What is moderate oligohydramnios during pregnancy. Low water during pregnancy: causes and consequences. Signs and treatment of pathology. Poor blood supply to the baby due to violations in the structure of the placenta

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According to the classical medical definition, oligohydramnios(oligohydramnion - lat.) is called a decrease in the volume of amniotic fluid (amniotic fluid) less than 500 ml at full-term pregnancy. That is, if a woman in the period of 40 - 41 weeks of pregnancy, the amount of amniotic fluid is 500 ml or less, then this condition is oligohydramnios. But this definition reflects only one aspect - what is considered low water on the eve of childbirth. Consider what in modern obstetric practice can be understood as oligohydramnios in general, and what is the significance of this parameter for assessing the course of pregnancy, as well as the growth and development of the fetus.

Low water in pregnant women - what is it?

The amount of amniotic fluid is not a static value, because as the fetus grows and develops, the volume of amniotic fluid changes, which begins to be secreted from the 8th week of gestation and continues until the very birth. Thus, the amount of amniotic fluid at each stage of pregnancy is different. Moreover, at any stage of pregnancy, their number may be less than normal, which will also be oligohydramnios. That is, expanding the classical definition of oligohydramnios, we can say that this is a condition in which the volume of amniotic fluid is less than the lower limit of normal for this particular gestational age.

Currently, based on numerous observations and calculations, tables have been developed with the average, maximum and minimum volumes of amniotic fluid characteristic of each week of gestation, starting from the 14th. That is, oligohydramnios can be determined starting from the 14th week of pregnancy.

However, we repeat that the concept of oligohydramnios is dynamic, that is, it can periodically appear or disappear during pregnancy. This means that the same woman, for example, at 23 weeks had oligohydramnios, and at 33 weeks of pregnancy it is gone. In such cases, doctors talk about functional oligohydramnios, which occurs in response to various environmental influences and resolves on its own within a month. Strictly speaking, such oligohydramnios is transient, that is, temporary, and therefore refers to functional disorders, and not to pathologies. The vast majority of cases of oligohydramnios are just such transient, functional disorders that are not dangerous for the growth and development of the fetus and do not violate the normal course of pregnancy and childbirth.

If oligohydramnios is persistent, that is, it does not go away and is fixed at different stages of pregnancy, for example, at 23, at 25, at 30 weeks of pregnancy, then we are talking about pathology. In such cases, oligohydramnios is a sign of severe violations of the course of pregnancy and fetal development.

Therefore, when a woman is diagnosed with oligohydramnios according to the results of ultrasound, there is no need to be upset or nervous, since in the vast majority of cases this is a functional feature of her pregnancy, and not a pathology. But if oligohydramnios is combined with malformations or does not go away within a month, then this condition is considered pathological and requires treatment. Remember that the incidence of pathological oligohydramnios is only 0.2 - 0.3% of cases, and it is necessarily combined with developmental disorders of the fetus and placenta, visible on ultrasound. Therefore, if the ultrasound doctor did not see malformations of the fetus or placenta, but diagnosed "oligohydramnios", then this always indicates the functional characteristics of the woman and does not require any treatment, with the exception of vitamin prophylaxis.

In principle, oligohydramnios is not so much an independent pathology as a single symptom, reflecting a combination of various disorders in the growth and development of the fetus or the course of pregnancy. Therefore, the isolated determination of oligohydramnios without CTG, dopplerometry and screening for malformations by ultrasound and biochemical tests (AFP, hCG, etc.) is not diagnostically accurate and justified.

Oligohydramnios in pregnant women - the diagnostic significance of the indicator

The diagnostic significance and value of such an indicator as oligohydramnios is currently very low. The fact is that before the advent of ultrasound, dopplerometry, CTG and other methods of examining a pregnant woman, fetal pathology and the likelihood of various deformities were determined indirectly, according to various indicators that correlated with impaired growth and development of the child.

One of these indicators is the amount of amniotic fluid. Doctors of past centuries determined their number in order to indirectly assess how well and according to the norm the fetus is developing. Indeed, until the middle of the 20th century, there was simply no such informative method as ultrasound, which allows you to examine the fetus and determine how it develops, accurately measuring its size and seeing all the organs and parts of the body. And the doctor, not seeing the child in the womb, had to somehow assess whether it is developing normally. It was in that era that doctors determined the amount of amniotic fluid and many other parameters that indirectly made it possible to judge the growth and development of the fetus.

