Why does oligohydramnios occur during pregnancy. Is oligohydramnios a cause for panic or a temporary phenomenon? Lack of water often leads to dangerous consequences

The article discusses oligohydramnios during pregnancy. We talk about the causes and consequences of this condition, how dangerous it is for the pregnant woman and the fetus, and the necessary treatment. You will learn how to determine oligohydramnios in pregnant women, what prevention will help prevent the development of pathology, reviews of women.

Oligohydramnios (oligohydramnios) is a pathology of amniotic fluid, during which, during a full-term pregnancy, a decrease in their amount to 500 ml or less is observed. According to various data, this condition occurs in 0.3-5.5 cases of all births.

pregnant woman and fetus

Amniotic fluid, also known as amniotic fluid, is the source of nutrition for the baby in the womb. They contain nutrients, vitamins, oxygen and hormones - everything that is necessary for the growth and development of the fetus. Also, all metabolic products (urine, mucus, etc.) are released into the amniotic fluid. Amniotic fluid protects against the influence of harmful factors and various infections. When labor is approaching, the amniotic sac exerts pressure on the cervix, which leads to its opening.

At different stages of pregnancy, a different amount of amniotic fluid is observed, associated with changes in the needs of the growing fetus. In the first 6 weeks of pregnancy, the amount of amniotic fluid is small, but already in the 3rd trimester, namely at 38 weeks, their level reaches 1-1.5 liters, which is the norm. In the next 2 weeks (39-40 weeks), the amount of amniotic fluid decreases to 600 ml, which means the onset of an early birth.

In the case when the indicators of amniotic fluid are lower, we are talking about oligohydramnios of varying degrees. In practice, there were cases when the expectant mother had almost no amniotic fluid. By the way, many pregnant women are wondering what is more dangerous, oligohydramnios or. It should be noted that both of these conditions pose a certain threat to both the pregnant woman and the fetus, and therefore require some attention from the doctor.

Kinds

Depending on the severity, experts distinguish moderate, severe and relative oligohydramnios.

With moderate oligohydramnios, the level of amniotic fluid slightly deviates from the norm. In this case, the pregnant woman is recommended a special diet, in which the diet should contain a lot of fresh vegetables and fruits, as well as foods containing a large amount of vitamins and minerals. At the same time, the expectant mother should be under the constant supervision of a doctor in order to prevent a possible deterioration in the condition.

With severe oligohydramnios, inpatient treatment with the use of medicines is necessary, since such a condition can cause a number of serious complications in a child.

Relative oligohydramnios is observed in late pregnancy and is most often due to aging of the placenta. With a correct diagnosis, you can hope for a positive prognosis and return everything back to normal. The main thing is that the development of the fetus is not disturbed and the expectant mother will be under the strict supervision of doctors.

As a rule, according to vital indications, women with oligohydramnios undergo a caesarean section.

Causes of oligohydramnios

The factors that influence the occurrence of oligohydramnios in women are not fully understood. According to medical practice, in most cases, the development of a pathological condition at different stages of pregnancy is influenced by such reasons:

. An increase in blood pressure can occur in every expectant mother, but during pregnancy this phenomenon is insignificant. With a strong increase in blood pressure, oligohydramnios can develop, especially in late pregnancy. The mechanism of formation of such a pathology is due to a malfunction of the placenta due to impaired blood flow due to increased blood pressure in the mother. In this case, the severity of oligohydramnios depends on the pressure indicators. Oligohydramnios against the background of hypertension can lead to delays in the development of the fetus (lag in size compared to the norm).
Multiple pregnancy, during which the distribution of blood flow in the common placenta is uneven. This leads to the fact that one of the fruits receives more oxygen and nutrients, while the other gets almost nothing. Often such a pathology is observed in one of the fetuses in the background of the syndrome of shunting (dumping) of blood in the placenta from one fetus to another. Most often, such violations are minor and do not pose a threat to the child.
Severe congenital pathologies and malformations in the development of the fetus, including renal pathologies and genetic anomalies in the development of the face. As a rule, such a pregnancy is terminated.
Insufficiency of development of the epithelium of the fetal bladder or reduced secretory function of the aqueous membrane.
Postponed but not completely cured bacterial infections. In this case, the pathogenic flora can be both in the birth canal and in the amniotic fluid, which is determined using special tests.
Metabolic disorders, in particular obesity.
Post-term pregnancy - in this case, aging and placental abruption occurs, which leads to a deterioration in the performance of its functions. Most often, in such a situation, an artificial birth is caused.
Leakage of amniotic fluid due to membrane damage.

