Low water is scary. Oligohydramnios during pregnancy, causes, symptoms, treatment. Video: Polyhydramnios and oligohydramnios

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Oligohydramnios in pregnant women - what is it?

Currently, based on numerous observations and calculations, tables have been developed with average, maximum and minimum volumes of amniotic fluid characteristic of each week of gestation, starting from the 14th. That is, oligohydramnios can be detected starting from the 14th week of pregnancy.

However, we repeat that the concept of oligohydramnios is dynamic, that is, it can periodically arise or disappear throughout pregnancy. This means that the same woman, for example, had oligohydramnios at 23 weeks, but no longer has it at 33 weeks of pregnancy. In such cases, doctors talk about functional oligohydramnios, which occurs in response to various environmental influences and goes away on its own within a month. Strictly speaking, such oligohydramnios is transient, that is, temporary, and therefore refers to functional disorders, and not to pathologies. The vast majority of cases of oligohydramnios are just such transient, functional disorders that are not dangerous for the growth and development of the fetus and do not disrupt the normal course of pregnancy and childbirth.

If oligohydramnios is persistent, that is, it does not go away and is recorded at different stages of pregnancy, for example, at 23, 25, 30 weeks of pregnancy, then we are talking about pathology. In such cases, oligohydramnios is a sign of severe disturbances in the course of pregnancy and fetal development.

Therefore, when a woman is diagnosed with “oligohydramnios” based on ultrasound results, there is no need to be upset or nervous, since in the vast majority of cases this is a functional feature of her pregnancy, and not a pathology. But if oligohydramnios is combined with developmental defects or does not go away within a month, then this condition is considered pathological and requires treatment. Remember that the incidence of pathological oligohydramnios is only 0.2 - 0.3% of cases, and it is necessarily combined with developmental disorders of the fetus and placenta, visible on ultrasound. Therefore, if the ultrasound doctor did not see any malformations of the fetus or placenta, but diagnosed “oligohydramnios,” then this always indicates a functional characteristic of the woman and does not require any treatment, with the exception of vitamin prophylaxis.

In principle, oligohydramnios is not so much an independent pathology as a single symptom, reflecting a combination of various disorders of growth and development of the fetus or the course of pregnancy. Therefore, an isolated determination of oligohydramnios without CTG, Doppler measurements and screening for developmental defects using ultrasound and biochemical tests (AFP, hCG, etc.) is not diagnostically accurate and justified.

Oligohydramnios in pregnant women - diagnostic significance of the indicator

One of these indicators is the amount of amniotic fluid. Doctors of past centuries determined their number in order to indirectly assess how well and according to the norm the fetus is developing. Indeed, until the middle of the 20th century, such an informative method as ultrasound, which allows you to examine the fetus and determine how it is developing, accurately measuring its size and seeing all the organs and parts of the body, simply did not exist. And the doctor, without seeing the child in the womb, had to somehow assess whether he was developing normally. It was in that era that doctors determined the amount of amniotic fluid and many other parameters that indirectly made it possible to judge the growth and development of the fetus.

However, at present, the norms of fetal growth and development are perfectly monitored by ultrasound, the pathology of the placenta is determined using Doppler ultrasound, and fetal hypoxia is detected by CHT. That is, there are instrumental methods that allow much more accurate identification of fetal pathologies, dysfunction of the placenta, etc. And therefore, the definition of oligohydramnios is a kind of tribute to tradition. Because of this, many gynecologists do not pay attention to oligohydramnios at all if, according to the results of ultrasound and CTG, the child is developing normally, since they quite rightly consider this condition to be a feature of a particular pregnant woman.

Oligohydramnios - causes of development

Specific causative factors of oligohydramnios, attributed to each of the five listed groups, are reflected in the table:

Currently, the most common causes of oligohydramnios in pregnant women are the following factors:

• Preeclampsia;
• Maternal hypertension;
• Diabetes mellitus in the mother;
• Any infectious and inflammatory diseases in the mother (for example, sore throat, pyelonephritis, influenza, acute respiratory infections, etc.);
• TORCH complex infections (toxoplasmosis, rubella, cytomegalovirus, herpes) suffered during pregnancy;
• Chronic intrauterine fetal hypoxia.