However, at present, the norms of growth and development of the fetus are perfectly monitored by ultrasound, the pathology of the placenta is determined using dopplerometry, and fetal hypoxia is detected by KGT. That is, there are instrumental methods that allow much more accurate detection of fetal pathologies, placental dysfunction, etc. And so the definition of oligohydramnios is a kind of tribute to tradition. Because of this, many gynecologists do not pay attention to oligohydramnios at all, if, according to the results of ultrasound and CTG, the child develops normally, since they quite rightly consider this condition to be a feature of a particular pregnant woman.

Low water - causes of development

The reasons for the development of oligohydramnios can be various pathologies of the fetus and placenta or severe chronic diseases that a pregnant woman has. That is why the entire set of causes of oligohydramnios is divided into the following large groups:
1. Causes associated with congenital malformations in the fetus;
2. Causes associated with fetal pathology;
3. Causes associated with metabolic disorders in a pregnant woman due to severe chronic diseases;
4. Causes associated with the pathology of the placenta;
5. Other.

Specific causative factors of oligohydramnios, attributable to each of the five listed groups, are reflected in the table:

Causes associated with congenital malformations in the fetus	Underdevelopment of the urethral valves
	Agenesis (absence) or narrowing of the urethra
	Bilateral narrowing of the ureters
	Bilateral narrowing of the junction of the ureters with the renal pelvis
	Prune belly syndrome
	Agenesia (absence) of the kidneys
	Bilateral polycystic kidney dysplasia (Potter-I syndrome)
	Polycystic kidney disease (Potter-II syndrome)
Causes associated with fetal pathology	Intrauterine infection of the fetus (for example, cytomegalovirus infection, chlamydia, mycoplasmosis, etc.)
	Retardation of intrauterine development of the fetus
	Chromosomal abnormalities of the fetus (for example, Down syndrome, Marfan, etc.)
Causes associated with severe chronic diseases in a pregnant woman	Chronic diseases of the cardiovascular system (for example, hypertension, thrombophlebitis, venous insufficiency, etc.)
	Preeclampsia
	Chronic kidney disease (eg, pyelonephritis, glomerulonephritis, renal failure, etc.)
	Collagen diseases (eg, systemic lupus erythematosus, scleroderma, dermatomyositis, periarteritis nodosa, rheumatoid arthritis, rheumatism, serum sickness, etc.)
	Obesity
	Diabetes
	Dehydration of the mother's body, for example, after severe diarrhea, vomiting, etc.
	Smoking more than 10 cigarettes per day
Causes associated with pathology of the placenta	placental insufficiency
	Multiple infarctions of the placenta
	Anomalies in the development of the placenta (for example, atrophy and focal sclerosis of the decidua, necrosis of the amnion, etc.)
Other	Pregnancy over 42 weeks
	Premature rupture of membranes
	Rupture of membranes with leakage of amniotic fluid
	Intrauterine (antenatal) fetal death
	Idiopathic oligohydramnios (cause unknown)
	Iatrogenic oligohydramnios caused by long-term use of drugs from the group of prostaglandin synthetase inhibitors (for example, Indomethacin, Naproxen, Fenoprofen, flufenamic acid, etc.). These drugs are commonly used to stop preterm labor.

Thus, most of the causes of oligohydramnios are quite successfully treated with modern methods, and therefore this condition is not a cause for panic. The only group of causes of oligohydramnios that is not treated are congenital malformations of the fetus, which, however, are always detected on control ultrasounds performed at 12, 22 and 32 weeks of pregnancy. In other cases, oligohydramnios can be cured, and the woman will give birth to a perfectly healthy child.

Currently, the most common causes of oligohydramnios in pregnant women are the following factors:

preeclampsia;
Maternal hypertension;
Maternal diabetes;
Any infectious and inflammatory diseases in the mother (for example, tonsillitis, pyelonephritis, influenza, acute respiratory infections, etc.);
TORCH complex infections (toxoplasmosis, rubella, cytomegalovirus, herpes) during pregnancy;
Chronic intrauterine fetal hypoxia.

Hypertension and diabetes mellitus cause oligohydramnios, the severity of which is determined by the duration of the course and the compensation of the disease. Therefore, it is very important to control the blood pressure of pregnant women with modern, effective and safe drugs. A pregnant woman with diabetes, for the prevention of oligohydramnios and other complications, must adhere strictly to the diet, without making mistakes.

If oligohydramnios has developed before 28 weeks, then doctors recommend termination of pregnancy, since in most cases it is impossible to predict its outcome.

