Why oligohydramnios in pregnant women. Influence of oligohydramnios on the condition of a woman. Poor blood supply to the baby due to violations in the structure of the placenta

The joyful expectation of expectant mothers is sometimes overshadowed by such words as "oligohydramnios" or "polyhydramnios". Doctors do not always take the trouble to explain what this means and what consequences it threatens. So future mothers have to find out what kind of condition it is and how to treat oligohydramnios in pregnant women.

About amniotic fluid

All the time when a child develops in the womb, he is in a kind of bubble that performs several functions at once. Firstly, it protects the fetus from shocks, sudden movements, etc. Secondly, it serves as a barrier against bacteria, viruses and other threats. This bladder is filled with the so-called amniotic fluid, or amniotic fluid. All the secretions of the fetus fall here, it also swallows the substance surrounding it. The waters are constantly changed so that the medium remains sterile, at least in the normal case. On recent weeks full update occurs every 3 hours. But sometimes some deviations do occur, which can cause various problems or testify to any violations.

Norms

There is a special indicator - index amniotic fluid(IAJ), which is used to judge the sufficiency of water. Each week has its own indicators, but in general case the norm is a number from 100 to 200 millimeters. This is very conditional, since the IAI is a rather approximate indicator, which often misleads doctors and expectant mothers. That is why only with information on the quantity amniotic fluid in dynamics, we can talk about a tendency to increase or decrease their number relative to individual norm. And then you can already talk about polyhydramnios or oligohydramnios in pregnant women, respectively. What is it and how does it express itself?

Low water - what is it?

In pregnant women, the amount of amniotic fluid is sometimes diagnosed below normal. In this case, they speak of low water. This diagnosis can be made from the 14th week, and this is not uncommon, but it should not be taken lightly either. The volume of amniotic fluid at the end of pregnancy normally reaches 1-1.5 liters. And if oligohydramnios in pregnant women is not treated and controlled, then this figure can drop to 0.5 liters. It is not hard to guess that this is unlikely to have a good effect on the baby, because the amniotic fluid helps to develop his digestive and respiratory systems. In fact, this condition is, rather, not an independent disease, but a symptomatic complex or even just a feature. But why does oligohydramnios occur in pregnant women?

Causes

Depending on what causes this condition, oligohydramnios is divided into primary and secondary. In the latter case, the volume of amniotic fluid decreases due to damage amniotic membranes and leaks. The first includes all other reasons, and they can be very different. Many of them are very serious: intrauterine infection, nicotine intoxication. This condition can also be caused cardiovascular diseases maternal or kidney problems, obesity, hypertension, late toxicosis etc. It may also be a problem in the development of the fetal organs: lack of kidneys or urethra, improper functioning excretory system, chromosomal abnormalities. Sometimes oligohydramnios in pregnant women can be triggered by taking certain medications, such as drugs that stop preterm labor. In other cases, it may just be a feature of the body, and there is no need to worry. Inflammatory processes and viral diseases carried by the expectant mother can also reduce the amount of water, but this is usually temporary. Within a month after recovery, most often the condition is completely normal.

But it is up to the doctor to decide whether to treat this condition and how to do it. Before prescribing drugs, it is necessary to conduct Dopplerography, CTG and get the results of tests for infections. Based on information about the health status of the mother and fetus, one can also think about next steps in order to compensate for the lack of water. The reasons are also identified by the doctor, because if this diagnosis sounds enough early dates, there is reason to suspect serious violations in the development of the fetus.

signs

This diagnosis can be more or less confidently made only after ultrasound and calculating a specific amniotic fluid index. And still, insufficiently accurate measurements can only cause unnecessary unrest. But an obstetrician-gynecologist can suspect oligohydramnios, for example, because of the small size of the abdomen.

The woman herself, as a rule, cannot feel this condition, but if the fetus moves less than 10 times a day, there is reason to worry, although this may indicate a variety of problems. Only in the most serious cases oligohydramnios in pregnant women can give itself out as intense thirst, dry mouth, pain in the lower abdomen, especially during movements, nausea and weakness. And although this is extremely rare, about a third of expectant mothers hear the words " moderate oligohydramnios from their doctors. But not everyone knows what the consequences may be.

What threatens?

Oligohydramnios, if observed indeed serious deviations from the norm, may have very backfire Therefore, you should not neglect the recommendations of the doctor.

