What Causes Low Amniotic Fluid Level In A Pregnant Woman?
Questions:
1. What could be the primary reasons other than dehydration to see low level of Amniotic Fluid level ? How should we mitigate them?
2. Is this Saline Procedure Safe for 7th month Pregnant Lady? How long should we continue this based on Amniotic fluid level?
What would you suggest, Overall Next Steps?
Looking forward to hear from you,
Thanks,
XXXX
oligohydramnios
Detailed Answer:
Hello,
Thanks for the query to hcm,
Oligohydramnios in second trimester is usually due to congenital foetal renal anomalies like bilateral pelviectasia or uteroplacental deficiency due to thrombophilias or cases of gestational hypertension or in IUGR cases. The treatment offered in form of increased water intake and astymin injections and L-arginine satchets have been known to increase the amniotic fluid volume to a certain extent especially in third trimester without any renal anomalies and in cases of uteroplacental deficiency. They are standard management procedures for intervention in case of Oligohydramnios.
The aim in such cases is to extend the pregnancy till at least 34 weeks till foetal lung maturity is achieved but antenatal corticosteroids should be given in form of 2 doses of betamethasone 12mg 24hrs apart to hasten the pulmonary maturity in the child as there may be a chance of preterm delivery if the amniotic fluid volume is not increased by medical method.
Also, Antepartum transabdominal amnioinfusion is the method that has been addressed as a technique for the restoration of a normal amniotic fluid volume, in order to prolong gestation and to prevent fetal complications at least until pulmonary maturity is achieved. This is followed to maintain an AFI more than 6cm in third trimester with the aim to continue again till 34 weeks. The baby is likely to be a growth retarded child and can have structural deformities if allowed to grow with reduced fluid volume.
Another important concern id preterm premature rupture of membranes in such cases when delivery is imminent and a neonatal ICU support is mandatory for the child after delivery.
So for management at present:-
1. weekly AFI scans to monitor fluid volume.
2. Umbilical artery doppler studies for uteroplacental insufficiency and to watch for reversal of flow, ( indicative of termination of pregnancy).
3. BED REST AND nutritious diet with medical management to be continued.
4. antenatal steroids for foetal lung maturity.
If by 32 weeks anytime, foetal movements decrease then she should be admitted in the hospital for every 3rd day scan and management further to decide time for termination of pregnancy.
Regards
thanks
Detailed Answer:
Thanks.
You may contact me for any further queries.
XXXXXXX completed her graduation in BHMS (Homoeopathic Medicine) last year. She is interpreting the medical terminology used in the answer.
Thanks for your help.
Regards,
XXXX