Oligohydramnios during pregnancy: causes, consequences, treatment, what to do? Oligohydramnios in pregnant women: what is dangerous and how to treat Oligohydramnios in pregnant women treatment

The phenomenon of oligohydramnios during pregnancy is quite rare (three to four cases per thousand births) and is expressed in an insufficient amount of amniotic fluid (less than 500 ml). This condition serves as evidence that there are abnormalities in the body of a pregnant woman that are dangerous to the health and proper development of the fetus.

Amniotic fluid (amniotic fluid) serves as a source of nutrition for the fetus. They contain nutrients, vitamins, hormones, oxygen, salts, that is, everything that is necessary for the growth and development of the fetus. In addition, all the products of its metabolism (mucus, urine, etc.) are secreted into it. At the same time, they protect it from the effects of adverse factors and various infections. As labor approaches, the amniotic sac puts pressure on the cervix, causing it to open.

It should be noted that the amount of amniotic fluid at different stages of pregnancy is different, which is associated with changes in the needs of the fetus. For example, in the first six weeks of pregnancy the amount of amniotic fluid is small, but by the third trimester (thirty-eighth week) their level ranges from 1000 to 1500 ml, which is considered normal (in the next two weeks the amount of amniotic fluid decreases to 600 ml, which indicates the approach childbirth). If their number is below this level, then oligohydramnios of varying degrees occurs. In practice, there are cases when a pregnant woman had practically no amniotic fluid.

There are moderate and severe oligohydramnios during pregnancy, depending on the severity. In the first option, the amount of amniotic fluid has slight deviations from the norm. In this case, the pregnant woman is recommended to normalize her diet, include in her diet various foods that contain many vitamins and minerals, and also be under constant medical supervision to prevent deterioration of the condition. In case of severe oligohydramnios, treatment in a hospital with the use of medications is required, since this condition is fraught with the development of negative complications in the form of deformation of the fetal skeletal system (injury of the spine, large joints), abnormal development of its limbs, asphyxia leading to a malfunction of the central nervous system, fusion the surface of the fetus with amnion and, as a result, the formation of developmental defects, retardation in growth and weight (the baby’s skin becomes dry and covered with wrinkles). In most cases, for health reasons, women undergo a caesarean section. Oligohydramnios also causes children to be born with low weight and insufficient vitality.

Symptoms and signs of oligohydramnios.
There are no obvious deviations in the well-being of a pregnant woman with oligohydramnios. With severe oligohydramnios, a pregnant woman may experience weakness, dry mouth, and nausea. In addition, a woman may experience aching pain, which is especially pronounced when the fetus moves. This is due to the fact that after twenty weeks of pregnancy, the child’s activity in the womb increases significantly; if amniotic fluid is insufficient, its shock-absorbing function is lost, against which the woman experiences severe pain. Therefore, only a specialist can diagnose this pathological condition using a gynecological examination and ultrasound.

The main signs of oligohydramnios are a lag in the size of the uterus from the norm at a given stage of pregnancy, non-compliance with the norms for abdominal circumference at a given stage of pregnancy, and limited fetal mobility. To confirm the diagnosis, an ultrasound is prescribed, with the help of which the amount of amniotic fluid is determined, and if oligohydramnios occurs, then the degree of its severity is determined, as well as the condition of the fetus is assessed. If the presence of this pathology is suspected, a woman is also prescribed a gynecological examination.

It is worth noting that when there is insufficient amniotic fluid, spontaneous miscarriages and premature births are often observed. Contractions during childbirth are ineffective and very painful, and the cervix dilates slowly. In most cases, labor has a long period, and when the amniotic sac is opened, a small amount of thick fluid stained with fetal feces is formed.

Causes of oligohydramnios.
The reasons for this anomaly in the development of pregnancy are not fully understood. According to medical practice, in most cases the reasons for the development of oligohydramnios at different periods can be:

Severe congenital pathologies and malformations in the development of the fetus, among which pathologies in the development of the kidneys and hereditary anomalies of facial development can be noted. In most cases, this pregnancy is terminated.
Insufficient development of the epithelium of the fetal bladder, or reduced secretory function of the aqueous membrane.
High blood pressure during pregnancy. An increase in blood pressure (blood pressure) can be observed in every pregnant woman, but during the normal course of pregnancy this phenomenon is insignificant. But with a strong increase in blood pressure, oligohydramnios may develop, usually at the end of the third trimester. The mechanism of development of this pathology is due to dysfunction of the placenta against the background of impaired blood flow due to increased blood pressure in the mother. It is worth noting that the severity of oligohydramnios depends on pressure readings. With oligohydramnios and hypertension, delays in fetal development may be observed (lag in size compared to the norm).
Transferred but not fully treated bacterial infections. Pathogenic flora can be found not only in the birth canal, but also in the amniotic fluid. All this is revealed using special tests.
Multiple pregnancy, in which the distribution of blood flow in the common placenta is uneven, as a result of which one of the fetuses receives more nutrients and oxygen, while the other receives practically nothing. Often this pathology occurs in one of the fetuses in twins due to the syndrome of shunting (discharge) of blood in the placenta from one fetus to the other. Usually the violations are minor and not dangerous for the baby.
Post-term pregnancy. In this case, the placenta ages and detaches, as a result of which it can no longer perform its functions. In this case, doctors artificially induce labor.
Metabolic disorders, in particular obesity.

