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What Causes Low Amniotic Fluid Level In A Pregnant Woman?
Question: XXXXXXX 25, During her sixth month of pregnancy. Doctor identified that XXXXXXX has low amniotic fluid level of 6. As per doctors advice, she is drinking good amount of water, close to 1 litre of coconut water, one glass Sweet Lemon Juice, L-Arginine Granules sachets- twice daily from 10-15 days. Yesterday doctor reviewed again said the amniotic fluid level has neither gone down or nor went up, it's still at the same level as earlier. Doctor admitted XXXXXXX in Hospital and gave Saline: 1. RL 500ML IV Fluid, 2. FRUCONIR IV, 3. VENFLON 20 IV, 4. ASTYMIN 3 200 ML. and discharged her same day evening. Doctor suggested to have this Saline Procedure again after three days on Monday to see, if there is any improvement in Amniotic fluid level.
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
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
Brief Answer:
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
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
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
thanks
Detailed Answer:
Thanks.
You may contact me for any further queries.
thanks
Detailed Answer:
Thanks.
You may contact me for any further queries.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thankyou Doctor for the Detailed Answer.
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
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
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