Pregnant woman has stomach pain

signs

Low water does not cause any specific deviations in the well-being of the expectant mother. Symptoms of severe oligohydramnios are:

nausea;
weakness;
dry mouth;
aching pain during fetal movements - from the 20th week of pregnancy, the activity of the child in the womb increases significantly, and if there is a shortage of amniotic fluid, its depreciation function is lost, which leads to severe pain. For this reason, only a specialist can diagnose a pathology with the help of a gynecological examination and ultrasound;
lagging behind the size of the uterus from the norm at this stage of pregnancy;
discrepancy between the circumference of the abdomen at this stage of pregnancy;
limited fetal mobility;
loss of appetite.

How does oligohydramnios affect a pregnant woman

Oligohydramnios, especially if it is pronounced, poses a particular threat to both the fetus and the expectant mother. With an insufficient amount of amniotic fluid in the early stages of pregnancy and in the 2nd trimester, spontaneous miscarriages often occur. Low water is also dangerous in late pregnancy, as in this case it is fraught with premature birth.

Contractions during childbirth with oligohydramnios are quite painful and practically ineffective, moreover, in this case, there is a slow opening of the cervix. This is of a long-term nature, and when the fetal bladder is opened, a small amount of thick and fetal-colored liquid is observed.

What is dangerous oligohydramnios for a baby

Amniotic fluid is the place of growth and development of the fetus. Their deficiency negatively affects the growth and development of the child in the womb. In the early stages of pregnancy, this condition can lead to the formation of clubfoot in the baby and congenital dislocation of the hips, various deformities of the skull. In the later stages, such a pathology is dangerous as a complication of labor.

In oligohydramnios, the amniotic sac does not dilate the cervix or only causes it to dilate slightly. That is why childbirth most often occurs by caesarean section.

Ignoring the treatment of oligohydramnios during pregnancy can lead to a number of negative consequences. Severe oligohydramnios is dangerous with such complications in a child as:

deformation of the skeletal system of the fetus (trauma of large joints and spine);
abnormal development of the limbs;
asphyxia leading to disruption of the central nervous system;
splicing of the surface of the fetus with the amnion, followed by the appearance of malformations;
growth retardation;
deficiency of body weight;
excessively dry skin and the appearance of wrinkles on it;
the birth of a child with low weight and insufficient viability.

Important: in most cases, healthy children are born during pregnancy with moderate oligohydramnios. There may be only a slight hypotrophy of the fetus of varying severity, which is quite natural, since hypotrophy and oligohydramnios are the result of placental insufficiency. At the same time, in the future, such children often get sick and are very excitable.

Diagnostics

To confirm the diagnosis, the specialist prescribes an ultrasound examination, which allows you to determine the amount of amniotic fluid, and if the diagnosis is confirmed, determine the severity of oligohydramnios and the condition of the fetus. Also, if a disease is suspected, a gynecological examination is performed.

For the diagnosis of pathology, the calculation of IAI (amniotic fluid index) is used. This indicator is calculated by measuring in 4 places the free space between the fetus and the uterine wall. The resulting numbers are added up, and then divided by 4.

In the case when the index is 5-8 cm, this means a normal amount of amniotic fluid. With an amniotic fluid index of 2-5 cm, we are talking about moderate oligohydramnios. If the IAI is less than 2 cm, then this indicates severe oligohydramnios.