Low water - reviews of outcomes

In the vast majority of cases, women in various forums indicate that their oligohydramnios successfully passed in a month, and they gave birth to healthy babies at term naturally. Some women indicate that they took the metabolic complex (vitamins + Curantil + Actovegin), while others did not treat the identified condition. However, both in those who took the metabolic complex and in those who did not take it, oligohydramnios disappeared after a month, which was recorded according to the results of ultrasound. Such observations of women indicate that the vast majority of cases of oligohydramnios are physiological. Before use, you should consult with a specialist.

Amniotic fluid is a natural life support system for a child during his intrauterine stay. Amniotic fluid ensures the growth and development of the baby - with a sufficient amount of it, these processes occur in an adequate form and the baby is born full-fledged.

This specific biological environment occurs only 12 days after conception and becomes the main substance present in the woman's uterus.

It fills the amniotic sac, consisting of two membranes - amnion and chorion, each of which ensures the tightness of the uterine cavity and ensures the safety of the baby. When he is ready to be born, these membranes open on their own, and the fluid flows out: in obstetrics, this is called "the discharge of amniotic fluid."

The discrepancy between the volume of amniotic fluid and the gestational age should be detected in a timely manner. This is one of the reasons why it is important to visit the antenatal clinic regularly, without neglecting the doctor's recommendations.

The optimal amount of amniotic fluid varies from woman to woman, but if the level is dangerously low, the condition is called oligohydramnios. Usually, such a pathology develops at the end of the third trimester and can cause serious fetal pathologies.

Not in all cases, this pathology is associated with a sharp decrease in fluid intake. In other words, even when a woman has bouts of vomiting and leads to dehydration, this does not mean that favorable conditions have been created for the occurrence of amniotic fluid insufficiency.

The fact that oligohydramnios during pregnancy is not caused by a sharp violation of the woman's water balance has become a good reason for numerous studies of this problem. As a result, it was found that the level of amniotic fluid is an indicator of the functional ability of the placenta.

Oligohydramnios can lead to fetal growth retardation, slow heart rate, and in severe cases, even fetal death.

It is difficult to know the amount of amniotic fluid currently available on your own, however, according to the optimal amount for your gestational age, you can determine the table below, where AFI is the amniotic fluid index.

GESTATIONAL AGE	NORMA IAZH, ML
16 WEEK	73-201
WEEK 17	77-211
WEEK 18	80-220
WEEK 19	83-225
20 WEEK	86-230
WEEK 21	89-235
WEEK 22	92-238

Signs and causes of oligohydramnios during pregnancy

It is not always possible to trace the moment when pathological changes in the body began. But there are also such signs of oligohydramnios, which are determined even during pregnancy:

Facial anomalies of the fetus: on ultrasound, for example, a massive bridge of the nose, widely spaced eyes, low-set ears are determined.
Postpartum renal failure of the child: postpartum urine output is low or non-existent.
Underdevelopment of the lungs: if the baby survives at birth, it is likely that he will have significant breathing difficulties.

Among other reasons, the following factors predominate:

Leakage of water: this occurs due to damage to the membrane.
Multiple pregnancy, with uneven distribution of blood circulation in the placenta.
Violations of the health of the expectant mother is one of the most common causes of oligohydramnios. Predisposing factors such as dehydration, arterial hypertension, eclampsia, diabetes mellitus and chronic hypoxia affect the level of amniotic fluid.

Especially predisposes to the deficiency of amniotic water existing chronic diseases of the kidneys and bladder. The risk group for the development of oligohydramnios also includes women with diseases of the reproductive system that are relevant at the time of pregnancy.

Diagnostics

There are two types of amniotic fluid deficiency: early and late. The early type occurs against the background of a dysfunction of the fetal membranes and is diagnosed by ultrasound in the second trimester. Late is diagnosed, usually after 26 weeks, and this can occur due to fetal developmental arrest.

It is possible to suspect a low level of amniotic fluid in the case when the size of the child is smaller than necessary for his gestational age.

A widely used method for measuring amniotic fluid is to conditionally divide the uterus into four sections. It is determined how deep the waters are in each of them. These amounts are then added together. According to the results of the study, the level should exceed 5 cm.

There is another diagnostic method - the study of the maximum vertical pocket. The deepest areas of the liquid are measured in each square in centimeters. A depth of less than two centimeters is considered low.

Sterile examination of the cervix with a speculum helps detect any rupture of the membranes. Often the doctor is alarmed by the discrepancy between the level of the height of the fundus of the uterus and the circumference of the woman's abdomen.

Why is oligohydramnios dangerous during pregnancy?

If the pathology is detected in the first half of pregnancy, complications can be more serious and include compression of the fetus's organs as a result of birth trauma. In addition, the threat is growing.

If oligohydramnios is detected in the second half of pregnancy, the risk of developing conditions such as intrauterine growth restriction of the fetus and n increases.