If oligohydramnios develops before 28 weeks, doctors recommend termination of pregnancy, since in most cases it is impossible to predict its outcome.

Oligohydramnios – reviews of outcomes

Even if, after the next examination, you heard a terrible diagnosis: oligohydramnios, stop panicking! Insufficient amniotic fluid is not a death sentence, but just a symptom. In addition, there are different stages of oligohydramnios and, perhaps, for your body, such indicators are the norm. It's time to figure out what oligohydramnios is during pregnancy, the causes and consequences of which worry you.

What is amniotic fluid?

Your body, like a clock, is tuned to bear and give birth to a child. Not only is the fetus protected by the placenta, it is constantly in the amniotic fluid, which simultaneously serves as food and protects it from external influences of infections. This amniotic fluid contains vitamins and hormones, salts and oxygen necessary for the baby’s growth. All of them enter the child’s body when he swallows liquid.

Unfortunately, not only food can affect amniotic fluid. Infections and viruses easily penetrate the amniotic fluid, which negatively affects the development of the child. As a result, quantitative changes in amniotic fluid and diagnosis, for example, of oligohydramnios.

Oligohydramnios – what is it?

Oligohydramnios is a deviation from the normal amount of amniotic fluid in the direction of its decrease. There is a distinction between moderate and severe oligohydramnios. In the latter case, the amount of amniotic fluid is reduced by 3 or more times.

• The first good news: such a deviation is quite rare, medical indicators range from 0.7 to 5.5%, and even then the highest number characterizes moderate oligohydramnios during pregnancy, which is not considered critical;
• The second positive argument is that in the first and third trimester, oligohydramnios, especially moderate ones, is not a 100% threat to the development of the baby, and it is even possible that the small amount of amniotic fluid you have is of a genetic nature.

Amniotic fluid index table

The amount of amniotic fluid can be determined by the ratio of the volume of the abdomen and the height of the uterus, as well as during an ultrasound examination (read the article on the topic: Is it possible to determine the gestational age by ultrasound?>>>).

Measurements during ultrasound

1. During an ultrasound, the presence of a so-called free pocket is determined. This pocket is nothing more than the distance between your baby and the front wall of your tummy;
2. A specialist may suspect oligohydramnios if this space is less than 2 cm, while the norm is 5 cm;
3. At the same time, the amniotic fluid index will be calculated for you; the principle is the same, but measurements are taken at four different points around the baby. The AFI norm is determined by week, but please note that even within a day the data may fluctuate slightly.

The resulting numbers in mm are checked against the table. Interestingly, the average reaches its peak at week 27 – 156 mm, and at week 42 it drops to 110 mm. The table also shows possible fluctuations, again by week:

Thus, oligohydramnios during pregnancy at week 32 is diagnosed when the AFI is below 77 mm. (read the current article: Ultrasound at 32 weeks of pregnancy >>>), while at 22-26 weeks only at 89 and below AFI.

Conventional measurements

You can also talk about oligohydramnios if the size of the uterus and abdominal girth do not correspond to your gestational age, but no one will diagnose you without an additional ultrasound.

Why is oligohydramnios dangerous?

Low hydramnios is a sign that a certain malfunction has occurred in your body. The causes of oligohydramnios during pregnancy, namely whether these disorders are genetic, or whether external factors have affected the functioning of the placenta and the production of amniotic fluid, will be determined by a specialist, but the fact that such a condition can be dangerous is a fact.

Consequences

Check out the list of dangers associated with oligohydramnios during pregnancy.

• There is a 50% risk of premature birth;
• During delivery at term, there is a decrease or absence of labor in 80% of pregnant women;
• The risk of miscarriage increases significantly (up to 50%);
• In a third of pregnant women, oligohydramnios developed as a consequence of an infectious or inflammatory process;
• With a critically low amount of amniotic fluid, the risk of fetal hypoxia is 20%, and hypertrophy or asphyxia is 75%;
• In half of the cases with oligohydramnios, birth is carried out by caesarean section.

Causes

You will not find clear medical parameters in any reference book, but there are certain assumptions:

1. There is a tendency towards oligohydramnios during pregnancy due to genetic factors. If your mother or grandmother had small babies with a small belly, you may have the same story;

There is no need to worry when oligohydramnios is moderate and the child feels normal. Another thing is if your relatives, as a result of oligohydramnios during pregnancy, had problematic childbirth, you need to warn your doctor and geneticist about this.