Diagnosis of oligohydramnios.
The diagnosis is made only after an ultrasound examination. For diagnosis, calculation of AFI or amniotic fluid index is used. This indicator is calculated by measuring in four places the free space between the fetus and the wall of the uterus. The resulting numbers are added up, and the result is divided by 4. If the index is 5-8 cm, this indicates a normal amount of amniotic fluid; if the IAF is 2-5 cm, this indicates moderate oligohydramnios; if the amniotic fluid index is less than 2 cm, there is pronounced oligohydramnios.

Treatment of oligohydramnios.
To treat this pathology of pregnancy, it is necessary to identify the cause of its development, for which the pregnant woman is prescribed:

Ultrasound, Dopplerography, which allows you to determine the amount of amniotic fluid, the quality of blood circulation in the umbilical cord, the fetal cerebral artery and the woman’s uterine arteries, and the degree of developmental delay of the fetus.
Tests and smears for bacteria and STDs.
Fetal CTG to determine the condition and well-being of the fetus.

Various methods of treating pathology can be used. In particular, in case of metabolic disorders or obesity, the pregnant woman is prescribed medications and is also recommended a certain diet. In most cases, for oligohydramnios, complex treatment is carried out, including the use of vitamins, medications to improve metabolism in the placenta, and medications to treat the underlying disease that caused the oligohydramnios. Treatment is carried out both on an outpatient basis (in the case of moderate oligohydramnios) and in a hospital (severe oligohydramnios, accompanied by increased uterine tone). In the first case, the woman is recommended to limit physical activity, eliminate any physical activity, follow a gentle regimen, take prescribed medications, and also regularly see a gynecologist.

In case of oligohydramnios, specialists may prescribe an ultrasound examination (every week), Doppler sonography once every three days, and an extraordinary CTG of the fetus in order to monitor the anomaly and prevent its development, as well as to take timely measures, if necessary, that will preserve the health of the mother and the fetus.

In case of severe severe oligohydramnios, which threatens the health of the fetus, the doctor may raise the question of early delivery, provided that the timing of pregnancy allows.

If, with oligohydramnios in early pregnancy, fetal malformations are discovered that are incompatible with its life, then a decision is made to terminate the pregnancy.

If ultrasound results show aging of the placenta and oligohydramnios, treatment for fetoplacental insufficiency is prescribed. On an outpatient basis, drugs such as Actovegin and Curantil are often prescribed for the treatment of oligohydramnios.

Severe oligohydramnios in pregnant women in combination with fetal hypoxia is often eliminated by cesarean section even in premature pregnancy, which is due to severe suffering of the fetus.

The effect of oligohydramnios on a woman’s condition.
Oligohydramnios has an extremely negative effect on the course of pregnancy, complicating it. In addition to pain, this pathology of pregnancy development can lead to its termination. In addition, it causes weakness in labor, since an amniotic sac of insufficient size cannot influence the rate of dilatation of the cervix (usually it is opened artificially). In this case, they may prescribe medications that stimulate contractions.

The effect of oligohydramnios on the fetus.
Amniotic fluid is the site of fetal growth and development. Their insufficiency negatively affects the growth and development of the baby, in particular in the early stages of pregnancy, due to this pathology, clubfoot can form, various types of deformations of the skull can be observed, congenital dislocations of the hips can occur, and in the later stages, oligohydramnios complicates the course of childbirth. With this anomaly, the amniotic sac does not function as a wedge that promotes dilatation of the cervix. In most cases, due to contraindications to natural childbirth, a caesarean section is performed.

It is worth noting that in most cases of pregnancies with moderate oligohydramnios, healthy children are born. Only fetal malnutrition of varying degrees of severity can be observed, which is understandable, since malnutrition and oligohydramnios are the result of fetoplacental insufficiency. It should be said that children of mothers who experienced oligohydramnios during pregnancy subsequently often get sick and are very excitable.

Prevention of oligohydramnios.
To prevent oligohydramnios, it is recommended to avoid vigorous physical activity, but this does not mean giving up movement. Therefore, leisurely walks in the fresh air are recommended for pregnant women.

Eat balanced meals at least five times a day in small portions.

Timely examination, passing the necessary tests that will help identify the presence of factors that provoke the development of oligohydramnios and prescribe appropriate treatment.

In conclusion, I would like to note that in no case, when diagnosing “oligohydramnios,” do not panic, do not be nervous or despair, because this is not the worst thing that can happen during this difficult period for a woman. Nowadays, modern medical equipment and the latest drugs make it possible to carry a baby to term and give birth to him healthy in most problematic cases. Therefore, follow all medical recommendations and have a successful delivery!

