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Is IV Fluids Every Other Day At 34th Week Of Pregnancy A Necessity When AFI Measurement Is Abnormal?

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Posted on Tue, 18 Dec 2018
Question: I am in 34th week of pregnancy and as per the scan my AFI is 6.8 cms and the doctor as asked my to go for IV fluids every other day starting today. I would like to know if I should really go for it?
doctor
Answered by Dr. Purushottam Neurgaonkar (44 minutes later)
Brief Answer:
Some more information, Arginine sachets.

Detailed Answer:

Hi,

First of all do not panic.

Please fully trust in your treating doctor. The amount of liquid around the baby is below 8. It is definitely a concern for your doctor.

Usually, intravenous fluids along with amino acid infusion, helps to increase the amniotic fluid volume.

I will be happy to know about a few things in detail to help you out in a better way:
- Are you having any associated medical disorder during pregnancy like high blood pressure and high sugar levels?
- Was USG done to know about Manning's score or biophysical profile?
- Was Doppler study of umbilical artery and fetal middle cerebral artery done? What were the PI values?

Meanwhile, I will suggest you to take vitamin B 6,9,12,E,C supplements regularly from now onwards. Use of Arginine sachets two times a day in a glass of water with meals is advisable. Avoid refined sugar, deep fried foods and bakery products in the diet. Drink plenty of water.

I hope this answer helps you. Please feel free to communicate with me again.

Thanks.

Regards,
Dr. Purushottam Neurgaonkar
OBGYN
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Purushottam Neurgaonkar (1 hour later)
Thank you for super quick response doctor. Here are the details you had requested:

1. Are you having any associated medical disorder during pregnancy, like high blood pressure and high sugar levels? - No, I don't have any associated medical disorder.
2. Was USG done to know about Manning's score or biophysical profile? - Yes we got USG done and here are the details below:

BPD: 8.66cm - 35 weeks - 0 days
HC: 31.77cm - 35 weeks - 0 days
AC: 30.82cm - 34 weeks - 5 days
FL: 6.55cm - 33 weeks - 5 days
Foetal heart: 148 beats/min
Placenta: Posterior left lateral, Grade II maturity
Amniotic fluid: AFI - 6.8 cm (oligohydramnios)
Expected fetal weight: 2471 gms, +/- 370.69 grams
Average GA by Ultrasound: 34 weeks 2 days
EDD by ultrasound: 09/04/2018

3. Was Doppler study of Umbilical artery and Fetal middle cerebral artery done? What were the PI values? Not yet, would you recommend that we do this?

As recommended we will go ahead with the suggestion on medication.

Regards
doctor
Answered by Dr. Purushottam Neurgaonkar (2 hours later)
Brief Answer:
Repeat USG with Doppler flow study.Continue treatment.

Detailed Answer:
Hi,

I have gone through your reply. It's giving me almost all the information that I was expecting. Thanks for the same.

1) It is good to know that you don't have any medical issues during pregnancy.

2) USG is showing head circumference of the baby is larger than the abdominal circumference.
Usually, after 32 weeks it should be larger abdominal circumference than abdominal one.

This suggests the beginning of uteroplacental insufficiency. Meaning resistance to blood supply to placenta and subsequent supply to the baby. Reduced amount of liquor is one of the effects of it.

To ascertain the blood flow towards the placenta, a Doppler flow study is essential. Please seek help from a sonologist doctor to know about the Doppler flow indices of uterine artery, umbilical artery and fetal middle cerebral artery.

High PI values of middle cerebral artery and low PI values of the umbilical artery are expected. This will ensure that pregnancy can be extended for a week without risk to baby and medical therapy to increase water around the baby can be successful.

Anyway, please start on the medical line of treatment as suggested, repeat USG after 7 days with Doppler study, it will be of help.

Please keep calm. Meditate regularly. Think positive. Exercise deep breathing.

Things will be fine in the due course of time. May God bless you with a bundle of joy.

I hope this answer helps you.

Thanks.

Regards,
Dr. Purushottam Neurgaonkar
OBGYN
Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Purushottam Neurgaonkar

OBGYN

Practicing since :1992

Answered : 2236 Questions

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Is IV Fluids Every Other Day At 34th Week Of Pregnancy A Necessity When AFI Measurement Is Abnormal?

Brief Answer: Some more information, Arginine sachets. Detailed Answer: Hi, First of all do not panic. Please fully trust in your treating doctor. The amount of liquid around the baby is below 8. It is definitely a concern for your doctor. Usually, intravenous fluids along with amino acid infusion, helps to increase the amniotic fluid volume. I will be happy to know about a few things in detail to help you out in a better way: - Are you having any associated medical disorder during pregnancy like high blood pressure and high sugar levels? - Was USG done to know about Manning's score or biophysical profile? - Was Doppler study of umbilical artery and fetal middle cerebral artery done? What were the PI values? Meanwhile, I will suggest you to take vitamin B 6,9,12,E,C supplements regularly from now onwards. Use of Arginine sachets two times a day in a glass of water with meals is advisable. Avoid refined sugar, deep fried foods and bakery products in the diet. Drink plenty of water. I hope this answer helps you. Please feel free to communicate with me again. Thanks. Regards, Dr. Purushottam Neurgaonkar OBGYN