1. If you notice a decrease in abdominal volume ahead of schedule, there is a risk of leakage of amniotic fluid (important article

Oligohydramnios during pregnancy is a decrease in the amniotic fluid index compared to normal values ​​characteristic of a particular period of gestation. Clinicians identify a large number of predisposing factors that influence the development of this condition, ranging from addiction to bad habits to complicated pregnancy.

The disease has characteristic symptoms, which female representatives are unable to ignore. The main ones include a feeling of severe pain during fetal movement and constant aching pain in the lower abdomen.

Diagnosis is based on instrumental laboratory studies and a thorough physical examination of the patient. The whole danger of the disease is that it can be completely asymptomatic, and this is fraught with a lack of timely diagnosis and therapy, as well as the development of complications.

Treatment of oligohydramnios during pregnancy is often conservative, but in especially severe cases, immediate delivery is resorted to.

Etiology

The amount of amniotic fluid increases as the gestation period increases. Amniotic fluid performs several very important functions, including:

• ensuring protection of the placenta and umbilical cord;
• regulation of metabolism between the fetus and mother;
• protecting the fetus from mechanical irritants.

It follows from this that the consequences of such a disease will primarily affect the unborn baby.

Oligohydramnios in pregnant women can develop under the influence of the following negative predisposing factors:

• abnormalities in the structure or functioning of the kidneys in the fetus - in these situations, a low amniotic fluid index will be observed from the initial stages of pregnancy;
• the course of serious chronic illnesses in the expectant mother - this includes pathologies of the cardiovascular system, kidney ailments and other organs of the urinary system;
• infectious lesions of the organs of the female reproductive system - this category includes STDs such as and;
• the presence of any stage in a woman;
• improper metabolism;
• strong in females, which can be caused by excessive vomiting and diarrhea. It is worth noting that such manifestations are considered one of the characteristic signs of pregnancy;
• a pregnant woman’s addiction to bad habits - not all women, having learned that they will become a mother in the near future, refuse to drink alcohol or smoke cigarettes;
• infections of a bacterial or viral nature suffered during the period of bearing a child, for example, or, as well as pathologies such as, or;
• complicated pregnancy – , and ;
• pathologies of the placenta, in particular insufficiency or other developmental abnormalities;
• multiple pregnancy;
• damage to the amniotic sac, which leads to leakage of amniotic fluid;
• true post-term pregnancy - in which the period of intrauterine development of the fetus exceeds forty-two weeks;
• various anomalies in the development of the membranes - the development of such disorders can be affected by family history, poor ecology or exposure to radiation;
• amnion hydrorhea;

Despite such a wide list of predisposing factors, in some cases it is not possible to find out the causes of oligohydramnios during pregnancy.

Classification

In gynecology, it is customary to distinguish several forms of this disease, each of which is determined depending on the degree of deviation in relation to the norm of the amniotic fluid index. This is determined during an ultrasound.

Thus, pathology is divided into:

• moderate oligohydramnios during pregnancy– the index varies from five to two centimeters. The disease is considered such if the volume of water has decreased from 400 to 700 milliliters compared to the norm. For example, by the end of bearing a child, the normal level should be 1000–1500 milliliters;
• severe oligohydramnios in pregnant women- a similar value is less than two centimeters. In this case, the amount of amniotic fluid does not exceed five hundred milliliters.

Symptoms

The nature of the clinical picture will differ depending on the form in which the pathology occurs.

For example, moderate oligohydramnios during pregnancy can be completely asymptomatic, without affecting the well-being of the expectant mother. In such cases, the disease can be diagnosed only by the results of an ultrasound examination. In some cases, patients complain of a feeling of discomfort or slight pain during fetal movement.

Signs of oligohydramnios during late pregnancy, which indicate a severe course of the pathology, are presented:

• discrepancy between the size of the abdomen and the period of intrauterine development of the fetus;
• strong, occurring with every movement of the child inside the womb;
• constant aching pain in the lower abdomen;
• dry mouth;
• weakness and nausea, which are in no way related to early toxicosis;
• excessive ease in palpating parts of the fetal body;
• other manifestations of deterioration in health.