Knowing the dangers of oligohydramnios during pregnancy, the observing gynecologist may decide to perform a caesarean section. However, this is acceptable if the gestational age has already reached 28 weeks. Even a premature baby will be safer than being in a uterus with low amniotic fluid levels.

Treatment of oligohydramnios in pregnant women

There is currently no specific treatment strategy for oligohydramnios. In some cases, this pathology causes a miscarriage, in others the child is born dead or dies shortly after birth. If the child survives to birth, there is a need for resuscitation.

Sometimes amnioinfusion can help prevent developmental problems in the baby. The essence of this procedure is that the doctor places a saline solution into the uterus through its neck.

This method helps prevent some problems, such as premature abruption of the placenta or shrinkage of the umbilical cord.

The prognosis depends on the duration of pregnancy. If pathologies of fetal development are detected before 28 weeks, and oligohydramnios is diagnosed, doctors, for medical reasons, insist on terminating the pregnancy.

If a low amniotic fluid level is detected before 34 weeks, appropriate treatment is recommended. If treatment is ineffective, the only way out is premature birth.

Prevention of pathology

There is only one action that will help to significantly reduce the likelihood of developing oligohydramnios - this is the complete elimination of the root cause that causes this pathology.

However, in some cases it is still impossible to influence those factors, the likelihood of which is equally high for pregnant women of all ages:

Anomaly in the structure of the epithelium that makes up the amniotic sac. Even a full-fledged woman cannot be immune from this situation.
Metabolic disorders in the mother also imply water balance disorders. This negatively affects the formation of a sufficient amount of amniotic fluid. The metabolic rate directly depends on the usefulness of the functioning of the thyroid gland and nutrition. When planning motherhood, it is necessary to review the diet and visit an endocrinologist for the purpose of a follow-up medical examination.
Intoxication of the mother's body with alcohol, nicotine, chemicals or drugs provokes a violation of the placental circulation and, as a result, a reduction in the amniotic fluid.
Since it is known that polyhydramnios and oligohydramnios during pregnancy are caused by exceeding its term, the only way to avoid such a situation is to stimulate labor.

In general, the condition is correctable if established in a timely manner. Oligohydramnios suggests for pregnant women a closer attention to their body and the exact implementation of medical prescriptions.

Only in this case, you can avoid many unpleasant consequences by giving birth to a healthy baby, while maintaining your own health.

For pregnant women diagnosed with amniotic fluid insufficiency, it is important to eat well, drink plenty of fluids, follow the doctor's recommendations regarding physical activity, inform him of changes in the state of the body, especially if it is worsening or any signs of preterm labor.

Useful video about oligohydramnios during pregnancy

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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:

Trental. Improves blood microcirculation. It can be prescribed both in the form of tablets and intravenously.
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."
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:

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.
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.
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.
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.
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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Oligohydramnios is called an insufficient amount of amniotic fluid. This condition is not very common, and its indicators depend on the individual characteristics of the woman's body. The causes and consequences of oligohydramnios during pregnancy often require medical intervention.

Throughout its development, the unborn child is surrounded by fetal membranes and the placenta. These organs are formed and perform their work exclusively during the period of gestation, therefore they are called the organs of pregnancy.

Their main function is to form and maintain optimal conditions for the development and formation of the unborn child, and amniotic fluid plays a significant role in this process.

The aqueous membrane, also called the amnion, is a bladder in which the fetus is enveloped in amniotic fluid. It adjoins the internal cavity of the uterus and passes to the umbilical cord, and its walls are responsible for the production of amniotic fluid.

By the end of pregnancy, their number can reach from 800 to 1500 ml. This liquid contains in its composition hormones, proteins, salts and carbohydrates, without which it is impossible to ensure the full metabolism of the fetus. By the second half of pregnancy, she becomes a little cloudy.

The amount of amniotic fluid gradually increases. It expands the walls of the uterus, providing more space for an actively growing fetus. Amniotic fluid is of great importance for the unborn child, creating a unique habitat.

They provide him with the opportunity to move, allow him to develop normally, protect him from external influences and compression by internal organs. In addition, the water-filled fetal bladder is of great importance in the speed and degree of cervical dilatation at the initial stage of childbirth.

There are different degrees of deviation of the volume of the liquid from the normal. In medical practice, a moderate (it occurs much more often) and a pronounced degree are distinguished, and, in the second case, the decrease can reach 3 times.

Oligohydramnios during pregnancy, the causes and consequences of which may be different, is rare: less than 6% of cases. Moreover, moderate oligohydramnios is much more common - a condition that is not considered critical. With rare exceptions, in the I and III trimesters, moderate oligohydramnios does not threaten the unborn child in any way.

