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Amniotic fluid problems: Everything you should know

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Amniotic fluid is the medium in which the child develops and is therefore of utmost importance. Sometimes there are problems in this fluid, which can be resolved on their own or with treatment.

Problems with the amniotic fluid can be of three types:

  1. Too much liquid.
  2. Too little liquid.
  3. An infection in the amniotic fluid

The problems sometimes affect the mother, sometimes the fetus, and sometimes both. They can occur at different times during pregnancy and are usually detected by clinical assessment or ultrasound.

Problems with the amniotic fluid

1. Too much amniotic fluid

Too much amniotic fluid is called hydramnios or polyhydramnios. It is estimated to occur in 1 in 100 pregnancies. In most cases, this problem is mild and appears in the second half of pregnancy.

In more than half of the cases, the cause is unclear. In other cases, the cause may be one or more of the following :

  • A multiple pregnancies
  • Gestational diabetes
  • Fetal anemia
  • Congenital anomalies
  • Infections in the fetus

Symptoms

In some cases, the increased amniotic fluid causes no symptoms. However, if the excess is significant, it can generate the following signs:

  • Rapid growth of the uterus
  • Early contractions
  • An upset stomach (mother)
  • Shortness of breath or difficulty breathing in the mother

Complications

Although most cases of excess amniotic fluid can be treated without problems, complications of varying severity sometimes occur:

  • Premature delivery
  • Premature rupture of membranes
  • Severe breathing problems in the mother
  • Heavy vaginal bleeding after childbirth
  • Postpartum hemorrhage: the uterus stretches and cannot return to its original shape
  • Placental abruption: occurs only after premature rupture of the membranes
  • Umbilical cord prolapse: occurs when the umbilical cord comes out of the vagina before the baby does

2. Too little amniotic fluid

Too little amniotic fluid is called oligohydramnios. It is estimated that this abnormality affects fewer than 10% of pregnant women, but only 5% of all cases are diagnosed.

This condition is most common in the third trimester, but can also occur at any time. If it occurs early in pregnancy, it often leads to more serious consequences.

It is not always possible to determine the cause of low amniotic fluid. But it is usually related to one of the following factors:

  • Fetal death
  • Multiple births
  • Changes in the placenta: such as premature rupture of membranes
  • Maternal diseases: gestational diabetes, preeclampsia, dehydration, lupus
  • Fetal abnormalities: congenital malformations, intrauterine growth restriction, infections
  • After pregnancy: when the pregnancy has passed beyond the estimated delivery date

Symptoms

Amniotic fluid deficiency rarely causes noticeable symptoms. In any case, the size of the uterus, in this case, is usually smaller than expected for the gestational age. In addition, the mother may feel a decrease in fetal movements.

Complications

Lack of amniotic fluid can result in the following:

  • Cesarean section: In some cases, the fetus cannot tolerate vaginal delivery
  • Growth stagnation: With the risk of fetal death
  • Fetal compression: Causes limb deformities, depressed chin, and flattened nose
  • Potter’s syndrome: Occurs when there are malformations and the fetus’s lungs do not grow as they should

3. Intra-amniotic infection

Another potential problem with the amniotic fluid is chorioamnionitis or intra-amniotic infection. This can occur in the amniotic fluid alone, or in combination with a similar condition in the placenta.

The main cause of intra-amniotic infection is the presence of pathogens in the maternal genital tract. These microorganisms can spread up into the uterus. Usually, the body can resist this type of infection, but there are some conditions where it cannot:

  • Too much touching of the vagina during childbirth
  • Premature rupture of membranes
  • Meconium in the amniotic fluid
  • Long labor

Symptoms

There are no characteristic symptoms of intra-amniotic infection. However, fever, abdominal pain, and vaginal discharge are common. In addition, the heart rate of the mother and fetus is very fast.

Complications

This problem with the amniotic fluid can lead to complications, such as the following:

  • Fetal death
  • Septic shock
  • Postpartum bleeding
  • Premature birth
  • Fetal cramps
  • Bacteremia in the mother
  • Cerebral palsy in the child
  • Premature detachment of the placenta
  • Acute respiratory distress syndrome in the mother

Diagnosis

Problems with the amniotic fluid often cause no symptoms. Sometimes the only sign is that the uterus is too big or too small. In the case of intra-amniotic infection, there is a fever. It is very common for these problems to be discovered by chance during an ultrasound. A test can determine the amount of amniotic fluid present.

Additional tests are usually done afterward to determine the specific cause. The most common are blood tests and amniocentesis.

Treatment for problems with the amniotic fluid

The treatment of problems with the amniotic fluid is based on regular ultrasounds to monitor progress. Regular monitoring of the fetal heart rate is also carried out. If there is too much amniotic fluid, this can usually only be monitored, unless the excess is extreme. If this is the case, the fluid is drained out with a needle through the mother’s abdomen.

When there is too little fluid, delivery can be planned for the 36th or 37th week. If there is an infection, antibiotic treatment is usually carried out. It is important to examine to detect signs, such as the size of the abdomen, the mother’s breathing difficulties, and the frequency of the baby’s movements.

It is also important to keep all follow-up appointments during pregnancy, as well as the ultrasounds prescribed by the doctor.

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