The detection of this condition in the I or II trimester automatically raises the question of the advisability of prolonging the pregnancy. In the early stages, this indicates severe malformations, and even later it can cause problems such as underdevelopment of the skeleton, lungs and digestive system, low body weight. In addition, oligohydramnios that has not been treated or has been inadequately treated can lead to preterm or complicated labor and is associated with increased perinatal mortality. Weak labor activity is often recorded, since a small fetal bladder simply puts too little pressure on the cervix, not helping it to open. This can cause acute hypoxia, that is, oxygen starvation of the fetus, and in severe cases, even suffocation and death. So do not be too frivolous even to the diagnosis of "moderate oligohydramnios". Treatment, if the doctor prescribes it, is necessary. After all, this is the health of not only the mother, but also the child, whose condition is much more difficult to control.

Treatment

The expediency of prolonging pregnancy is determined by the state and rate of development of the fetus. If it is oppressed and lags behind in development, further support is problematic, and a caesarean section is used for a period of 32 weeks or more. If growth is normal, then there is usually no need for urgent delivery.

In order to compensate for this condition, drugs are often used that improve the blood supply to the placenta and uterus. These are, for example, the long-established means "Actovegin" and "Kurantil", which are also used in the diagnosis of "oligohydramnios". The causes of the condition, if they are established, of course, must be eliminated. In most cases, oligohydramnios, especially if it is moderate, responds well to treatment and can go away even within a month. But if the reasons are serious, and this condition does not go away, then everything will not be so simple. In the absence of effect, if time permits, pronounced oligohydramnios- a reason for urgent delivery through caesarean section.

Self-treatment, of course, is unlikely to be effective, and without proper monitoring of the condition and proper diagnosis, it can become simply dangerous. Therefore, if there is a suspicion that the course of pregnancy is unusual, it is better to consult a doctor once again.

Control

Unfortunately, you can see the actual amount of water only in the process of childbirth. And until this moment, it remains only to be content with approximate calculations. In Russia, standard pregnancy management includes 3 ultrasound examinations. However, if the diagnosis is "oligohydramnios", the treatment is in full swing, then it is necessary to evaluate its effectiveness. Since this can be done more or less reliably only with the help of ultrasound, this method is used. In parallel, it is necessary to monitor the condition of the fetus - for this, cardiotocography and dopplerography are most often used. If all indicators, except for the IAI, are normal, then doctors are quite calm about the diagnosis of "fetal oligohydramnios" and perceive it, rather, as a feature of the course of a particular pregnancy.

Prevention

Some of the causes that can provoke oligohydramnios in pregnant women can be easily eliminated. The expectant mother needs to consume enough fluids, even if she has swelling. In addition, even before pregnancy, you need to be tested for genital infections and cure them. Of course, it is worth getting rid of bad habits: the use of nicotine, alcohol and drugs. When identifying such conditions as preeclampsia and diabetes pregnant women, you need to follow the recommendations of the doctors who will prescribe the treatment. Oligohydramnios in pregnant women - although in reality a rather serious diagnosis, is still relatively rare, not least due to the fact that doctors more often detect a tendency to reduce the amount of water and take action in time.

Should I be worried?

If we are talking not about a trend or a moderate form, then there is cause for concern. Persistent oligohydramnios, which is fixed several times within 1-3 months, definitely requires treatment. As already mentioned, a significant decrease in the volume of amniotic fluid at a fairly early date adversely affects the intrauterine development of the child. However, most often everything ends quite well, especially if doctors do not fix other abnormalities. But in order not to become an exception, you must strictly follow the recommendations of the gynecologist, or at least not neglect them.

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

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

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

Why does low water occur?

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

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

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

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

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

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

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

Symptoms of oligohydramnios

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

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

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

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

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

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

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

Causes of oligohydramnios

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

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

• Another cause of oligohydramnios are all kinds of bacterial infections that were transferred to a pregnant woman and not cured qualitatively. Sometimes the danger is hidden in infections that a woman had long before pregnancy. In such a situation, pathogenic microflora with the help of analyzes is detected both in the birth canal and in the amniotic fluid. The manifestation of such a danger can be detected at 20 weeks of pregnancy, when, under the influence of hormones, the infection begins to progress, in parallel with this, oligohydramnios develops. For a period of 30 weeks, oligohydramnios acquires pronounced character.
• oligohydramnios is often observed in the case of multiple pregnancy. The cause of this disease in such a situation may be the uneven distribution of blood flow in the placenta. In this case, one child gets more oxygen and nutrients than the other. Similar situation can lead to the death of a weaker embryo, therefore, stationary monitoring is necessary.
• Another reason for oligohydramnios is overexposure. At 36 or 37 weeks, the baby is already fully formed and can appear at any time. Sometimes women carry a baby for more than 40 weeks, but it is important to know that starting from 38 weeks, oligohydramnios can develop. The reason for this is the "shelf life" of the placenta, which has already served its due time and is beginning to age. Sometimes obvious aging of the placenta is noted as early as 37 weeks. As a result, it peels off and fails to perform its functions. Under such circumstances, doctors raise the question of caesarean section or induction of labor by piercing the placenta. Do not be afraid if doctors offer to do an operation for a period of 37 or 38 weeks. By this period, the child is already completely ready for the birth.