What is amniotic fluid and how does it work:

Reasons for development

The exact reasons why there is a lack of amniotic fluid have not yet been established.

Obstetric practice statistics show that the most common prerequisites for this condition are:

Intoxication of the body with any harmful substances. This happens in cases where the expectant mother has bad habits, or she works in an industry associated with harmful substances. You can also encounter toxic substances in everyday life if you abuse household chemicals in cleaning.
Violation of metabolic processes, a tendency to overweight and obesity. Correcting the situation in this case is sometimes possible with a properly selected diet.
Violation of the function of the membrane of the fetal bladder.
Multiple pregnancy. Amniotic fluid may not be enough for 1 or more fetuses. This leads to the fact that one of them gets more nutrients and oxygen.
Transferred infections of a bacterial nature.
Pregnancy reversal. The placenta, which has outlived its allotted time, is aging. This leads to its flaking and the impossibility of the full performance of functions.
Late toxicosis.
Increased blood pressure. Many expectant mothers face this problem, but with oligohydramnios it is more pronounced.
Anomalies in the development of the internal organs of the child
Diseases of the genitourinary system - both in acute and chronic form.
Violation of the integrity of the fetal membrane and the resulting leakage of water.

Severe oligohydramnios is often associated with intrauterine malformations, the most common among which are anomalies in the development of the skull and the formation of the kidneys. In such situations, the diagnosis is usually established after the 10th week of the term, and additional studies of the fetal condition are required.

The second most common cause of oligohydramnios are viruses that can cross the placental barrier. It can be a common flu or SARS, which the expectant mother had had in the period after conception.

Quite often, women with obesity, as well as with acquired and congenital diabetes mellitus, suffer from oligohydramnios. In this case, oligohydramnios can begin as early as the first trimester.

Somewhat less often, infectious agents penetrate the fetal membranes from the vagina. Having a negative effect on the amnion, these diseases lead to a violation of the metabolism and production of fetal water.

There are no steps that can be taken to 100% prevent this pathology.

But future mothers are advised to avoid excessive physical exertion, preferring measured walks in the fresh air, eat right and undergo scheduled examinations and studies without delay, follow the instructions of a specialist.

What is dangerous oligohydramnios

The amount of amniotic fluid produced is directly determined by the functional ability of the placenta, on which the growth and development of the unborn child depends.

Oligohydramnios during pregnancy, the causes and consequences of which may be of a different nature. The disorders associated with this pathology affect the work of the placenta, can lead to premature birth, miscarriage, fetal hypoxia.

In about half of the cases, women with this diagnosis require a caesarean section.

If the problem appeared in the second trimester, and critical fetal malformations or a slowdown in its development are diagnosed, the doctor may suggest the option of terminating the pregnancy. If there are no malformations, medical correction of placental insufficiency is performed.

Symptoms

In addition to ultrasound, the problem can be recognized by the following signs:

painful and severely uncomfortable sensations during normal fetal movements until the end of the second trimester;
persistent feeling of dryness of the oral mucosa;
girth of the abdomen - too small, does not correspond to the deadline;
measurements of the height of the fundus of the uterus do not correspond to the norm and differ downwards;
aching feeling in the abdomen.

If oligohydramnios is mild, the listed symptoms sometimes do not manifest themselves in any way, but the problem can be identified as a result of the examination. You should not resort to self-medication and try to diagnose the pathology on your own, without the help of a specialist.

Classification

Depending on the stage at which this pathology occurs, its two types are distinguished:

Before 10 weeks, early oligohydramnios may appear, which in many cases is associated with problems in the formation of fetal membranes.
In the II-III trimesters, a late form of oligohydramnios is diagnosed, which is most often associated with concomitant complications and pathological conditions, including those associated with the work of the organs of pregnancy.

Of great importance is how strongly the reduction in the level of the liquid is expressed. If the decrease is insignificant, then objective external symptoms may be absent. If the deficit reaches 700 ml, we are talking about severe oligohydramnios.

Diagnosis of oligohydramnios during pregnancy

The diagnosis is based on the examination of the woman and the analysis of her complaints. In addition, the doctor prescribes a number of tests and studies. Usually it is possible to suspect a pathology as a result of a routine examination. The specialist pays special attention to the discrepancy between the normal height of the uterine fundus and the volume of the abdomen.

Of great importance is the careful collection of anamnesis, which will allow with maximum accuracy to identify the root cause of this condition, on which the tactics of therapy depend.