The optimal amount of amniotic fluid, based on the gestational age, is presented in the table below.

To identify the real cause of oligohydramnios, a pregnant woman is prescribed:

tests and swabs for the presence of bacteria and sexually transmitted diseases;
fetal CTG to determine the condition of the child in the womb;
conducting ultrasound and Dopplerography, which allow to determine the level of amniotic fluid, the quality of blood circulation in the umbilical cord, the cerebral artery of the fetus and the arteries of the uterus of a woman, the degree of developmental delay.

Pregnant woman at the doctor's appointment

Treatment

There is no specific treatment strategy for oligohydramnios. It all depends on what kind of factor provoked the pathological condition. In case of metabolic disorders and obesity, the pregnant woman is prescribed medication and adjusts the diet.

Most often, with oligohydramnios, complex treatment is prescribed with the use of vitamins and drugs to improve metabolism in the placenta, drugs to treat the underlying disease that caused oligohydramnios. With moderate oligohydramnios, therapy is carried out at home, and treatment of severe oligohydramnios is performed in a hospital.

To eliminate a moderate form of pathology, experts recommend removing any physical activity, taking prescribed drugs, regularly seeing a specialist and switching to a diet enriched with vitamins and useful microelements.

With oligohydramnios, ultrasound can be prescribed every week, dopplerography - 1 time in 3 days, extraordinary fetal cardiotocography to monitor the anomaly and prevent its development and take timely measures to preserve the health of the child and woman.

Severe oligohydramnios, which threatens the health of the fetus, can lead to early delivery, but only if the timing of pregnancy allows.

In the event that oligohydramnios with malformations in the fetus is detected in the early stages of pregnancy, experts decide on.

In the case when the results of ultrasound show placental aging and oligohydramnios, placental insufficiency therapy is prescribed. On an outpatient basis, drugs such as Actovegin and are used for this purpose.

Severe oligohydramnios in pregnant women, accompanied by fetal hypoxia, is usually eliminated by caesarean section, even if the pregnancy is premature. This is due to the fact that the fetus is experiencing severe suffering and the presence of hypoxia in it can lead to serious consequences.

In some cases, a procedure such as amnioinfusion helps prevent the development of problems in the fetus. During it, the doctor places a saline solution into the uterus through her neck. This technique allows you to cope with problems such as premature detachment of the placenta or shrinkage of the umbilical cord.

The prognosis depends on the duration of pregnancy. If a pathology is detected before the 28th week and a diagnosis of oligohydramnios is made, specialists for medical reasons insist on terminating the pregnancy. If a low amniotic fluid index is detected up to 34 weeks, appropriate treatment is prescribed. If it turns out to be ineffective, then in this case there is only one way out - premature birth.

Prevention

How to prevent oligohydramnios during pregnancy? It is enough to follow these recommendations:

exclude strong physical exertion, but at the same time take leisurely walks in the fresh air;
eat balanced and at least 5 times a day in small portions;
visit a gynecologist in a timely manner and take all the necessary tests that will help determine the presence of factors that cause oligohydramnios, and immediately undergo the necessary treatment.

Such a phenomenon as oligohydramnios during pregnancy is quite rare (three to four cases per thousand births) and is expressed in an insufficient amount of amniotic fluid (less than 500 ml). This condition serves as evidence that there are deviations in the body of a pregnant woman that are dangerous for the health and proper development of the fetus.

Amniotic fluid (amniotic fluid) is the source of nutrition for the fetus. They contain nutrients, vitamins, hormones, oxygen, salts, that is, everything that is necessary for the growth and development of the fetus. In addition, all the products of its metabolism (mucus, urine, etc.) are excreted into it. At the same time, they protect it from the effects of adverse factors and various infections. When labor is approaching, the amniotic sac presses on the cervix, as a result of which it should open.

