Brief Answer:
Get Doppler ultrasound done, renal anomalies should be ruled out in fetus

Detailed Answer:
Hi dear, I have gone through your question and understand your concerns. An AFI of 5.7 indicates low levels of amniotic fluid around the fetus. However, the fetal growth is adequate as fetal weight is corresponding to the gestational age.
Oligohydramnios with normal fetal growth can be due to:
1. Renal anomalies in the fetus
2. Congenital anomalies or genetic syndrome
3. Decreased fluid intake by the mother
4. Idiopathic, in which no cause is found.
Hermin is amino acid containing fluid, given in order to increase the fluid, betnesol is the drug given to accelerate fetal lung maturity if it has to be delivered earlier in view of oligohydramnios, while alivher is sildenafil which is currently in experimental stage, shown in several studies to increase the blood supply to the placenta and hence increase the fluid. It is not to cause any adverse effects on the fetus.
However, I will suggest you to get a fetal Doppler ultrasound to assess the blood flow, and rule out any renal anomaly in the fetus by a ultrasound, preferably by a fetal medicine specialist.
You should continue taking4-5 litres of fluids, high protein diet and adequate rest, as these are known to increase the amniotic fluid levels sufficiently, if no other pathology is detected.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma

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Brief Answer:
Please upload all reports

Detailed Answer:
Hi dear, I have reviewed the report of the NT/NB scan, and it is completely normal. The report of anomaly ultrasound and double marker is not uploaded. Kindly upload them so that I can review them. Also please tell whether you got your glucose tolerance test done and whether you are suffering from any chronic illness like renal disease, autoimmune disease or high blood pressure.
There is no clear percentage of how much the AFI will increase with hermin, however it is shown to increase the amniotic fluid levels in most of the patients.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

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Brief Answer:
Sildenafil is safe

Detailed Answer:
Hi dear, I have reviewed your reports. All the reports are normal except low AFI in recent ultrasound.
You have not uploaded the complete report of level 2 scan, so I am unable to comment upon the fetal renal system.
The basic effect of alivher or sildenafil is that it increases blood flow and perfusion by dilating the blood vessels. So yes, it will significantly increase blood flow to the baby, and is a proven treatment agent for treating oligohydramanios ( decreased amniotic fluid levels ).
The dose prescribed to you is ok. There would be no side effects to the baby. Get the ultrasound and Doppler repeated in a week. If the amniotic fluid levels further decline or the colour changes on Doppler deteriorate, the baby would need to be delivered urgently by C section. Keep a count of the baby's movements ( count for one hour each after breakfast, lunch and dinner - totally 3 hours , by lying on the left lateral side , the total of the 3 hours should be atleast 10 movements ). Drink atleast 4 - 5 litres of fluids daily, maximizing water intake, take high protein diet and rest.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

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Brief Answer:
Renal system is completely normal

Detailed Answer:
Hi dear, according to the ultrasound report, the renal system of the fetus is completely normal.
You can get back to me for further queries later by asking a direct question to me on health care magic portal.
Wishing you all the best.
Regards
Dr Deepti Verma

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