If you experience one or more of the above symptoms, you should seek medical help as soon as possible. This is due to the fact that such a pathology is to a certain extent dangerous for the woman, but for the most part has an adverse effect on the fetus.

Diagnostics

Despite the fact that oligohydramnios in the later stages or in the early stages of pregnancy is determined only by ultrasound, establishing the correct diagnosis requires an integrated approach.

Primary diagnosis includes:

• familiarization of the clinician with the medical history and life history of the patient - to determine the most accurate predisposing factor;
• studying information regarding the course of this period of gestation and previous pregnancies, if any;
• conducting a thorough physical examination - in this case the volume of the abdomen is assessed, as well as a gynecological examination - during the process the doctor determines the discrepancy in the size of the uterus;
• a detailed survey of the patient - regarding the presence, first time of occurrence and degree of how expressed the symptoms of oligohydramnios are.

Laboratory diagnostic activities involve the following:

• gynecological smear studies - to identify signs of inflammation and the presence of pathological bacteria;
• PCR tests - they are necessary to determine the DNA of bacteria or viruses that could cause STDs;
• serological tests.

Instrumental diagnostics include:

• Ultrasound - this procedure allows you to accurately determine the amniotic fluid index, and also clarifies the condition and maturity of the fetus;
• Doppler study – to monitor the state of blood flow in the “mother-fetus” system;
• Cardiotocography is the recording of the baby's heart rate inside the womb. The need is to clarify the condition of the fetus and the tone of the uterus.

Treatment

Today there are no methods to artificially restore normal values ​​of amniotic fluid. However, clinicians use the following methods to treat oligohydramnios:

• taking medications;
• elimination of concomitant pathologies;
• urgent delivery.

Drug therapy is necessary to eliminate placental insufficiency and consists of using:

• vasodilators that expand the lumen of blood vessels;
• antioxidants to prevent the development of oxidative processes;
• antiplatelet agents to reduce blood clotting;
• vitamin complexes;
• immunomodulators.

Treatment of associated ailments will be individual:

• for amnionic hydrorrhea, strict bed rest, vitamins and medications are indicated to reduce the tone of the uterus;
• for viral infections, they resort to taking anti-inflammatory drugs. This is necessary to maintain pregnancy and prevent intrauterine infection of the fetus;
• for STDs, antibiotics are required;
• In case of post-term pregnancy, the amniotic sac is punctured. The procedure is called amniotomy.

If a deterioration in the condition of the fetus is detected during diagnosis, the patient is prescribed immediate delivery, regardless of the stage of pregnancy. Childbirth with oligohydramnios is carried out by caesarean section.

Complications

Oligohydramnios is a pathology that is dangerous for both the expectant mother and the fetus. The consequences for the woman are:

• spontaneous termination of pregnancy;
• severe pain felt even with the slightest movement of the child inside the womb;
• complicated course of childbirth;
• premature labor;
• profuse hemorrhage in the early postpartum period.

Why is oligohydramnios dangerous for the fetus?

• intrauterine death;
• death during birth;
• intrauterine infection;
• disruption of the rate of intrauterine development;
• a wide range of injuries - deformation of the skull or spine, as well as fusion of the child’s skin with the fetal membrane. Elimination may require amputation of a limb or an operation that will lead to disfiguring deformations of the body;
• death in the first few days after birth.

Prevention

There are no specific preventive measures against oligohydramnios, but to reduce the likelihood of developing such a pathology, women during pregnancy need to:

• lead a healthy and moderately active lifestyle;
• eat properly and balanced;
• avoid emotional and physical stress;
• minimize dehydration of the body, as your doctor will advise you to do;
• register with the antenatal clinic in a timely manner;
• Visit your obstetrician-gynecologist regularly.

For the full intrauterine development of a child, a comfortable natural environment is necessary. Its role is played by amniotic fluid, which carefully envelops the fetus, protecting it from mechanical injury and infection. A deviation to a lesser extent from the normal volume of amniotic fluid or oligohydramnios is observed in approximately 3-4 cases out of 1000. Today on the website for mothers we will find out what danger this condition poses, the reasons for its development, and will also tell you how oligohydramnios is treated traditionally and folk remedies.

Why is oligohydramnios dangerous?

