor your health and respond to problems in time.

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

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

There is moderate and severe oligohydramnios

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

Symptoms of oligohydramnios

Oligohydramnios cannot be diagnosed with accuracy on its own. But some signs can become an alarming "bell".

First of all, they include:

frequent nausea,

Drawing pain in the lower abdomen

Increased pain sensitivity during fetal movement,

Dry mouth

Weakness.

Low water during pregnancy can be diagnosed by a doctor at the reception. Often, he is guided by deviations from the norms for the corresponding gestational age when measuring the volume of the abdomen, the height of the fundus of the uterus. Ultrasound will show more accurate results. This examination will determine the number of amniotic norms, and also diagnose the development of the fetus in appropriate conditions.

Causes of oligohydramnios

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

1. Infectious diseases of the mother. These include SARS, influenza, chronic diseases, inflammation, infections of the genital organs.

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

3. Violation of the urinary system of the fetus, most often associated with problems in the functioning of the kidneys.

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

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

6. Also, the causes of oligohydramnios include obesity, metabolism, diabetes mellitus.

Dangers in oligohydramnios

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

1. Complication in the development of the fetus. This may be malnutrition (intrauterine growth retardation), hemicephaly (insufficient development of the brain), hypoxia (oxygen deficiency), amniotic constriction (union of the skin of the fetus), deformity of the limbs or muscles of the fetus.

2. Spontaneous termination of pregnancy (miscarriage).

3. Premature labor activity.

4. Difficult, prolonged childbirth.

5. Intrauterine fetal death.

Treatment for oligohydramnios

If severe oligohydramnios is diagnosed, the pregnant woman is hospitalized, a thorough examination is carried out (ultrasound, cardiogram, blood and urine tests). In order to determine the course of treatment, it is necessary to correctly identify the cause of oligohydramnios. Only after that appropriate methods are assigned to eliminate it. At the same time, the entire course takes place under the strict supervision of specialists and the necessary examinations, including ultrasound and dopplerography. It is also very important to switch to proper nutrition, taking vitamins to improve the blood supply to the placenta, limiting motor activity and physical activity, and bed rest. Most importantly, even with moderate oligohydramnios, do not resort to self-medication.