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):

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.
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:

Fetal movements are painful and interfere with normal sleep.
Nagging pain in the lower abdomen.
Weakness, dry mouth, constant feeling of nausea, not associated with toxicosis.
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:

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.
Abnormal development and infection of the membranes.
Violation of the uniform distribution of blood circulation during.
Prolonged or post-term pregnancy. Aging of the placenta leads to a decrease in the production of the required amount of amniotic fluid.
Congenital anomalies of the face and pathologies of the fetal kidneys.
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:

Ultrasound with Doppler sonography 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.
CTG (cardiotocography) is required to monitor the baby’s heart rate and clarify the tone of the uterus.
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:

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.
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.
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.
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.
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:

To lower blood pressure, chokeberry juice is used, which is also rich in vitamins.
An infusion of lingonberry leaves will help with inflammatory processes.
If the last trimester of pregnancy coincided with mid-spring, then you can take a course of an excellent diuretic - birch sap.
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.

Update: October 2018

Amniotic fluid is the fluid that surrounds the fetus throughout pregnancy. It contains minerals, urea, glucose, proteins, fats and carbohydrates. Among the components of water there are a large number of hormones, immune factors, and bactericidal substances. As the gestation period increases, the water accumulates hairs and skin scales of the fetus.

Why amniotic fluid is needed?

Amniotic fluid plays a very important role in maintaining the life of a small person. In fact, this is the only habitat of the fetus that performs the following tasks:

prevents mechanical damage to the fetus
creates a favorable space so that the fetus can move unhindered
protects the umbilical cord from compression during childbirth
actively participates in fetal metabolism
stimulates the development of the lungs (due to the movement of fluid in them in two directions)
has antimicrobial and properties

How is amniotic fluid formed?

Amniotic fluid accompanies the fetus throughout almost the entire pregnancy. In the first trimester, when the embryo's organs are just forming, some of the mother's blood penetrates the fetal membranes, forming a small level of fluid. This level can be seen as early as 3 weeks of pregnancy. There is an opinion that the baby’s blood plasma can also “leak” through his skin in the shortest possible time.

In the second trimester, the main source of amniotic fluid is the fetus itself. Urine and fluid secreted by the lungs enter the space surrounding it.

From there it can be swallowed by the fetus, and part of it is absorbed directly into the mother’s blood. For example, during full-term pregnancy, the fetal lungs secrete up to 400 ml of fluid per day, the volume of urine per day can reach 1 liter.

Ingestion of water begins from 18-20 weeks of pregnancy, by 40 weeks the fetus swallows up to 500 ml of water per day (see). Within 3 hours, the amniotic fluid is completely renewed.

The total amount of amniotic fluid depends on the balance of these two processes (formation and excretion of fluid).

What is oligohydramnios?

Oligohydramnios is a decrease in the level of amniotic fluid to 0.3-0.5 l during full-term pregnancy. About 0.3–5.5% of all pregnancies are accompanied by oligohydramnios of varying severity.

Causes of oligohydramnios

The main cause of oligohydramnios during pregnancy is considered to be impaired functioning of the fetal kidneys. But there are many more factors that affect the balance of amniotic fluid:

Fetal malformations
- posterior urethral valves
- absent or narrowed urethra
- bilateral obstruction of the ureters and other parts of the urinary tract
- undercut belly syndrome
- absence of two kidneys
- bilateral cystic renal dysplasia
- polycystic kidney disease (infantile form)
- cloaca abnormalities

Fetal chromosomal abnormalities
Disorders of the placenta (placental development abnormalities)
Post-term pregnancy
Antenatal fetal death
Squeezed twin syndrome in multiple pregnancies
Oligohydramnios caused by the use of prostaglandin synthetase inhibitors
Oligohydramnios due to prenatal water leakage
Causeless (idiopathic) oligohydramnios

Absence of both kidneys

The malformation, more common in boys, is characterized by the complete absence of both kidneys and severe oligohydramnios. This condition is lethal, that is, the fetus dies in utero or immediately after birth. The causes of the pathology are also considered to be chromosomal abnormalities and exposure to unfavorable factors (maternal diabetes, smoking and cocaine use, rubella virus infection).

When performing an ultrasound, the doctor notes a low level of amniotic fluid, the absence of a shadow of the kidneys and bladder. It is important to note that if the bladder is visible, then the fetus still has at least one kidney. And with unilateral agenesis (absence of a kidney), the condition of the fetus usually does not suffer, the quality of life of such a child is practically no different from other children.

Infantile form of polycystic kidney disease

A hereditary disease, the main symptom of which is huge kidneys with cystic deformation (in the form of large cavities). The disease is usually detected in the second half of pregnancy using ultrasound; an additional sign is severe oligohydramnios. The prognosis of the disease is quite poor; most children do not survive the first year. If a pathology is detected, it is necessary to undergo full karyotyping (determining the number and shape of chromosomes), since the risk of recurrence of polycystic kidney disease in future children is 1:4.

Posterior urethral valve syndrome

Pathology of male fetuses, in which valves form in the urethra. These growths interfere with the flow of urine from the bladder. Over time it stretches. As the disease progresses, the kidneys also enlarge. Therefore, ultrasound examinations of such babies reveal large kidneys, a distended bladder, and oligohydramnios. The prognosis depends on the onset of the disease and the degree of development of the lungs (very often they are underdeveloped).