To exclude the possibility of an infectious factor, laboratory tests of blood and urine are prescribed. A smear is taken to identify pathogenic microflora, which allows you to refute or confirm the suspicion of infection of the child. The final diagnosis is made by ultrasound. Sometimes CTG is performed to clarify the well-being of the child.

Ultrasound helps to make a final diagnosis in case of suspected oligohydramnios and thereby prevent undesirable consequences, as well as partially eliminate the causes of such a pathology of the course of pregnancy.

If the patient was diagnosed with the same pathology in previous pregnancies, there is a high probability that it is genetic in nature and has a connection with the individual characteristics of the organism.

This fact is of great importance when taking an anamnesis, as it often allows to exclude serious health problems of the expectant mother. Information about whether family members have had similar problems is also important.

Treatment of oligohydramnios during pregnancy

Therapy is determined by the form and degree of oligohydramnios, as well as the general health of both the fetus and the patient herself. If the pathology manifests itself moderately, and there are no bright symptoms, expectant tactics are used in the II trimester. Therapy is carried out on an outpatient basis.

A pronounced form of oligohydramnios, associated with uterine hypertonicity, requires hospitalization. Treatment in a hospital is also indicated when diagnosing pathology at 34 weeks of gestation and later. Even one of these criteria is usually a sufficient reason for the placement of the expectant mother in the clinic until delivery.

Regardless of the form of oligohydramnios, its treatment should begin with the correct organization of the woman's lifestyle.

It is important to protect her from stress and overwork, to avoid physical activity. In some cases, bed rest is indicated.

Medical therapy

Drug therapy involves the use of drugs that stabilize uteroplacental blood flow. Medicines are actively used that normalize the functions of the placenta, as well as vitamin and mineral complexes. In the case of diagnosing uterine hypertonicity, the appointment of tocolytics is indicated.

Of great importance is the direct impact on the causative factor. If we are talking about infection, the doctor prescribes antiviral or antibacterial agents. At the same time, concomitant diseases that can affect the insufficient production of amniotic fluid are treated.

Women with oligohydramnios require careful monitoring by an obstetrician-gynecologist. The main efforts are directed to the full formation and development of the child, and the continuation of pregnancy until the planned date of birth.

If conservative therapy does not bring the expected results, and the level of amniotic fluid continues to decrease, leading to a deterioration in the condition of the fetus, premature delivery may be required.

There is a high probability of primary weakness of labor activity, fetal hypoxia and the development of complications during childbirth. If conservative therapy leads to positive results, upon reaching 38 weeks of pregnancy, a planned caesarean section is performed.

Folk remedies

Oligohydramnios during pregnancy, the causes and consequences of which cannot always be established with high accuracy, is practically untreatable. Complete restoration of the normal amount of amniotic fluid by medical means is impossible. But some simple folk methods can have a positive effect on the course of pregnancy diagnosed with oligohydramnios.

The use of fresh chokeberry. It is enough to consume 100 g of berries before meals every day.
If oligohydramnios was provoked by inflammatory diseases of the genitourinary system, you can use a decoction of: strawberry leaves, birch leaves, yarrow, peppermint, rowan and rose hips, nettle leaves and succession. Ready broth is used 3 times a day for half a cup.
Treatment with a decoction of lingonberry leaves has an anti-inflammatory and diuretic effect. It should be consumed in a quarter cup before meals.
If the lack of amniotic fluid is associated with an increase in the blood pressure of the expectant mother, eating corn grits will help correct the situation. It is best to mix it with a little warm water.

Any folk recipes using herbs and fees can cause an allergic reaction in a future mother and child, so you should be careful when using them.

Diet

If oligohydramnios is associated with metabolic failures and an overweight woman, a properly selected diet will help stabilize the situation, about which it is recommended to consult a specialist.

The causes and consequences of oligohydramnios during pregnancy can be very serious, so the right diet can be not only one of the measures to combat this condition, but also a good way to prevent it.

Possible complications and consequences of oligohydramnios

Low water during pregnancy, the causes and consequences of which are different, is primarily dangerous because the fetus is not protected by a sufficient amount of amniotic fluid from external influences.

This can lead to a number of complications:

An increase in the number of contacts of the fetus with the membrane of the fetal bladder. This sometimes causes them to grow together.
The internal organs of the mother may begin to squeeze the unborn child. This leads to clubfoot, curvature of the spine, skeletal disorders, hip dysplasia, and malformations of the skull.
Violation of the mobility of the fetus, associated with a lack of amniotic fluid, leads to developmental delays. There may be problems with the growth and formation of the nervous system.
Increased risk of having an underweight baby. The probability of this pathology is less than 10% with a moderate form of oligohydramnios and more than 75% with a severe form.
Drying of the skin of the unborn child.
Oxygen starvation of the fetus.
Deficiency of nutrients coming from the amniotic fluid.

