Low Amniotic Fluid

was talking abt tat i have low fluid in my waterbag on my last appt at kkh. so jus went online to find out and read more abt this issue...


What is amniotic fluid?
Amniotic fluid fills the sac surrounding your developing baby and plays several important roles:

•It cushions your baby to protect him from trauma (if you take a tumble, for instance).
•It prevents the umbilical cord from becoming compressed and reducing your baby's oxygen supply.
• It helps maintain a constant temperature in the womb.
• It protects against infection.
• It allows your baby to move around so that his muscles and bones develop properly.
• It helps the digestive and respiratory systems develop as your baby swallows and excretes it and "inhales" and "exhales" it from his lungs.

Where does amniotic fluid come from?
During the first 14 weeks of your pregnancy, fluid passes from your circulatory system into the amniotic sac. Early in the second trimester, your baby starts to swallow the fluid, pass it through his kidneys, and excrete it as urine, which he then swallows again, recycling the full volume of amniotic fluid every few hours. (Yes, this means that most of the fluid is eventually your baby's urine!)

So your baby plays an important role in keeping just the right amount of fluid in the amniotic sac. Sometimes, though, this system breaks down, resulting in either too much or too little fluid — both of which can present problems.

How much amniotic fluid should I have?
Under normal circumstances, the amount of amniotic fluid you have increases until the beginning of your third trimester. It generally peaks at 34 weeks, at which point you may carry about a quart of the stuff. After that, it gradually decreases until you give birth.

When there's too little fluid at any point in your pregnancy, it's called oligohydramnios. When there's too much, it's called hydramnios or polyhydramnios. According to the March of Dimes, about 8 percent of pregnant women are found to have low levels of amniotic fluid at some point, usually in their third trimester. Among those still pregnant two weeks past their due date, 12 percent have this condition.

How will I know if I have low levels of amniotic fluid?
Your practitioner may suspect this problem if you're leaking fluid, measuring small for your stage of pregnancy, or not feeling your baby move very much. She may also be on the lookout for it if you've previously had a baby whose growth was restricted; if you have chronic high blood pressure, preeclampsia, diabetes, or lupus; or if you're past your due date.

To find out what's going on, she'll send you for an ultrasound. The sonographer will measure the largest pockets of amniotic fluid in four different sections of your uterus and add them together to see where you rate on the amniotic fluid index (AFI). A normal measure for the third trimester is between 5 and 25 centimeters (cm). A total of less than 5 cm is considered low.

What could be causing this problem?
Experts don't always know what causes low levels of amniotic fluid. It's most common late in the third trimester, particularly if you're overdue. The later in pregnancy the condition develops, the better the outlook for your baby. Here are some of the most common causes:

Leaky or ruptured membranes
A small tear in your amniotic membranes allows some fluid to leak out. This can happen at any point in your pregnancy, but it's more common as you approach delivery. You may notice the leaking fluid yourself if you find that your underwear is wet, or your practitioner may discover it during an exam.

A ruptured membrane can increase the risk of infection to both you and your baby because it provides a way for bacteria to enter the amniotic sac. Occasionally, a tear will heal on its own, the leaking will stop, and the fluid level will return to normal. (This is usually the case if the leaking happens after an amniocentesis.)

Placental problems
A problem with your placenta, such as a partial abruption, keeps it from supplying enough blood and nutrients to your baby and causes him to stop recycling fluid.

Certain medical conditions
As mentioned above, certain conditions — such as chronic high blood pressure, preeclampsia, diabetes, and lupus — can result in low amniotic fluid levels.

Carrying twins or multiples
You're at risk for low fluid levels if you're carrying twins or multiples. Oligohydramnios is likely in the case of twin-to-twin transfusion syndrome, in which one twin suffers from too little amniotic fluid while the other creates too much.

Fetal abnormalities
If you're found to have low levels of amniotic fluid in your first or second trimester, it may mean that your baby has a birth defect. If his kidneys aren't there or aren't developing properly (Potter's syndrome) or his urinary tract is blocked, your baby won't produce enough urine to maintain the level of amniotic fluid. A congenital heart defect can also cause this problem.

What will happen if I'm diagnosed with oligohydramnios?
If you have low levels of amniotic fluid, your caregiver will follow your baby closely to be sure he continues to grow normally. How your pregnancy will be managed depends on how far along you are, how your baby's doing, and whether you have other complications.

If you're near term, labor will be induced. In some cases, you may need to have your baby early — if you have severe preeclampsia or your baby isn't thriving in the womb, for instance.

In any case, your baby will monitored very closely with frequent ultrasounds and nonstress tests, as well as biophysical profiles and possibly Doppler studies. You'll be asked to drink plenty of fluids, do fetal kick counts, and let your caregiver know immediately if you notice your baby becoming less active.

Low levels of amniotic fluid can increase your risk of complications during labor. The main concern is that the fluid level will get so low that your baby's movements or your contractions will compress the umbilical cord.

During labor, your practitioner may pass a flexible catheter through your cervix so that she can pump a steady supply of warm saline solution into the amniotic sac to reduce the risk of cord compression. If your baby can't safely tolerate labor, your doctor or midwife will recommend a c-section.

information all taken from http://www.babycenter.com/0_low-amniotic-fluid-oligohydramnios_1199460.bc?showAll=true