Prune-belly syndrome

A rather rare congenital malformation of a child, combining three main features:

absence or underdevelopment of the muscles of the anterior abdominal wall
disorder of the structure of the urinary system in the form of a large bladder
undescended testicles into the scrotum

In the case of a severe form of the syndrome, other anomalies may be added to these signs: dilation of the ureters, renal dysplasia and dilation of the renal pelvis. Sometimes this syndrome is combined with Potter's syndrome, when the child's kidneys are affected due to blockage of the urinary tract, the lungs do not develop, and a state of oligohydramnios occurs.

The syndrome is diagnosed already at the end of the second trimester, when an ultrasound reveals a huge fetal bladder. The prognosis of this disease is unfavorable, especially if oligohydramnios develops (in this case, termination of pregnancy is suggested). If a mild form is diagnosed, then observation and surgical intrauterine treatment are possible, although in this case the child’s chances of surviving the first year are very low.

Abnormalities of the cloaca

Anomalies of the cloaca are a rare combination of defects of the genitourinary system and the digestive tract of the fetus. Violations occur at the stage when these two systems are still combined into one.

Ultrasound reveals fluid and cysts in the child’s abdomen, absence or abnormal development of kidneys, and defects of the duodenum. Often the bladder and bowels are located outside the abdomen and are not covered by skin. With such pathologies, screening may indicate an increased level of AFP.

Often the pathology leads to the death of the child, but modern surgical methods make the chances of life for such babies quite high.

General features of malformations of the fetal urinary system:

Most of these defects are accompanied by a reduced amount of amniotic fluid (due to the small volume of urine excreted)
Severe oligohydramnios in pregnant women or anhydramnios (complete absence of water) are an unfavorable prognostic sign. In such cases, underdevelopment of the lungs is often observed - the main cause of death in newborns with such defects.
Some defects can be treated surgically (bypass surgery) during pregnancy.
There is an isolated enlargement of the kidneys, not accompanied by oligohydramnios, which goes away on its own during pregnancy.

Fetal chromosomal abnormalities

Most chromosomal diseases occur with polyhydramnios or a normal amount of water. In some cases (if the syndrome is associated with disorders in the urinary system), there may be a decrease in the level of amniotic fluid. The main diagnostic value is the second trimester and other ultrasound signs of chromosomal pathologies.

Intrauterine infections

In 30-40% of cases of severe oligohydramnios, infection of the membranes occurs. When transmitting infection from mother to fetus, the placenta and fetal membranes serve as an intermediary. Their inflammatory changes lead to placental insufficiency, decreased water levels and delayed development of the child. A complete absence of water is often observed during infection in the 1st trimester, resulting in congenital malformations of the fetus.

Fetoplacental insufficiency

Insufficient blood supply to the fetus by the placenta can occur for many reasons:

genetic disorders of the placental bed
infections
gestosis
diabetes mellitus and other chronic maternal diseases
impaired ovarian function and many other factors

But the result is always the same: gradual (and sometimes sudden) oxygen starvation of the fetus. The most sensitive organ to hypoxia is the brain. Nature has invented a way to protect it by redistributing blood throughout the fetal vessels. As a result, other organs begin to receive less oxygen. These include the kidneys and lungs, which are directly responsible for the amount of amniotic fluid. Therefore, with placental insufficiency, oligohydramnios is a common occurrence.

Post-term pregnancy

The exact causes of oligohydramnios during post-term pregnancy are still unclear. A possible reason is the inability of the maternal body to satisfy the needs of an overripe fetus, which leads to fetoplacental insufficiency and, as a consequence, oligohydramnios.

Antenatal fetal death

Intrauterine death of a child is almost always accompanied by oligohydramnios. Firstly, acute placental insufficiency most often leads to death. Secondly, immediately after the death of the fetus, its kidneys and lungs stop producing amniotic fluid. Therefore, the decrease in the level of amniotic fluid can be very sharp, and the volume of the abdomen can decrease significantly.

Squeezed twin syndrome

In case of multiple pregnancy with twins, that is, as a result of fertilization of one egg, which subsequently splits, the number of complications is quite high. One of the most dangerous and common pathologies is fetafetal blood transfusion syndrome.

Almost 70% of identical twins share a placenta, that is, they are monochorionic monozygotic twins. It often happens that additional vessels are formed in the thickness of this placenta, connecting the twins. If at the same time the part of the placenta that supplies blood to one child (donor) begins to work worse, then most of the blood goes to the second twin (recipient). As a result, the recipient begins to produce more urine and becomes polyhydramnios. And the donor does not receive enough blood and oxygen, begins to lag in growth and develops oligohydramnios.