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

Examinations and analyzes for oligohydramnios

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

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

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

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

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

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

Treatment of oligohydramnios

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

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

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

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

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

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

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

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

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

The condition of a woman with oligohydramnios

oligohydramnios has severe consequences and renders Negative influence during pregnancy, resulting in pain, this is especially pronounced during the period of active fetal movement. In addition, a small amount of amniotic fluid can lead to abortion. The risk of miscarriage is especially high in the first trimester of pregnancy.

Regardless of the form of oligohydramnios (moderate or severe), there is a complication of the course of childbirth. It may show up as weakness. birth process- minor contractions and weak attempts.

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

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

Prevention of oligohydramnios

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

Throughout pregnancy, the baby develops in a water bladder that contains amniotic fluid. As the fetus grows, the fluid volume also increases. It allows the fetus to move quietly in the womb, is a protection against injury. Also, the liquid contains the necessary nutrients, hormones and vitamins.

What is low water?

By the end of the third trimester, amniotic fluid can be from 1 to 1.5 liters. If the ultrasound value is below the norm, then the woman is diagnosed with oligohydramnios.

Distinguish between severe and moderate oligohydramnios . With moderate oligohydramnios, the indicator in most cases does not fall below 600-700 ml. Signs of expressed - 400-500 ml.

Usually, with moderate oligohydramnios, there is no reason for hospitalization, no treatment is prescribed. Symptoms are corrected by proper nutrition and daily routine. But if a woman has a pathology, then she is immediately sent to the hospital for preservation / treatment, because this threatens with serious deviations in the development of the child. And in this case, it does not matter what week of pregnancy is: they are hospitalized both in the second trimester and in the third.

Also, with severe oligohydramnios, there is a tendency to premature birth and spontaneous miscarriages.

Causes

Upon learning of pregnancy, every girl must register with women's consultation and be constantly monitored by a gynecologist. But even the most responsible mothers, who take all the tests every two weeks, have a tendency to unforeseen complications that can threaten the life of the child.

Reasons for insufficient amniotic fluid:

1. Insufficient secretion of amniotic fluid.
2. Water leakage.
3. Anomaly in the development of the fetal membranes. They can fix up to 20 weeks.
4. Deviations in the development of the fetus. If the fetus has a kidney defect, then the diagnosis of oligohydramnios is usually made already in the early stages of pregnancy.
5. Hypertension in pregnancy. During pregnancy, a woman's blood pressure may increase. The danger is represented by pronounced jumps from low scores to high. If you do not start treatment, then the consequences can be sad: there may be a delay in the development of the child, slow growth and weight gain. Quite often, such symptoms are detected at 20-21 weeks.
6. bacterial infections. The danger is chlamydia, ureaplasmosis, etc. Often, diseases do not occur during pregnancy, but long before it. It's just that the woman was not treated, and the disease became chronic. Such infections are detected by tests at 20 weeks. It is at this time that bacteria begin to multiply under the influence of hormones. If it was not possible to fix dangerous infections in time, then at a period of 30 weeks the woman already has serious oligohydramnios and all the ensuing consequences.
7. This diagnosis is made to mothers who are carrying more than one baby. The reasons are the uneven distribution of water and abnormal blood flow in the placenta. As a result, one child develops in comfortable conditions, and the second has to fight for survival. Polyhydramnios is also observed in one child and signs of severe oligohydramnios in the second. Between children there may be a difference in development - a week or more. If the specialists failed to make the necessary diagnosis, then one of the fetuses may die.
8. The norm is considered to be childbirth that falls on the 36-40th week. But already from the 38th week, the placenta ceases to perform all the functions assigned to it. That's when the lack of fluid can begin. If labor does not begin at week 38, then a caesarean section may be prescribed. This question is especially acute if the 40-42nd week is already underway.
9. With overweight mothers, such a diagnosis can be made already at the first or second ultrasound, that is, at 12 or 22 weeks, respectively. Mommy should be taken to the hospital, she is prescribed proper nutrition. Most often, babies are born no later than 36–37 weeks.