2 weeks after fertilization of the egg, a natural biological environment is formed, which, in addition to the fetus itself, is the main content of the uterus. Amniotic fluid or amniotic fluid fills a sealed cavity - the fetal sac, creating a reservoir with a nutrient medium for the normal intrauterine existence of the baby.

If the volume of amniotic fluid deviates from the established norms to a lesser extent, this may mean the presence of oligohydramnios of varying degrees, and this is always a reason to be wary.

For each woman, the optimal volume of amniotic fluid is determined individually, but if the gynecologist suspects that their level potentially threatens the child’s health, a diagnosis of “oligohydramnios” may be made. The amount of fluid produced depends on the functional capacity of the placenta; if these indicators are greatly reduced, the risk of delays in fetal development, disturbance of its heart rhythm, and also its death increases.

In gynecology, there are two forms of oligohydramnios, which are diagnosed only after an ultrasound and are determined by calculating the amniotic fluid index (AFI):

1. Moderate. It is recorded if this indicator in a pregnant woman is in the range from 2 to 5 cm, which corresponds to a decrease in the volume of amniotic fluid by 400-700 ml compared to the norm. Moderate oligohydramnios involves treatment at home under regular medical supervision, when you need to normalize your diet and enrich your diet with vitamins and minerals.
2. Expressed. It is recorded if the IAF is less than 2 cm, which corresponds to a volume of amniotic fluid of up to 500 ml. Severe oligohydramnios requires inpatient drug treatment in a hospital setting. Without taking the necessary measures to eliminate the pathology, this condition can seriously affect the development of the fetus when there is deformation of the skeletal system, pathology of the extremities, fusion of the baby’s skin with the fetal membranes, disruption of the normal functioning of the central nervous system, and retardation in growth and development. Particularly dangerous is oligohydramnios diagnosed in the first trimester of pregnancy, when the pathology can cause serious damage to the health of the fetus and even lead to miscarriage.

If the baby's vital signs begin to decline, the woman is given a cesarean section or insists on premature delivery. Severe oligohydramnios can cause children to be born with low body weight and disabilities.

Why does oligohydramnios develop?

It is not possible to find out exactly when the amount of amniotic fluid began to decrease, but some signs may indicate the development of oligohydramnios:

1. Fetal movements are painful and interfere with normal sleep.
2. Nagging pain in the lower abdomen.
3. Weakness, dry mouth, constant feeling of nausea, not associated with toxicosis.
4. When palpated during a medical examination, parts of the fetal body can be clearly felt.

Now you know what oligohydramnios can mean, and we will look further at the causes and treatment of this pathology.

In fact, the causes of oligohydramnios have not yet been studied in detail, but gynecologists point to the following:

1. Amnionic hydrorhea or leakage of amniotic fluid due to disruption of the integrity of the fetal membrane. To restore the volume of amniotic fluid, bed rest is sufficient.
2. Abnormal development and infection of the membranes.
3. Violation of the uniform distribution of blood circulation during.
4. Prolonged or post-term pregnancy. Aging of the placenta leads to a decrease in the production of the required amount of amniotic fluid.
5. Congenital anomalies of the face and pathologies of the fetal kidneys.
6. Maternal health problems: persistent increase in blood pressure in a pregnant woman, dehydration, eclampsia, diabetes mellitus.

The diagnosis of oligohydramnios is also made more often in women with diseases of the genitourinary system. Previous bacterial infections that were not treated and were in the woman’s birth canal can penetrate into the amniotic fluid.

Treatment methods for oligohydramnios

Moderate oligohydramnios is not a threatening factor for the health of the child if a woman monitors her diet, nutritional regimen and is constantly under the supervision of a doctor. This condition is treated on an outpatient basis and does not require hospitalization.

Treatment is aimed at eliminating the causes that caused the development of the pathology (pyelonephritis, high blood pressure, cystitis), so at home the woman will have to take the medications prescribed by the doctor.

Before finally deciding on a diagnosis, the doctor must refer the pregnant woman to a number of examinations:

1. Ultrasound with Dopplerography to determine IAF, the general condition of the fetus and its exact gestational age, as well as to identify pathology in the mother-child system.
2. CTG (cardiotocography) is required to monitor the baby’s heart rate and clarify the tone of the uterus.
3. A smear if you suspect water leakage and the presence of STDs.