Without treatment, this pathology leads first to the death of the donor from oxygen starvation, and then to the recipient from severe swelling and intoxication. But modern methods can significantly reduce the mortality and morbidity of such twins:

coagulation of additional vessels using laser
Caesarean section as soon as possible after the death of the donor fetus (to save the life of the recipient fetus)
in the short term, if the donor dies, the umbilical cord is closed (so that decay products and hormones do not reach the living fetus)

Iatrogenic oligohydramnios (caused by indomethacin)

Urine production by the fetus, and therefore the level of amniotic fluid, is controlled by many hormones and substances. These substances include prostaglandins, which regulate the diameter of the renal arteries. Drugs that suppress the synthesis of prostaglandins reduce renal blood flow and the amount of urine excreted by the child, which threatens the kidneys.

Indomethacin is a common drug with this effect, used to reduce the amount of amniotic fluid and prolong pregnancy. It must be used with extreme caution, as it can lead to fetal renal failure.

Leakage of amniotic fluid

Classic, followed by rupture of amniotic fluid. Often the membranes rupture before contractions. In a full-term pregnancy, labor begins after this, and its course differs little from the classic version. Completely different outcomes and prognosis occur if the membranes rupture before 36 weeks of pregnancy.

Causes of premature rupture of membranes

incompetence of the cervix (isthmic-cervical insufficiency)
membrane infection
polyhydramnios
abnormal fetal position and narrow pelvis
medical procedures (amniocentesis, cordocentesis and others)

If the membranes rupture from below, then more often a complete rupture of water and subsequent birth occurs. If the gap is located from above, then water can leak gradually, practically without reducing the overall level of amniotic fluid. Therefore, the combination of even moderate oligohydramnios with suspicious liquid discharge from the vagina can be dangerous for the health of the mother and child; it is advisable to conduct additional research. Using test strips, you can detect amniotic fluid in the vagina and prescribe treatment. Depending on the duration of pregnancy, the condition of the fetus and mother, blood and urine tests, pregnancy extension or labor induction will be carried out.

Idiopathic oligohydramnios

Oligohydramnios, not accompanied by any of the above pathologies, is considered idiopathic, that is, causeless. Most often, the amniotic index is slightly reduced, and the condition of the mother and fetus is stable. As the period increases, the amount of water may return to normal, or it may remain small until birth, without affecting the baby’s health.

Symptoms of oligohydramnios

the volume of the abdomen and the height of the uterine fundus lag behind the timing of pregnancy
low fetal motor activity
liquid vaginal discharge (due to rupture of membranes)

At each visit to the antenatal clinic, the pregnant woman’s abdominal volume is measured, which can indirectly reflect the amount of water. By the end of full-term pregnancy, it reaches 90-100 cm, but the value can vary if the woman is obese.

The main way to diagnose oligohydramnios is to determine the amniotic index using ultrasound.

How is the amount of amniotic fluid determined by ultrasound?

The main way to determine the level of amniotic fluid is to conduct an ultrasound examination. There are several techniques that allow you to estimate the volume of amniotic fluid with great accuracy.

Measuring a vertical pocket

If the largest of the pockets in two planes does not exceed 1 cm, then a diagnosis of oligohydramnios can be made.

Determination of amniotic fluid index

During this method, the entire cavity of the pregnant uterus is divided into 4 parts using two perpendicular lines passing through the navel. The maximum diameter of the liquid volume is then measured in each quadrant. By summing the data obtained in all quadrants, the amniotic fluid index is obtained.

To evaluate the results for each stage of pregnancy, special centile tables have been created, according to which doctors write a conclusion. If the index value is less than the 5th percentile, then a diagnosis of oligohydramnios can be made. Although oligohydramnios has practical significance only when the index is less than 2.5 percentile.

If you need to assess the level of amniotic fluid in the first half of pregnancy, then the uterus is divided into two quadrants with a vertical line.

Gestational age	Amniotic fluid index, cm
Gestational age	5th percentile	50th percentile	95th percentile
14 weeks	2,8	5,0	8,6
16 weeks	3,6	5,8	9,6
18 weeks	4,6	6,8	11,1
20 weeks	5,5	8,0	12,9
22 weeks	6,3	9,3	14,9
24 weeks	7,0	10,7	16,9
26 weeks	7,5	12,0	18,7
28 weeks	7,6	13,0	19,9
30 weeks	7,5	13,6	20,6
32 weeks	7,1	13,6	20,4
34 weeks	6,4	12,9	19,4
36 weeks	5,6	11,8	17,9
38 weeks	4,7	10,3	15,9
40 weeks	3,7	8,6	13,9

Why is oligohydramnios dangerous during pregnancy?

The appearance of amniotic cords. If the amount of amniotic fluid is sharply reduced, adhesions may occur between the fetal skin and the amniotic membrane. They can entangle or pull parts of the fetus, which leads to deformation or even amputation of limbs.
Impaired labor (due to a flat membrane). Contractions may be too weak and irregular.
Compression of the umbilical cord during childbirth, up to acute hypoxia and fetal death.
Disturbed position of the fetus in the uterus.

How to treat oligohydramnios?

The main principle of treating oligohydramnios during pregnancy is pathogenetic. This means that a decrease in the level of amniotic fluid in itself cannot be cured; the cause of this condition must be found. To do this, ultrasound includes a gynecological examination, monitoring of fetal heartbeats, genetic screenings, and tests.