It should be noted that the amount of amniotic fluid at different stages of pregnancy is different, which is associated with changes in the needs of the fetus. For example, in the first six weeks of pregnancy, the amount of amniotic fluid is small, but by the third trimester (thirty-eighth week), their level ranges from 1000 to 1500 ml, which is considered normal (in the next two weeks, the amount of amniotic fluid drops to 600 ml, which indicates the approach childbirth). If their number is below this level, then there is an oligohydramnios of varying degrees. In practice, there are cases when there was practically no amniotic fluid in a pregnant woman.

There are moderate and severe oligohydramnios during pregnancy, depending on the severity. In the first variant, the amount of amniotic fluid has minor deviations from the norm. In this case, the pregnant woman is recommended to normalize the diet, include in the diet various foods that are rich in vitamins and minerals, and also be under the constant supervision of a doctor to prevent deterioration. With severe oligohydramnios, treatment in a hospital with the use of medications is required, since this condition is fraught with the development of negative complications in the form of deformation of the skeletal system of the fetus (injuries of the spine, large joints), abnormal development of its limbs, asphyxia leading to a malfunction of the central nervous system, fusion the surface of the fetus with an amnion and, as a result, it has malformations, stunting and weight loss (the baby's skin becomes dry and wrinkled). In most cases, for health reasons, women are given a caesarean section. Oligohydramnios is also the reason for the birth of children with low weight and insufficient vitality.

Symptoms and signs of oligohydramnios.
There are no obvious deviations in the state of health of a pregnant woman with oligohydramnios. With severe oligohydramnios, a pregnant woman may experience weakness, dry mouth, and nausea. In addition, a woman may experience pain of a aching nature, which is especially pronounced when the fetus moves. This is due to the fact that after twenty weeks of pregnancy, the activity of the child in the womb increases significantly, with insufficient amniotic fluid, their depreciation function is lost, against which the woman experiences severe pain. Therefore, only a specialist can diagnose this pathological condition with the help of a gynecological examination, ultrasound.

The main signs of oligohydramnios are lagging behind the size of the uterus from the norm at a given gestational age, non-compliance with the norms of the abdominal circumference at a given gestational age, and limited fetal mobility. To confirm the diagnosis, an ultrasound is prescribed, with the help of which the amount of amniotic fluid is determined, and if oligohydramnios occurs, then determine its severity, as well as assess the condition of the fetus. If you suspect the presence of this pathology, a woman is also prescribed a gynecological examination.

It is worth noting that with an insufficient amount of amniotic fluid, spontaneous miscarriages and premature births are often observed. Contractions during childbirth are ineffective and very painful, while there is a slow opening of the cervix. In most cases, labor activity has a long period, and when the fetal bladder is opened, a small amount of thick liquid colored by the feces of the fetus is formed.

Causes of low water.
The reasons for this anomaly in the development of pregnancy are not fully understood. According to medical practice, in most cases, the reasons for the development of oligohydramnios at different times can be:

Severe congenital pathologies and malformations in the development of the fetus, among which pathologies in the development of the kidneys, hereditary anomalies in the development of the face can be noted. In most cases, such a pregnancy is terminated.
Insufficiency of development of the epithelium of the fetal bladder, or reduced secretory function of the aqueous membrane.
High blood pressure during pregnancy. An increase in blood pressure (blood pressure) can be observed in every pregnant woman, but during the normal course of pregnancy, this phenomenon is insignificant. But with a strong increase in blood pressure, oligohydramnios can develop, usually at the end of the third trimester. The mechanism of development of this pathology is due to impaired function of the placenta against the background of impaired blood flow due to increased blood pressure in the mother. It should be noted that the severity of oligohydramnios depends on the pressure indicators. With oligohydramnios against the background of hypertension, there may be delays in the development of the fetus (lag in size compared to the norm).
Past but not treated bacterial infections. At the same time, pathogenic flora can be found not only in the birth canal, but also in the amniotic fluid. All this is revealed with the help of special analyses.
Multiple pregnancy, in which the distribution of blood flow in the common placenta is uneven, as a result of which one of the fetuses receives more nutrients and oxygen, while the other gets practically nothing. Often, this pathology occurs in one of the fetuses in twins against the background of shunting (shedding) of blood in the placenta from one fetus to another. Usually violations are minor and not dangerous for the baby.
Pregnancy reversal. In this case, the placenta ages and exfoliates, as a result of which it can no longer perform its functions. In this case, doctors artificially induce labor.
Metabolic disorders, in particular obesity.