Cardiovascular diseases affect oligohydramnios. The reasons for their occurrence: smoking before and during gestation, past illnesses, viral infections like influenza and SARS, obesity and diabetes, congenital anomalies.

Basically, the causes of oligohydramnios are associated with the state of health of a woman before and during pregnancy. Only in some cases occurs due to pathologies.

What is the danger of the diagnosis?

Low water is also divided into earlier and later. If the diagnosis is made for up to 20 weeks, this is early, at 26–40 weeks it is later.

It is early low water that is most unfavorable for the development of the embryo. After all, in the first and vitor trimesters, vital signs begin to form and develop. important organs future child.

In the third trimester, it is much easier to treat a lack of water, as this is a completely normal symptom. This is especially true in the last weeks of pregnancy.

Why is oligohydramnios dangerous during pregnancy? A sufficient amount of amniotic fluid ensures the free movement of the fetus. In an advanced case, such a phenomenon at week 20 or less threatens the development of defects and deformities. Still fragile arms and legs are also bent.

Due to the small amount of amniotic fluid, there are: improper development of the urinary system, kidney defects and much more. Low water is not a permanent process. Sometimes it only lasts a few months or even weeks. Provoke serious deviations in development is capable of only prolonged pronounced oligohydramnios.

signs

An insufficient amount of amniotic fluid is dangerous because there are practically no pronounced symptoms. During pregnancy female body rebuilt, there is some discomfort. And few mothers recognize the symptoms in this. dangerous disease. An accurate diagnosis is made only by a specialist.

Moderate oligohydramnios during pregnancy is almost always asymptomatic. future mommy feels great and full of energy.

With severe oligohydramnios in a pregnant woman, symptoms such as:

• Continuous or intermittent cutting and aching pain lower abdomen.
• Sharp pains during fetal movement. This is especially true for a period of 36 weeks.
• Poor health of the mother - weakness, nausea, dizziness.
• Leakage of water - the release of a clear liquid from the vagina.
• The size of the abdomen does not correspond to the terms.
• Delayed development by several weeks.

You should be attentive to your condition and, at the slightest suspicion, immediately seek help.

Diagnostics

If oligohydramnios is suspected, a woman must undergo mandatory diagnostic procedures, which will show the state of life of the fetus:

• Laboratory examination.

Ultrasound examination will allow you to find out the exact volume of amniotic fluid. For this, they carry out special test, which allows you to determine the values ​​\u200b\u200bof AFI (amniotic fluid index). And already starting from the received figures, they make a diagnosis.

Normal indicators of IAI

According to the data in the table, it can be seen that the AFI at 22–30 weeks is approximately the same. Then the amount of amniotic fluid goes down. The seventh month is characterized by a slight drop in value.

Please note that this table is an average. For example, at week 20, the IAI can vary from 73 to 200 mm. At 32 and 33 weeks from 74 to 274 mm. So, when you see a figure in the conclusion of a doctor, do not panic.

Doctors sometimes want to play it safe and once again not expose the mother and child to risks.

The consequences of low water are far from the most pleasant. If the doctor does not like something, he offers to go to the hospital. You should not refuse this, because one week is nothing compared to the health of a son or daughter. However, moderate oligohydramnios at 35–37 weeks is quite normal sign and does not require treatment.

Treatment

As already mentioned, the reasons for the insufficient amount of amniotic fluid are different. Therefore, treatment is prescribed separately for each case. It matters here the mother's disease, abnormal development of the fetus, a week of pregnancy, etc. For example, if the mother is overweight, drugs are already prescribed from the 27th week to maintain the work of the placenta.

Moderate oligohydramnios during pregnancy is usually treated simply by adjusting the regimen. It is strongly recommended to reduce physical activity at least for a while and rest more, drink a course of vitamins (prescribed by a doctor, do not self-medicate!), Eat right and observe sleep patterns. After some time, you will be assigned a second ultrasound, and if the condition has stabilized, then you should simply follow these recommendations.

Even mild oligohydramnios can harm the baby.

If the change in the rhythm of life did not help you, then the doctor will prescribe outpatient or inpatient treatment in a hospital. The first option is usually suitable for women in the second trimester. You will have to take urine and blood tests. In case of water leakage - also a smear of liquid.