In addition, oligohydramnios affects the course of pregnancy, childbirth and the postpartum period:

In most cases, the listed consequences relate to a pronounced degree of oligohydramnios. The moderate form rarely causes significant complications, but requires observation by a specialist. Oligohydramnios can occur at almost any stage of pregnancy, and its main symptom, which the woman herself can recognize, is a relatively slow increase in the volume of the abdomen for the current period.

Oligohydramnios carries certain risks, but is one of the most serious pathologies that occur in pregnant women.

With a moderate course of oligohydramnios, the likelihood of fetal pathologies is extremely small, especially if the expectant mother follows the doctor's recommendations and follows the treatment plan.

Although the causes of oligohydramnios during pregnancy may not be obvious, and do not always lead to serious consequences, in the process of bearing a child, it is important to pay attention to any changes in health status and unusual symptoms.

If you mention them at a scheduled examination, this can help to diagnose oligohydramnios in a timely manner and provide the expectant mother with appropriate qualified assistance.

Article formatting: Svetlana Ovsyanikova

Video on the topic: oligohydramnios and polyhydramnios during pregnancy: causes and consequences

Causes of oligohydramnios during pregnancy, possible risks:

Polyhydramnios during pregnancy: causes and consequences:

When oligohydramnios is diagnosed, you should not be upset, having studied the problem from all sides, you can prepare for it and solve it even in the early stages.

Oligohydramnios: possible risks and treatment

Amniotic fluid is a liquid that helps the child develop, supplying him with everything he needs.

But here there may be deviations. There may be little water, then the diagnosis of oligohydramnios is established. There are different levels of diagnosis, depending on which treatment is selected.

What is oligohydramnios during pregnancy: risks

The volume of amniotic fluid is 300-500 ml, if it is less, then oligohydramnios is diagnosed. A pathology that can lead to serious consequences for both the baby and the mother, so it is so important to know its signs and consider them in time. Timely medical intervention will avoid developmental problems and the manifestation of anomalies. Statistics show that most often the diagnosis is made at the 37th week of pregnancy, and the reason for this is the aging of the placenta, a decrease in its activity.

1 trimester

If oligohydramnios is diagnosed from the very beginning of pregnancy, then it is not dangerous, because it does not affect the fetus. There is still time to get everything back to normal before the baby grows up. It can be diagnosed at week 16 during a planned ultrasound. The cause of the occurrence may be the failure of the fetal membranes, which I do not perform the functions assigned to them.

2 trimester

Oligohydramnios becomes a dangerous diagnosis from the 26th week, because with an exacerbation of the condition, the doctor will not perform delivery. At this time, the cause may be leakage of amniotic fluid, which is fraught with premature birth, and at such times the child may not survive. Such an unfavorable diagnosis can lead to:

To complications in the development of the unborn child - malnutrition, hemicephaly, amniotic constriction, deformities of the limbs.
To premature birth or termination of pregnancy.
To complex, long childbirth.

3rd trimester

The diagnosis at the end of pregnancy is dangerous, but the timing allows for delivery. If the water indicator was normal throughout the pregnancy, and in recent months a problem was discovered, then it is worth preparing for a long birth process. With oligohydramnios, the bladder becomes flat and cannot act as a wedge during cervical dilation stimulation. Doctors try to prescribe a caesarean section.

What is low water: pronounced, moderate and relative

Low water occurs in several types. Diagnosis, consequences, symptoms are radically different:

Moderate oligohydramnios is diagnosed with minor deviations from the norm. It is often determined at an early stage, so it can be eliminated quickly. Various diets are prescribed, nutrition is adjusted. With the right lifestyle, it is possible to bring the indicator of amniotic fluid to normal. The moderate form has no obvious symptoms, the woman feels normal. Only ultrasound will allow to come to such a diagnosis. But even with moderate, healthy babies are born, one has only to follow the recommendations of doctors. Statistics show that such a diagnosis occurs only in 5 percent of pregnant women by the end of the term.
With severe oligohydramnios, there are significant deviations from the norm. To avoid possible consequences, hospitalization and constant medical supervision are required. With a pronounced form, the following features are characteristic:

Pain during active movements of the fetus;
Aching pain in the lower abdomen;
Reducing the size of the uterus, and with it the circumference of the abdomen;
Deterioration of well-being.