Diagnosis of oligohydramnios.
The diagnosis is made only after an ultrasound examination. For diagnosis, the calculation of the IAI or the amniotic fluid index is used. This indicator is calculated by measuring in four places the free space between the fetus and the wall of the uterus. The resulting numbers are added up, and the result is divided by 4. If the index is 5-8 cm, this indicates a normal amount of amniotic fluid, if the IAF is 2-5 cm - about moderate oligohydramnios, if the amniotic fluid index is less than 2 cm - there is a pronounced oligohydramnios.

Treatment of oligohydramnios.
To treat this pathology of pregnancy, it is necessary to identify the cause of its development, for which the pregnant woman is prescribed:

Ultrasound, Dopplerography, which allow you to determine the amount of amniotic fluid, the quality of blood circulation in the umbilical cord, fetal cerebral artery and uterine arteries of a woman, the degree of fetal lag in development.
Tests and swabs for bacteria and STDs.
Fetal CTG to determine the condition and well-being of the fetus.

Methods for treating pathology can be used in a variety of ways. In particular, in case of metabolic disorders, obesity, a pregnant woman is prescribed medication, and a certain diet is also recommended. In most cases, with oligohydramnios, complex treatment is carried out with the inclusion of vitamins, medicines to improve metabolism in the placenta, drugs to treat the underlying disease that provoked oligohydramnios. Treatment is carried out both on an outpatient basis (in the case of moderate oligohydramnios) and in a hospital (severe oligohydramnios, accompanied by an increase in uterine tone). In the first case, a woman is recommended to limit physical activity, remove any physical activity, observe a sparing regimen, take prescribed medications, and also be regularly observed by a gynecologist.

With oligohydramnios, specialists can prescribe an ultrasound examination (every week), dopplerography every three days, an extraordinary fetal CTG in order to monitor the anomaly and prevent its development, as well as to take timely measures if necessary, which will keep the mother and fetus healthy.

With severe severe oligohydramnios that threatens the health of the fetus, the doctor may raise the issue of early delivery, provided that the timing of pregnancy allows.

If fetal malformations that are not compatible with his life are found with oligohydramnios in early pregnancy, then a decision is made to terminate the pregnancy.

If the ultrasound results show aging of the placenta and oligohydramnios, treatment of fetoplacental insufficiency is prescribed. On an outpatient basis, drugs such as Actovegin, Curantil are often prescribed for the treatment of oligohydramnios.

Severe oligohydramnios in pregnant women, combined with fetal hypoxia, is often eliminated by caesarean section, even with premature pregnancy, which is due to severe fetal suffering.

Influence of oligohydramnios on the condition of a woman.
Low water extremely negatively affects the course of pregnancy, complicating it. In addition to pain, this pathology of the development of pregnancy can lead to its termination. In addition, it is the cause of the weakness of labor activity, since the fetal bladder, insufficient in size, cannot affect the rate of cervical dilatation (usually it is opened artificially). In this case, they may prescribe medications that stimulate contractions.

The effect of oligohydramnios on the fetus.
Amniotic fluid is the site of growth and development of the fetus. Their deficiency negatively affects the growth and development of the baby, in particular, in the early stages of pregnancy, due to this pathology, clubfoot can form, various kinds of skull deformities can be observed, congenital dislocations of the hips can occur, and in the later stages, oligohydramnios complicates the course of childbirth. The amniotic sac with this anomaly does not perform the function of a wedge that promotes the opening of the cervix. In most cases, due to contraindications to natural childbirth, a caesarean section is performed.

