QuestionHello I am 32 weeks pregnant and have had a slightly complicated pregnancy. I went into to preterm labor at 22 weeks, have a placental lake, and have had bacterial vaginosis off an on throughout my pregnancy. Otherwise I am completely healthy. I have had monthly growth checks on the baby. Everything has been fine up untill my 32 week check. They discovered that the baby is big measuring at 34 weeks, but my amniotic fluid level (AFI) was 8.5 which they said is borderline low. My doctor said he would check it next week. My question is, is my baby currently in danger. I feel that he should check it sooner than a weeks time. Is there a danger of the AFI dropping within 7 days? The only intervention my doctor gave me was to drink 8 8oz glasses of water a day.
I have infertility issues and this baby was conceived using medications. I am extremely nervous about my pregnancy and I don't want to take any risks. What are your thoughts? Thank you
Kristi
AnswerDear Kristi,
Oligohydramnios is the condition of having too little amniotic fluid. Doctors can measure the amount of fluid through a few different methods, but most commonly it is by an amniotic fluid index (AFI) evaluation or deep pocket measurements. If an AFI shows a fluid level of less than 5 centimeters, the absence of a fluid pocket 2-3 cm in depth, or a fluid volume of less than 500mL at 32-36 weeks gestation, then a diagnosis of oligohydramnios would be suspected. About 8% of pregnant women can have low levels of amniotic fluid, with about 4% being diagnosed with oligohydramnios. It can occur at any time during pregnancy, but it is most common during the last trimester. This is a condition that often occurs in overdue women.
The risks associated with oligohydramnios often depend on the gestation of the pregnancy. The amniotic fluid is essential for the development of muscles, limbs, lungs, and the digestive system. In the second trimester, the baby begins to breathe and swallow the fluid to help their lungs grow and mature. The amniotic fluid also helps the baby develop muscles and limbs by providing plenty of room to move around.
If oligohydramnios is detected in the 1st half of pregnancy, the complications can be more serious and include:
-Compression of fetal organs resulting in birth defects
-Increased chance of miscarriage or stillbirth
If oligohydramnios is detected in the 2nd half of pregnancy, complications can include:
-Intrauterine Growth Restriction (IUGR)
-Preterm birth
-Labor complications such as cord compression, meconium stained fluid and cesarean delivery
Since you are close to full term, if your AFI would start dropping too drastically, delivery is usually what most doctors recommend in situations of low amniotic fluid levels. Other treatments that may be used include:
-Amnio-infusion during labor through an intrauterine catheter. This added fluid helps with padding around the umbilical cord during delivery and is reported to help lower the chances of a cesarean delivery.
-Injection of fluid prior to delivery through amniocentesis. The condition of oligohydramnios is reported to often return within one week of this procedure, but it can aid in helping doctors visualize fetal anatomy and make a diagnosis.
-Maternal re-hydration with oral fluids or IV fluids has shown to help increase amniotic fluid levels.
But for right now, since your levels are still within normal limits, increasing your intake of fluids is appropriate, along with a follow-up AFI in one week. More than likely, they will look at delivering you once you technically reach full-term at 37 weeks if everything else looks good.
I hope that this information has helped you and answered your question. I wish you well.
Brenda