If there are no additional signs other than oligohydramnios, then nothing needs to be treated. Monitoring the condition of mother and child is required. There is information that mothers may experience oligohydramnios. Some pregnant women with edema begin to arrange “fasting” days with limited fluid intake, which is extremely undesirable. Adequate fluids per day are necessary to maintain balance in the body.

If additional signs of trouble are detected, the primary disease must be treated:

For congenital fetal defects– surgical treatment (if appropriate) or termination of pregnancy. A wait-and-see approach is possible.
For chromosomal abnormalities– assessment of the child’s viability, after which – termination of pregnancy or expectant management
For intrauterine infection– antiviral or antibacterial treatment (if necessary), monitoring the child’s condition. Before treating such diseases, you need to carry out all the necessary tests.
For placental insufficiency– treatment with vascular drugs up to 20 weeks (Curantil), after 20 weeks – expectant management. If fetal development is severely delayed, the pregnant woman should give birth as early as possible (preferably after 33 weeks)
In post-term pregnancy– induction of labor or expectant management (if the fetus is in normal condition)
For complications of multiple pregnancy– treatment by shunting the blood vessels of the placenta, pumping out excess amniotic fluid from the recipient fetus. If the donor fetus dies, they usually try to deliver the pregnant woman as early as possible to preserve the life of the recipient fetus.
When fruit membranes rupture– induction of labor or expectant management. The main task is to prevent infection of the fetus and allow the lungs to develop (with the help of hormone therapy).

How is childbirth conducted with severe oligohydramnios?

If an ultrasound reveals significant oligohydramnios, then doctors perform an early opening of the amniotic sac. The fact is that with a small volume of amniotic fluid, the bubble takes on a flat shape. As a result, it not only does not stimulate labor, but can even disrupt it. Therefore, it is better to open such a fetal bladder.

If oligohydramnios is extremely severe, then, if indicated, a caesarean section may be used.

Prevention of oligohydramnios

You can reduce the risks of oligohydramnios (but not make them zero) by properly preparing for pregnancy and following all doctor’s recommendations:

Take 400 mcg of folate per day
Get tested for HIV, syphilis and TORCH complex
If a woman did not have chickenpox or rubella as a child, get vaccinated against rubella and chickenpox before pregnancy.
To refuse from bad habits
Control diabetes, hypertension and other chronic diseases
Avoid taking medications without consulting a doctor during pregnancy

The baby, while in the womb, is protected not only by the placenta, but also by the amniotic fluid. This liquid is a source of vitamins, hormones, salts, and oxygen for the child. However, in some cases, harmful microorganisms can penetrate into the amniotic fluid, which is reflected in its quantity - and can cause the development, for example, of oligohydramnios.

Causes of oligohydramnios during pregnancy – who is at risk?

When you hear such a diagnosis at your next examination, there is no need to panic!

Oligohydramnios varies in severity:

In some cases, treatment procedures are limited to diet and vitamin therapy.
Modern medicine corrects more complex conditions with the help of therapeutic measures.

The pathological condition in question is a consequence of deformation of the villi of the aqueous membrane - or their inability to produce a sufficient amount of amniotic fluid.

There are several reasons that can provoke this phenomenon:

1. Anomalies in fetal development

These include:

Absence of both kidneys. A similar defect can be observed during ultrasound. There will be no shadows in the area of the kidneys and bladder. This condition leads to death during pregnancy or immediately after birth. Bad habits of the mother, some infections, work in hazardous industries, as well as chromosomal diseases can cause the absence of two kidneys in the fetus.
Formation of valves in the urethra, which leads to bladder distension and kidney enlargement. Diagnosed only in boys.
Enlargement of the kidneys with the formation of cavities in them. This defect often makes itself felt in the 3rd trimester of pregnancy and has an unfavorable prognosis for the child’s life. This defect is hereditary, so parents must undergo karyotyping.
Undercut belly syndrome. It combines many defects in the structure of the urinary system, testicles, as well as the muscle tissue of the peritoneum. In some cases, all this negatively affects the development of the lungs. This pathology is extremely rare in practice, and if it is detected, doctors recommend terminating the pregnancy.
The diameter of the urethra is too small- or its complete absence.
Errors in the structure of the cloaca. This defect affects the digestive tract and genitourinary system. Fluid accumulates in the abdominal cavity and cysts form. In some cases, the bladder and intestines are not covered by skin.
Blocking the lumen of both ureters.

Video: Polyhydramnios and oligohydramnios

2. Intrauterine infections

Harmful agents penetrate the placenta and membranes of the fetus through the genitals of the expectant mother, thereby provoking inflammatory phenomena.

Such conditions in the first weeks of pregnancy can cause a complete absence of amniotic fluid.

3. Poor blood supply to the baby due to disturbances in the structure of the placenta

The following phenomena can lead to this:

Infection.
Late toxicosis.
Malfunctions of the ovaries.
Chronic ailments in a pregnant woman (including diabetes mellitus).