It is worth noting that in most cases of pregnancies with moderate oligohydramnios, healthy children are born. Only fetal malnutrition of varying severity can be observed, which is quite understandable, since malnutrition and oligohydramnios are the result of placental insufficiency. It should be said that the children of mothers, who had oligohydramnios during the period of gestation, subsequently often get sick and are very excitable.

Prevention of low water.
To prevent oligohydramnios, it is recommended to exclude strong physical exertion, but this does not mean giving up movements. Therefore, pregnant women are shown leisurely walks in the fresh air.

A balanced diet at least five times a day in small portions.

Timely examination, delivery of the necessary tests that will help identify the presence of factors provoking the development of oligohydramnios, and prescribe appropriate treatment.

In conclusion, I note that in no case, when making a diagnosis of "oligohydramnios", do not panic, do not be nervous and do not despair, because this is not the worst thing that can happen in this difficult period for a woman. Nowadays, modern medical equipment and the latest drugs make it possible to bear a baby and give birth to him healthy in most problematic cases. Therefore, follow all medical recommendations and have a successful delivery!

Today we will talk about the factors of oligohydramnios, the symptoms of manifestation, methods of treatment and what consequences may arise for the baby and the expectant mother.

Reducing the amount of amniotic fluid is called oligohydramnios. In medicine, it is considered that this is a pathological condition that disrupts the normal course of pregnancy. This phenomenon is quite rare - only 4% of cases.

Why is it so necessary for the baby to have amniotic fluid:

it is his protection from injury;
allows the fetus to move, which contributes to its proper development;
closer to the date of birth help the baby to take the correct position;
when the fetus moves, the woman feels smoother movements that do not cause her pain.

Signs of oligohydramnios

The occurrence of the following signs can speak and be a signal of oligohydramnios:

with a slight form of oligohydramnios :

- there are no symptoms, the health of the future mother is within the normal range;

- You can find out about the reduction of this parameter using ultrasound.

with severe oligohydramnios:

- a woman feels unwell, dry mouth may be felt;

- the movements of the baby are accompanied by pain;

- from time to time in the lower abdomen there are pain;

- the size of the abdomen and the condition of the uterus do not correspond to the gestational age.

Below is a table with AFI parameters (amniotic fluid index) throughout pregnancy:

What causes malnutrition

A number of reasons contribute to oligohydramnios in a pregnant woman:

Acquired malformation of the kidneys, in which, as a rule, oligohydramnios appears from the first trimester of pregnancy
Chronic disease in a woman (diabetes, etc.)
Failure in metabolism
Dehydration
Nicotine
Past infectious disease (cold, flu and other diseases)
Disease of the reproductive system
If you are overbearing your baby
Leakage of amniotic fluid

Consequences of oligohydramnios

A decrease in the volume of amniotic fluid can become dangerous and have serious consequences for the baby and the expectant mother herself, and lead to a number of complications:

The walls of the uterus begin to fit snugly against the fetal sac, which causes pressure on the baby. It is difficult for the child to move and he takes an uncomfortable position, which further threatens with clubfoot, curvature of the spine, fusion of the fetal membrane with the skin.
With prolonged contact between the fetus and the amniotic sac, strands may appear that look like ribbons and threads (Simonart's ligaments). Their formation can lead to amputation of the limbs of the fetus and other injuries.
In the 2nd and 3rd trimester, a woman constantly feels pain in the lower abdomen. The expectant mother is experiencing pain when the baby is moving.
Weak labor activity, which is accompanied by strong contractions, and the cervix opens very slowly.
At the end of childbirth, bleeding may begin.