In the hospital, with a severe lack of amniotic fluid, a woman is given drugs that stimulate blood flow in the placenta. For example, Curantil and Actovegin, glucose. If the disease is caused by chlamydia or ureaplasmosis, then first of all, treatment for the infection will be prescribed.

If the drugs do not help, and the condition worsens, then they can stop treatment and prescribe an early birth. Such decisions are made extremely rarely and only if a woman before independent childbirth only a few weeks left. Usually this is at least the 33rd week. If the gestational age is more than 35 weeks, then drugs are prescribed that cause contractions so that the woman can give birth on her own.

Oligohydramnios is a serious problem that can lead to the birth of a child with severe pathologies. Therefore, it is very important to follow all the doctor's instructions.

If the expectant mother was diagnosed with "oligohydramnios" - this is not a reason to panic.

Oligohydramnios is treatable, and if detected in a timely manner, it is by no means a guarantee of difficult childbirth and health problems for the baby and mother.

Causes of the disease

Neither the age of the expectant mother, nor the number of births affect the fact of the onset of the disease.

Very often, this pathology is provoked by hypertension, metabolic disorders, diseases urinary tract or genitals.

Often, oligohydramnios is diagnosed with multiple pregnancies and overcarrying.

Another possible cause of the disease is the underdevelopment of the epithelium that covers the water membrane or the reduced secretory function of this membrane.

Unfortunately, some anomalies in the development of the child can cause oligohydramnios (for example, pathology of the development of the kidneys or face).

Symptoms of the disease

Anemia can be diagnosed by the following symptoms:

• the size of the uterus does not correspond to the gestational age
• mom is in pain when moving baby
• regular aching pain in the lower abdomen
• weakness
• dry mouth and nausea

It happens that in the last weeks of pregnancy, oligohydramnios (together with other pathologies of pregnancy) can cause labor stimulation. And if the doctor insists on this, it makes sense to consider this recommendation in a balanced way: the risk of an unsuccessful birth outcome increases.

Why is oligohydramnios dangerous during pregnancy?

Low water is a signal that there is a place for some pathologies of pregnancy, which, first of all, affect the development of the baby.

Amniotic fluid performs not only a protective function: they are involved in the metabolism between the baby and the mother, they contain oxygen, vitamins, salts, hormones and others. useful material. They help protect the fetus from dangerous infections and other adverse factors.

It must be understood that in different term pregnancy, the amount of amniotic fluid also changes. In the third trimester, they should be about 1-1.5 liters. If the indicators of a pregnant woman are below these values, we can talk about oligohydramnios.

Low water happens:

• moderate (not too small)
• pronounced (seriously below normal)

In the second case, the expectant mother will need to be hospitalized in the pregnancy pathology department. This is because medical supervision for a pregnant woman with a similar problem should be permanent and drug treatment cannot be avoided.

To leave oligohydramnios (especially pronounced) without treatment means to expose the life of the baby big risk. Here are just a few of the dangers that this diagnosis can entail:

• Malformations of the child
• The risk of squeezing the umbilical cord and, as a result, intrauterine death of the child
• Intrauterine infection of the fetus

Diagnosis of the disease

Necessary tests and examinations

Oligohydramnios is detected on ultrasound. But even without special equipment, the doctor can make this diagnosis.

To do this, he discovers that abdominal circumference And uterine fundus height pregnant do not correspond to the term, and the woman's complaints about low fetal activity only reinforce the diagnosis. Besides flat amniotic sac can be seen on vaginal examination.

But the doctor will not rely only on the examination: a pregnant woman, in whom the doctor questions the diagnosis of "oligohydramnios", will be made ultrasound And dopplerography.

KTG will give information about the state of the baby's heartbeat, and smears And standard analyzes will help to identify the very cause of oligohydramnios, which must be dealt with in the first place.

Only a comprehensive diagnosis, as well as setting the severity of oligohydramnios, can provide a basis for choosing a course of treatment.

Treatment and prevention during pregnancy

Treatment

It all depends on the severity of the disease and the causes that caused it. For example, if a metabolic disorder in a pregnant woman (obesity) provoked oligohydramnios, a woman will be prescribed to change her diet and diet.

At moderate polyhydramnios usually a pregnant woman is treated on an outpatient basis. Regular consultations with a doctor, taking special medications, reducing physical activity and physical activity at this time are mandatory.

Often put "paired" diagnosis: aging of the placenta and oligohydramnios. This requires taking certain drugs, as a dangerous pathology of pregnancy develops - fetoplacental insufficiency. Most often, drugs such as Actovegin are prescribed.