4. Fetal death

The main reason for this is, as a rule, fetoplacental insufficiency.

Amniotic fluid is produced in smaller quantities due to the stoppage of the kidneys and lungs.

Outwardly, this is manifested by a decrease in the abdomen of a pregnant woman.

5. Obesity

6. Multiple pregnancy - in cases where additional blood vessels begin to form in the common placenta

This provokes disruptions in the functioning of the placenta: one twin produces more urine against the background of active blood supply, while the second twin develops hypoxia.

7. Taking certain medications

In particular, this applies to Indomethacin, the main purpose of which is to reduce renal blood flow.

8. Rupture of membranes a few weeks before birth

During this process, amniotic fluid leaks.

This phenomenon may occur due to the following factors:

Diagnosis of isthmic-cervical insufficiency in an expectant mother.
The pelvis is too narrow and/or the baby is positioned incorrectly.
Inflammatory processes in the membranes.
Invasive interventions: cordocentesis, amniocentesis, etc.
Polyhydramnios.

Types, severity of oligohydramnios and timing of pregnancy

In the medical literature, the pathological phenomenon in question is classified according to two main criteria:

1. Based on the timing of pregnancy:

Previously, oligohydramnios up to 20 weeks. The culprit is often poor condition of the membranes.
Late oligohydramnios. It makes itself felt after the 20th week and, as a rule, is provoked by errors in the functioning of the placenta.

2. Depending on the degree of decrease in the level of amniotic fluid:

Moderate oligohydramnios. The volume of liquid ranges from 400 to 700 ml. This has virtually no effect on the condition of the fetus, and therapeutic measures are limited to diet.
Expressed. The level of amniotic fluid does not exceed 400 ml (with a normal level of 1000-1500 ml at 38 weeks). In such cases, the woman is hospitalized and provided with qualified medical care. Severe oligohydramnios has a very negative effect on lung function and can cause fetal death.

Signs and symptoms of oligohydramnios during pregnancy - diagnosis of oligohydramnios

Moderate oligohydramnios It practically does not manifest itself in any way, and it does not affect the development of the fetus.

If oligohydramnios is severe, the following symptoms occur:

Loss of strength, dizziness. The pregnant woman also complains of nausea, and in some cases there is vomiting.
Aching pain when the baby moves.
Dry mouth.
Small belly: after the 4th month it is almost invisible. In addition, the height of the uterine fundus does not meet the norms.

Alarming symptoms, if this is not the last week of pregnancy, are the appearance of watery vaginal discharge. This indicates leakage of amniotic fluid.

Another bad sign is a decrease in fetal mobility.

Diagnostic measures include the following procedures:

Examination by a gynecologist. At each visit, the specified specialist measures the volume of the expectant mother’s abdomen, as well as the height of the uterine fundus. These indicators should increase as the gestational age increases. The doctor is also interested in fetal mobility.
Ultrasound diagnostics. Guaranteeing a method for determining oligohydramnios. During the study, it is possible to establish the exact volume of amniotic fluid, assess the level of fetal development and structural features of the placenta, and identify degenerative conditions that caused oligohydramnios.
Laboratory research. As mentioned above, the pathological condition in question can be provoked by various infections. Testing of urine, blood, and vaginal swabs are helpful in detecting harmful agents.
Cardiotocography. Prescribed by a doctor if necessary, starting from the third trimester, to determine the individual health of the fetus, the general condition of the pregnant woman, as well as the tone of her uterus.
Doppler. It is carried out in case of severe oligohydramnios in order to study the condition of the placenta. When diagnosing fetoplacental insufficiency, this type of examination is carried out every 14-20 days.

Possible complications of pregnancy and childbirth with oligohydramnios - the main dangers and risks for the mother and child

Severe forms of oligohydramnios often lead to miscarriages or premature birth (in 50% of cases).

Other negative phenomena include:

Prolonged labor with slow dilatation of the cervix. A complete absence of labor is also possible. After childbirth, heavy bleeding may occur. Often, to solve this problem, they resort to caesarean section.
Compression of the umbilical cord during childbirth, which can lead to the development of acute oxygen deficiency or the death of the baby.
The formation of amniotic cords that wrap around the limbs and provoke their deformation. The possibility of their amputation cannot be ruled out.

Is it possible to cure oligohydramnios in pregnant women - treatment of oligohydramnios and choice of delivery tactics

When oligohydramnios is detected in an expectant mother, first of all, the cause of this phenomenon is determined. To do this, a comprehensive examination is carried out.

If oligohydramnios is the only symptom, therapeutic measures in the first two trimesters of pregnancy are limited vitamin therapy and protein-plant diet. The patient needs to minimize physical activity, get plenty of rest, and avoid stressful situations.

When oligohydramnios is diagnosed at the 34th week of pregnancy, or when this pathology is combined with uterine hypertonicity, the woman is hospitalized and her condition is monitored until the baby is born.

If the diagnosis has revealed a primary ailment, the main goal of treatment will be its elimination.