Only with this kind of oligohydramnios is a long delivery possible, an increased risk of bleeding after childbirth. To avoid complications during childbirth, doctors try to perform a caesarean section.

Relative oligohydramnios occurs in the last months of pregnancy and is most often associated with aging of the placenta. If such a diagnosis is made, you should not be upset, because the correct treatment will allow you to determine the causes and return everything to normal. The main thing is that the development of the fetus should not be disturbed with such a diagnosis. It's just that a pregnant woman will be under stricter control by doctors.

How is it diagnosed

The doctor makes a diagnosis after certain procedures. First, the volume of the abdomen, the height of the fundus of the uterus are measured, if there are obvious deviations from the norm, the specialist sends for an ultrasound scan. The examination will determine the amount of amniotic fluid, diagnose the development of the fetus according to the gestational age.

Attention is paid to the index of the amniotic fluid index. If it is 5-8, then all indicators are within the normal range. If 2-5 - moderate oligohydramnios; less than 2x - pronounced oligohydramnios. To determine the condition of the fetus, dopplerography is often prescribed, which shows the level of oxygen and nutrients supply. Cardiac monitoring may also be prescribed.

Signs and manifestation

In addition to traditional measurements and studies, clear signs of low water are:

Pain during fetal movement.
Drawing pains in the lower abdomen.
After 4 months, small belly size. The circumference is not correct;
Weakness, nausea, dry mouth.

Is it possible to determine yourself

It is impossible to independently determine oligohydramnios, a diagnosis can only be made by a specialist after additional studies.

Risks of oligohydramnios for a child

Possible risks:

The fetus becomes vulnerable under the influence of external factors. There is a high probability of compression of internal organs, the development of clubfoot and curvature of the spine.
Physical activity is disturbed, because the movements are constrained, the baby cannot rotate in the womb like the rest.
If there is little water, then the metabolic process between mother and child may be disrupted, which is fraught with developmental delay, and sometimes even missed pregnancy. In this case, it is necessary to act quickly, conduct an ultrasound scan and make sure the condition of the fetus, modernly extract it in order to save the woman.
The lack of oxygen during the development of the baby is reflected in the development of the nervous system.
Babies are born underweight and with certain developmental disabilities.
The likelihood of cord compression increases.
The skin also suffers and dries out gradually, hypotrophy may develop.
Frequent contact of the fetus with the fetal membrane can lead to fusion in it.

How to treat with medication?

Treatment is aimed at restoring blood flow in the uterus, placenta. It is important to identify the cause that provoked the problem and eliminate it. In the process of treatment, measures are taken to normalize the process of oxygen supply from the mother to the fetus through the placenta. Treatment as such does not exist, because artificially increasing the amount of water will not work. The task is to improve the condition of the mother, and with it the baby.

Treatment is selected taking into account the time. If the problem is detected in the third trimester, then the woman is hospitalized, where she receives vitamins, as well as drugs that help restore oxygen levels and improve blood circulation.

They try to normalize the level of sugar in the blood, eliminate possible infections that could provoke pathology. CTG is performed every day, which allows you to determine the condition of the fetus. Once every five days, an ultrasound or dopplerometry is prescribed. Doctors are trying to prolong the pregnancy and make it to natural childbirth. If the baby's health worsens, then a caesarean section is performed.

If the problem is identified at week 28 and serious deviations in the process of fetal formation are established, then some experts suggest interrupting it, because it is difficult to predict the outcome. With moderate oligohydramnios, treatment is carried out at home, but it is important to adhere to the recommendations - take medication, eliminate stress and be outdoors more often, increasing the number of walks.

Doctors are trying to identify and stop the disease that caused oligohydramnios. Having determined the cause, it is always easier to eliminate the consequences. Since oligohydramnios can be caused by a metabolic disorder of a pregnant woman, then a diet is prescribed that will allow all indicators to return to normal.

Prevention

The earlier oligohydramnios is detected, the more chances to restore the amount of water and come to a normal level. Prevention prevents a problem.

A pregnant woman is advised to avoid stressful situations, increase the number of walks in the fresh air. The diet should include not only vitamins and minerals, but also a lot of liquid. Not only water, but also milk, compotes, juices.

To prevent oligohydramnios, even before pregnancy, it is worth going through certain tests that will allow you to identify deviations and eliminate them in a modern way. Solve the problems of the cardiovascular, urinary systems, if any. To refuse from bad habits.

Low water is not yet the final verdict. You need to believe in yourself, tune in to childbirth in a positive way. It is important to listen to the recommendations of doctors and everything will be fine. Even with such a diagnosis, healthy babies are born, just the development process requires more careful monitoring.