At severe oligohydramnios required admission to hospital. If the risk of fetal life is quite high, the doctor may prescribe a caesarean section. If the gestational age allows, and the diagnosis does not tolerate other solutions, they also resort to early delivery.

Prevention

direct preventive measures oligohydramnios, unfortunately, cannot be. True, there is some simple rules that reduce the risk of this pathology. It is not difficult for them to follow almost every pregnant woman:

• Avoid strenuous exercise do not lift heavy things from the beginning of pregnancy
• Monitor your diet, eat fractionally, at least five times a day. Give up fast food and other "harmful things", monitor weight gain
• Timely submit all tests, follow all the doctor's instructions so that in case of danger, make a diagnosis in time
• Walking on fresh air , rest, positive emotions, the ability to relax. No matter how much they talk about the psychology of a pregnant woman, the significance of this aspect will not decrease. Unfortunately, constant stress and inability to control one's own emotions, one way or another, affects the course of pregnancy. Therefore, from this point it is worth starting the whole process of preparing for bearing a baby.

Do not be afraid of this diagnosis, severe oligohydramnios is not so common. But if the diagnosis is made, medical intervention cannot be avoided.

Only disciplined, responsible patients can hope for a successful outcome of pregnancy and childbirth with such a complex diagnosis.

Instead of a conclusion:

• oligohydramnios is a lack of amniotic fluid, which affects the metabolism between the mother and baby and can lead to serious problems in the growth and development of the child;
• a timely diagnosis and the fulfillment of all medical prescriptions for a pregnant woman indicate favorable predictions for the outcome of pregnancy;
• with oligohydramnios, the cause of this pathology is necessarily revealed, which requires correction;
• at moderate oligohydramnios a pregnant woman is treated on an outpatient basis, severe form of the disease requires hospitalization;
• if the diagnosis is a direct threat to the life of the baby, and the gestational age hypothetically suggests delivery, labor induction or caesarean section is likely;
• the occurrence of oligohydramnios does not depend on the age of the pregnant woman, nor on the number of births;
• a common cause that provokes this pathology is a disturbed metabolism, therefore, doctors strongly recommend women with obesity to go on a diet before planning a child

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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 future child surrounded by fetal membranes and 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 influence and compression of internal organs. In addition, the water-filled fetal bladder has great importance in the rate and degree of cervical dilatation initial stage 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:

1. Intoxication of the body with any harmful substances. This happens when the mother-to-be has bad habits, or she works in a hazardous substance-related industry. You can also encounter toxic substances in everyday life if you abuse them. household chemicals in cleaning.
2. Violation of metabolic processes, a tendency to overweight and obesity. Correcting the situation in this case is sometimes possible with a properly selected diet.
3. Violation of the function of the membrane of the fetal bladder.
4. 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.
5. Transferred infections of a bacterial nature.
6. Pregnancy reversal. The placenta, which has outlived its allotted time, is aging. This leads to its flaking and impossibility full implementation functions.
7. Late toxicosis.
8. Increased blood pressure. Many expectant mothers face this problem, but with oligohydramnios it is more pronounced.
9. Anomalies in the development of the internal organs of the child
10. Diseases of the genitourinary system - both in acute and chronic form.
11. 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 infectious agents penetrate to 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 have different character. 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 the objective external symptoms may be missing. 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. Specialist draws Special attention for discrepancy between the normal height of the uterine fundus and the volume of the abdomen.

Careful history taking is essential to enable maximum precision identify the root cause of this condition, on which the tactics of therapy depend.

To exclude the possibility of an infectious factor, are assigned laboratory research blood and urine. 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 definitive 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 body.

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 general condition health of both the fetus and the patient herself. If the pathology manifests itself moderately, and there are no vivid symptoms, in the II trimester, expectant tactics. 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 proper organization 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 medicines that stabilize uteroplacental blood flow. Actively used medicines, which 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. Are treated in parallel accompanying illnesses, which can affect the insufficient production of amniotic fluid.


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.

High probability of primary weakness 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 medical methods impossible. But some simple folk methods can provide positive influence on the course of pregnancy with diagnosed oligohydramnios.







• The use of chokeberry in fresh. 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 overweight women, 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, therefore proper diet can become not only one of the measures to combat this condition, but also in a good way its prevention.


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, dysplasia. hip joint, 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.
• An increased risk of having a child with underweight. The probability of this pathology is less than 10% with a moderate form of oligohydramnios and more than 75% with a severe form.
• Wither skin future 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.

Low water carries certain risks, but is among 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

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