Oligohydramnios at 20-21 weeks of gestation

As a rule, oligohydramnios is diagnosed from the second trimester of pregnancy (from about the 21st week). Requires extremely careful and consistent examination to detect chromosomal abnormalities and fetal mutilations. At this time, the likelihood of their occurrence is much greater than at others.

Oligohydramnios at 31-34 weeks of gestation

At later stages of pregnancy, from about 31 to 35 weeks, the amount of amniotic fluid, most often, decreases due to leakage of amniotic fluid. You can use special gaskets that will determine whether there is indeed a leakage of water.

Treatment of oligohydramnios

It is currently impossible to increase the volume of amniotic fluid artificially. Identified pathology before the 28th week of pregnancy is often recommended for termination, since it is impossible to predict all the consequences and its outcome.

At a later date, the woman is hospitalized in a hospital, where a number of measures will be taken to maintain the life of the fetus.

The treatment plan is drawn up individually for each woman, depending on the cause of oligohydramnios.

Also, in addition to the prescribed drugs, it is imperative to conduct studies that help to monitor the condition of the baby and keep the amount of amniotic fluid under control: ultrasound, dopplerometry, cardiotocography.

If the treatment does not have the expected effect, the doctor may decide on an early delivery by caesarean section.

A slight decrease in amniotic fluid is considered normal and is not treated, but requires constant monitoring by a doctor, restriction of vigorous physical activity, and compliance with a sparing regimen.

The occurrence of oligohydramnios in a woman does not always become a guarantor of pathologies and mutilations of the fetus. Just for the doctor, this becomes a signal for more careful and thorough monitoring of the course of pregnancy. A timely detected deviation from the norm of the volume of amniotic fluid and the beginning of treatment, as a rule, has a favorable outcome.

Health to you and your baby!

See you in the next article.

With the concurrence of certain negative circumstances, pregnancy can be accompanied by a number of various problems and complications, among which oligohydramnios is reasonably considered one of the most dangerous. This pathological condition is characterized by a decrease in the volume of amniotic fluid, without which the developing fetus can simply die.

Amniotic fluid is a nutrient medium from which the developing fetus receives the substances it needs during its stay in the mother's womb. The composition of the amniotic fluid includes many nutritional components, without which the normal growth and development of the child is impossible. The main components of the environment are: oxygen, vitamins and microelements, salts, some hormones, as well as many additional useful substances.

In addition to providing the child with the necessary nutritional components, the amniotic fluid protects the fetus from all sorts of infections and, in general, all kinds of negative effects. The amount of intrauterine fluid changes as the child grows and his needs increase.

Based on the average statistical data obtained in the course of numerous clinical studies, amniotic fluid indices were determined for each period of pregnancy. This index reflects the rate of normal amniotic fluid volume and acceptable deviations that are not a cause for concern.

We are talking about oligohydramnios in cases where the amniotic fluid index in the patient is not included in the lower limit of the norm for her term. Information regarding the normal volume of intrauterine fluid for different weeks of pregnancy is given in the following table.

Table. Amniotic fluid index for different weeks of pregnancy (16-25)

Pregnancy period, weeks	Average normal indicator, mm	Probable fluctuations, mm
16	121	73-201
17	127	77-211
18	133	80-220
19	137	83-225
20	141	86-230
21	143	88-233
22	145	89-235
23	146	90-237
24	147	90-238
25	147	89-240

The determination of the mentioned indicators is performed by the doctor during the next ultrasound examination.

The list of factors contributing to the development of oligohydramnios practically does not change for each stage of pregnancy. The most common reasons include the following:

kidney pathology in the fetus. In the presence of severe congenital diseases of this nature, oligohydramnios is usually noted from the initial stages of pregnancy;
ailments of a chronic nature, usually affecting the genitourinary and cardiovascular systems of the mother;
diseases of an infectious nature that affect the genitourinary system of the mother;
bad habits in women;
previously transferred diseases of a bacterial and viral nature;
pathology of the placenta;
multiple pregnancy (often there is a combination of oligohydramnios of one child with simultaneous polyhydramnios of the second).