These examinations are necessary to assess the condition of the fetus, determine the causes of oligohydramnios during pregnancy and prescribe treatment adequate to the severity of the diagnosed pathology:

1. For oligohydramnios caused by obesity and pathologies of metabolic processes in the mother's body, it is necessary to follow a proper diet, including foods rich in vitamins and minerals, as well as taking medications to improve blood circulation in the placenta.
2. If a viral infection is detected, antiviral drugs approved during pregnancy are prescribed, and restorative therapy is carried out with vitamin-mineral complexes and immunomodulators.
3. In case of pathology of the membranes, the woman is sent to a hospital for treatment and is constantly under the supervision of doctors. The main goal of doctors in this case is to maintain pregnancy and prevent infection of amniotic fluid.
4. If examinations have shown that the placenta is aging, and this fact has caused oligohydramnios, treatment of FPI (fetoplacental insufficiency) with drugs such as Curantil and Actovegin is prescribed.
5. Oligohydramnios in post-term pregnancy can be eliminated by puncture of the amniotic sac and stimulation of labor.

If severe oligohydramnios is diagnosed in the 8th month of pregnancy, drug treatment is prescribed in a hospital setting with constant monitoring of the child’s vital signs. If the condition of the fetus worsens, even with the use of drugs, the continued stay of the child in the womb becomes extremely dangerous, and, if time permits, the doctor may decide to perform a caesarean section or insist on premature birth.

Prevention of oligohydramnios with folk remedies

Many people are interested in the question: is it possible to treat oligohydramnios during pregnancy with folk remedies? It is in principle impossible to completely restore AFI to a normal level with medication or folk remedies. But for preventive purposes and to eliminate the causes of pathologies, traditional medicine methods can be used, but only after a conversation with a doctor. This approach will be especially useful for women whose previous pregnancy was already accompanied by oligohydramnios.

The website advises:

1. To lower blood pressure, chokeberry juice is used, which is also rich in vitamins.
2. An infusion of lingonberry leaves will help with inflammatory processes.
3. If the last trimester of pregnancy coincided with mid-spring, then you can take a course of an excellent diuretic - birch sap.
4. To treat inflammation of the genitourinary system, use an infusion of leaves of nettle, string, birch, yarrow, rose hips and rowan.

But remember, any folk remedy, even harmless at first glance, can cause not an improvement, but a deterioration of the original condition. Therefore, the first step is a consultation with your doctor.

A woman diagnosed with oligohydramnios should not be afraid of her condition, but she should not ignore it either. Severe oligohydramnios is not that common, but moderate oligohydramnios can be corrected if you follow the instructions of a specialist.

Under certain negative circumstances, pregnancy can be accompanied by a number of different kinds of problems and complications, among which oligohydramnios is reasonably considered one of the most dangerous. This pathological condition is characterized by a decrease in the volume of amniotic fluid, without which the developing fetus may simply die.

Amniotic fluid is a nutrient medium from which the developing fetus receives the substances it needs during its stay in the mother's womb. The composition of amniotic fluid includes many nutritional components, without which normal growth and development of the child is impossible. The main components of the environment are: oxygen, vitamins and microelements, salts, some hormones, as well as many additional useful substances.

In addition to providing the child with the necessary nutritional components, amniotic fluid protects the fetus from various types of infections and, in general, all kinds of negative influences. The amount of intrauterine water changes as the child grows and his needs increase.

Based on average statistical data obtained from numerous clinical studies, amniotic fluid indices were determined for each period of pregnancy. This index reflects the norm of amniotic fluid volume and permissible deviations that are not a cause for concern.

We talk about oligohydramnios in cases when the patient’s amniotic fluid index is not within the lower limit of the norm for her period. Information regarding the normal volume of intrauterine fluid for different weeks of pregnancy is given in the following table.

Table. Amniotic fluid index for different weeks of pregnancy (16-25)

The determination of these indicators is carried out by a doctor during the next ultrasound examination.

