Amniotic fluid is a fluid that protects and supports the fetus’ body while the fetus grows in the uterus. Amniotic fluid is produced after the amniotic sac forms or about 12 days after fertilization. The function of amniotic fluid is very vital for the fetus. These include protecting the fetus from impacts, helping the development of the fetus’ limbs, muscles, lungs and digestive system. By looking at the very important function of amniotic fluid for the fetus, what happens if the amount of amniotic fluid in the womb is small or what is known as (oligohydramnios)? Does it influence fetal movement? For more details, let’s look at the explanation below.
Oligohydramnios is a condition where the amount of amniotic fluid that protects the baby in the womb is too little than normal. In fact, the function of amniotic fluid in the womb is very important to support the baby’s life. However, it is important to know that not all pregnant women who have low amniotic fluid will definitely experience oligohydramnios. because, there are certain measurements at which pregnant women can be said to experience oligohydramnios.
Ideally, the volume of amniotic fluid at 12 weeks of gestation is around 60 milliliters (mL). As the fetus develops, the volume of amniotic fluid will also continue to increase until the gestational age reaches 34-38 weeks. After that, the number will decrease. If the amniotic fluid volume is less than 500 milliliters (ml) at 32-36 weeks of gestation, then this condition is called oligohydramnios. This condition can occur at various gestational ages. However, a small amount of amniotic fluid generally occurs in the third trimester or late pregnancy. The closer the due date gets, usually the volume of amniotic fluid will decrease. If you do not give birth after your due date, the risk of experiencing oligohydramnios is less. This is because amniotic fluid can decrease by half after reaching 42 weeks of gestation so that it becomes very low.
Symptoms of Low Amniotic Water or Oligohydramnios
The main symptoms of low amniotic fluid are not very obvious physically. For this reason, it is very important to ensure that mothers have regular pregnancy checks. If you lack amniotic fluid, your doctor may notice the following symptoms:
- The uterus is small for gestational age.
- Pregnancy weight does not increase much.
- The fetal heart rate suddenly drops.
- The mother experiences a decrease in the amount of amniotic fluid, which is detected via ultrasound.
- Significant decrease in fetal activity.
- Fluid leaking from the vagina.
Causes of Low Amniotic Water
Amniotic fluid contains nutrients, hormones and cells that form the immune system produced by the mother. However, at 20 weeks of gestation, the composition of amniotic fluid will be dominated by fetal urine. Therefore, abnormalities in the fetal urinary tract system can also affect the volume of amniotic fluid. Low amniotic fluid can be the result of a fluid leak or puncture of the amniotic sac after amniocentesis. In addition, there may be a fluid leak that is so small that it is not detected by a doctor’s examination.
Several factors can cause the volume of amniotic fluid to be low, namely as follows:
- The fetus’s urinary system is not fully developed.
One of the causes of low amniotic fluid is that the fetus’s urinary system is not developing properly. If the urinary system and kidneys fail to develop, the fetus will produce only a small amount of urine. In fact, urine is the main component of amniotic fluid when pregnancy enters the second trimester. - Placental disorders.
Placental disorders, such as placental abruption, cause obstruction to blood flow and nutritional intake for the fetus. This disrupts the fetus’s urine production, resulting in a small amount of amniotic fluid. - Premature rupture of membranes.
Small tears in the amniotic sac can cause amniotic fluid to seep out of the uterus. If premature rupture of membranes is allowed, the volume of amniotic fluid will decrease or even run out completely, causing disturbances to the fetus. - Complications of twin pregnancy.
Low amniotic fluid can also occur if a pregnant woman contains more than one fetus in her womb. The reason is, in identical twin pregnancies, pregnant women are at risk of experiencing twin to twin transfusion syndrome (TTTS) complications. This complication causes twin fetuses to share a placenta, which means that one of them must receive a small amount of amniotic fluid. - Taking certain medications.
Pregnant women who are taking high blood pressure drugs such as angiotensin-converting enzyme inhibitors (ACE inhibitors) can also cause the amniotic fluid volume to become low. Drugs that are included in the ACE inhibitor class include ramipril, captopril, and lisinopril. Apart from the factors above, certain diseases suffered by pregnant women, such as hypertension, diabetes or lupus, can also increase the risk of pregnant women having excessive amounts of amniotic fluid. A little.
Effects That Occur on the Fetus
If the amniotic fluid volume is too little for the fetus, there is a slight risk of intrauterine growth restriction and umbilical cord constriction during birth. Most likely the mother will give birth by caesarean section. In addition, babies born have the following symptoms:
- The distance between the two eyes seemed a bit far.
- The nose looks wide.
- Ear position lower than it should be.
Too little amniotic fluid can also disrupt the development of the baby’s lungs. This condition risks causing him to have difficulty breathing when he is born. If a doctor detects low amniotic fluid in the first or second trimester, the risks are greater, including miscarriage, premature birth, birth defects or stillbirth.
Treatment for Low Amniotic Water (Oligohydramnios)
Treatment for low amniotic fluid (oligohydramnios) will usually be done according to gestational age. However, before providing treatment, the doctor will carry out a series of examinations, including a pregnancy ultrasound, to determine the condition of the fetus in the womb. If there is little amniotic fluid at the end of pregnancy, usually the doctor will recommend that the baby be born immediately. This is intended to prevent complications in the baby. Meanwhile, if there is little amniotic fluid in the middle of pregnancy, the doctor will recommend the following treatments:
- Amnioinfusion, which is adding fluid to the amniotic sac.
- Increase fluid intake during pregnancy (drink enough water).
- Complete rest (bed rest).
If not treated immediately, low amniotic fluid can cause several serious complications, including premature birth, miscarriage, low birth weight babies, and Potter syndrome. To minimize the risk of low amniotic fluid during pregnancy, mothers need to increase their fluid intake during pregnancy, maintain their diet and not smoke. Apart from that, mothers also need to have regular check-ups with an obstetrician or midwife to monitor the condition of the uterus and fetus.