How does low water manifest itself?

The problem under consideration can be expressed and moderate. For oligohydramnios of a moderate nature, the almost complete absence of subjective manifestations felt directly by the patient is characteristic - the well-being of the pregnant woman practically does not deviate from the norm, and the lack of intrauterine fluid is determined only during an ultrasound examination.

For the expressed form of the disease in question, the following manifestations are characteristic:

shrinkage of the uterus. During the next medical examination, the specialist notes a decrease in the circumference of the patient's abdomen. During a vaginal examination, it is found that the height of the uterine fundus does not correspond to the indications of the norm, characteristic of a particular period of the patient's pregnancy;
pain while moving the child;
periodic discomfort of a aching nature in the abdomen;
deterioration of the woman's condition as a whole, accompanied by a feeling of dry mouth, as well as nausea, severe weakness.

Oligodiagnosis, diagnosed in the II trimester (namely, the 20th week is included in this period of pregnancy), is the most dangerous for both the developing fetus and the woman carrying it. The task of the specialist at this stage is to determine the feasibility of prolonging the pregnancy.

It was previously noted that there are 2 main varieties of oligohydramnios. The most dangerous, in this case, is a pronounced form of the disease, which can lead to the following problems:

disorders and pathologies of child development. In children born with oligohydramnios, deformities of the limbs and muscles, anomalies of the spine, a general slowdown in development, pathologies of the formation of the brain and skull are often noted. The most severe complication of oligohydramnios is hypoxia, which develops against the background of oxygen starvation. The possibility of the death of the child is not ruled out;
problems during childbirth. Even if the pregnancy can be maintained, labor activity in the future will most likely be extremely weak. There is a high risk of severe blood loss after delivery;
termination of pregnancy.

In patients with moderate oligohydramnios, the likelihood and intensity of the manifestation of these abnormalities is lower, however, the risks of the occurrence of the described problems are also present.

That is why the main task of a woman who had to deal with oligohydramnios at the 20th week of pregnancy or any other period is strict adherence to medical recommendations.

Treatment of the problem under consideration is an extremely difficult and responsible task that requires a qualified approach. Currently, medicine does not have medicines and special methods that allow artificially increasing or decreasing the content of amniotic fluid.

When oligohydramnios is detected, a woman is hospitalized in a hospital and all the necessary therapeutic measures, the main task of which is to maintain the normal state of the child and balance the uteroplacental circulation, are carried out under close medical supervision.

Directly the course of treatment is determined by a specialist. As a rule, women are prescribed vitamins, drugs to normalize placental function and improve uteroplacental blood flow, antibiotics (if various infectious diseases have led to oligohydramnios).

During therapy, doctors constantly monitor the amount of amniotic fluid and monitor the condition of the developing child. Such procedures as: fetal cardiotography, ultrasound, dopplerometry are regularly performed.

If the measures taken do not have a positive effect on the condition of the patient and the child, and oligohydramnios progresses, doctors in the vast majority of cases recommend early delivery, which at the 20th week of pregnancy is often identical to abortion.

In general, as practice shows, subject to timely diagnosis and proper treatment, the problem of oligohydramnios can be quite successfully solved. Many experts regard this ailment as a symptom of another disease, so the main goal of the prescribed therapy in most situations is to identify and eliminate the causes that led to the development of a lack of amniotic fluid.

In addition to drugs, women are recommended to reconsider some aspects of their life and. For example, experts often advise reducing physical activity.

Thus, oligohydramnios, although it is a rather dangerous disease, often threatening the death of the fetus, with a timely and competent approach, there is a high probability of normalizing the condition of the child and mother and the chances of having a healthy baby are significantly increased. The main thing is to strictly adhere to the recommendations of specialists, do not self-medicate and treat the solution of the problem as responsibly as possible.

Be healthy!