The list of factors contributing to the development of oligohydramnios remains virtually unchanged for each stage of pregnancy. Among the most common reasons, the following points should be noted:

• kidney pathologies in the fetus. In the presence of severe congenital diseases of this nature, oligohydramnios is usually observed from the initial stages of pregnancy;
• illnesses of a chronic nature, usually affecting the genitourinary and cardiovascular systems of the mother;
• infectious diseases affecting the mother’s genitourinary system;
• bad habits in women;
• previously suffered bacterial and viral diseases;
• pathologies of the placenta;
• multiple births (often a combination of oligohydramnios in one child and simultaneous polyhydramnios in the second).

How does oligohydramnios manifest itself?

The problem under consideration can be severe or moderate. Moderate oligohydramnios is characterized by an almost complete absence of subjective manifestations felt directly by the patient - the pregnant woman’s well-being practically does not deviate from the norm, and the lack of intrauterine fluid is determined only during an ultrasound examination.

For the expressed form of the disease in question, the following manifestations are characteristic:

• reduction of the uterus. During the next medical examination, the specialist notes a decrease in the patient’s abdominal circumference. During a vaginal examination, it is discovered that the height of the uterine fundus does not correspond to the normal readings characteristic of the patient’s specific period of pregnancy;
• pain when the child moves;
• periodic discomfort of aching nature in the abdomen;
• deterioration of the woman’s condition in general, accompanied by a feeling of dry mouth, as well as nausea and severe weakness.

Oligohydramnios, diagnosed in the second trimester (namely, this period of pregnancy includes the 20th week), is the most dangerous for both the developing fetus and the woman carrying it. The specialist’s task at this stage is to determine the feasibility of prolonging the pregnancy.

It was previously noted that oligohydramnios comes in two main varieties. The most dangerous, in this case, is the pronounced form of the disease, which can lead to the following problems:

• disorders and pathologies of child development. Children born with oligohydramnios often experience deformities of the limbs and muscles, spinal abnormalities, a general slowdown in development, and pathologies in the formation of the brain and skull. The most severe complication of oligohydramnios is hypoxia, which develops against the background of oxygen starvation. The possibility of the child’s death cannot be ruled out;
• problems during childbirth. Even if the pregnancy can be maintained, labor activity in the future will most likely be extremely weak. There is a high risk of severe blood loss after delivery;
• termination of pregnancy.

In patients with moderate oligohydramnios, the likelihood and intensity of manifestation of the listed deviations is lower, however, the risks of the occurrence of the described problems are also present.

That is why the main task of a woman who has had to deal with oligohydramnios at the 20th week of pregnancy or any other period is to strictly follow medical recommendations.

Treatment of the problem under consideration is an extremely difficult and responsible task that requires a qualified approach. Currently, medicine does not have drugs or special techniques that can artificially increase or decrease the content of amniotic fluid.

If oligohydramnios is detected, the woman is hospitalized in a hospital and all necessary medical measures, the main task of which is to maintain the normal condition of the child and balance the uteroplacental circulation, are carried out under close medical supervision.

The course of treatment is determined by a specialist. As a rule, women are prescribed vitamins, drugs to normalize the function of the placenta and improve uteroplacental blood flow, antibiotics (if various types of infectious diseases have caused oligohydramnios).

During therapy, doctors constantly monitor the amount of amniotic fluid and monitor the condition of the developing child. Procedures such as fetal cardiotography, ultrasound, and Doppler measurements are regularly performed.

If the measures taken do not have a positive effect on the condition of the patient and the child, and oligohydramnios progresses, doctors in the vast majority of cases recommend early delivery, which at the 20th week of pregnancy is often equivalent to abortion.

In general, as practice shows, with timely diagnosis and proper treatment, the problem of oligohydramnios can be quite successfully solved. Many experts regard this disease as a symptom of another disease, so the main goal of prescribed therapy in most situations is to identify and eliminate the causes that led to the development of amniotic fluid deficiency.

In addition to medications, women are recommended to reconsider some aspects of their life activities. For example, experts often advise reducing physical activity.

Thus, although oligohydramnios is a rather dangerous disease, often threatening the death of the fetus, with a timely and competent approach, there is a high probability of normalization of the condition of the child and mother and the chances of having a healthy baby are significantly increased. The main thing is to strictly adhere to the recommendations of specialists, not to self-medicate and to approach the solution of the problem as responsibly as possible.

Be healthy!

Video - Oligohydramnios during pregnancy 20 weeks