In this regard, the following measures can be taken:

Surgical manipulations for congenital anomalies. If they are inappropriate, he recommends terminating the pregnancy.
Antibiotic therapy to eliminate intrauterine infection. Before prescribing a specific drug, a pregnant woman should undergo a series of laboratory tests.
Expectant management or abortion in case of chromosomal defects. Here it is very important for the doctor to find out the level of fetal viability.
Hormone therapy, as well as prevention of infection due to rupture of fruit membranes.
Taking vascular medications up to the 20th week when placental insufficiency is diagnosed. After this period, the expectant mother is regularly monitored. If the fetus is significantly delayed in its development, a decision is made about early delivery. It is advisable to carry out a similar procedure after the 33rd week.
Shunting of placental vessels in case of “squeezed twin” syndrome. Excess amniotic fluid is pumped out of the recipient fetus.

Content

The natural life support system for a child in the womb is amniotic fluid. They are also called amniotic fluid. It is responsible for the development of the fetus, providing it with hormones, salts, oxygen and vitamins. If the amount of amniotic fluid does not correspond to the period of pregnancy, the woman is diagnosed with oligohydramnios.

What is oligohydramnios during pregnancy?

Amniotic (fetal) fluid is a biologically active liquid medium in which the fetus is located throughout pregnancy. Amniotic fluid plays an important role in maintaining the life of a developing baby:

creates a favorable environment where the fetus can move;
stimulates lung development;
prevents mechanical damage to the fetus;
controls metabolism;
during childbirth, protects the umbilical cord from compression;
exhibits antibacterial properties.

After the fertilized egg penetrates the mucous membrane of the uterine cavity, embryonic membranes begin to form around it: external (chorionic), internal (amniotic aqueous). Together they form the amniotic sac, which grows with the fetus. Inside this cavity is filled with amniotic fluid, which consists of 97% water. Its formation can be seen on ultrasound as early as the 3rd week of gestation, when some of the maternal blood penetrates through the membranes.

As the fetus grows, the amount of amniotic fluid changes. There is a constant exchange between her and the child:

In the second trimester, the source of amniotic fluid is the fetus itself. His urine (up to 1 liter per day) and fluid secreted by the lungs (up to 400 ml per day) enter the surrounding space.
From 18-20 weeks of pregnancy, the fetus begins to swallow water. By week 40, the amount of liquid ingested is about 500 ml daily. When the absorbed waters give the child everything he needs, they return to the amniotic space along with his urine.

The amniotic fluid is constantly completely renewed - approximately every 3 hours. Their total quantity depends on the balance of formation and excretion of amniotic fluid. Oligohydramnios is a condition in which the volume of amniotic fluid during a full-term pregnancy is reduced to 0.3-0.5 liters, depending on the gestational age. Another name for the pathology is oligohydramnios. This condition is not very common:

Functional oligohydramnios occurs in only 3-4 pregnant women out of 1000. This type of oligohydramnios is not considered pathological. Oligohydramnios occurs as a response to the actions of the external environment and goes away on its own within a month. For example, at 23 weeks amniotic fluid was not enough, but at 33 its level became normal.
Pathological oligohydramnios is diagnosed in only 0.2-0.3% of pregnant women. It does not go away and is fixed at different gestations, and not at a specific week.

Causes

Oligohydramnios in a pregnant woman still has no clearly identified causes. Gynecologists, based on medical practice, only identify risk factors for the development of this pathology. There is a tendency to oligohydramnios during pregnancy with the following deviations:

pathologies in fetal development, including the absence of both kidneys, their polycystic disease or dysplasia, cloacal anomalies;
underdevelopment of fetal bladder tissue;
chromosomal abnormalities;
post-maturity of the fetus;
multiple pregnancy;
infection of the amniotic sac;
fetoplacental insufficiency, abnormal development of the placenta;
history of bacterial infections;
chronic intoxication;
diabetes mellitus, chronic hypoxia, eclampsia, high blood pressure, kidney and bladder diseases in a pregnant woman;
facial abnormalities in the fetus, including a massive bridge of the nose, low-set ears, wide-set eyes;
amnionic hydrorhea – leakage of amniotic fluid;
severe toxicosis, gestosis;
systemic diseases of the connective tissue of a pregnant woman, such as systemic lupus erythematosus, rheumatoid arthritis.

Varieties

Medicine has several different classifications of oligohydramnios. Depending on the root cause of development, this deviation is divided into two main types:

Primary. Such oligohydramnios occurs against the background of intact membranes.
Secondary. It develops as a result of rupture of the amniotic membranes, leading to leakage of amniotic fluid.

According to the nature of the course, oligohydramnios is divided into acute and chronic. In the first case, the cause is infectious diseases suffered by the mother. Oligohydramnios here is often functional. Chronic oligohydramnios accompanies a woman throughout almost the entire pregnancy and requires closer study. Depending on the gestational age, oligohydramnios occurs:

Early. Diagnosed at 14-20 weeks of pregnancy. More often associated with insufficient functions of the amniotic membranes.
Late. Occurs at 21-40 weeks of pregnancy due to damage to the membranes.

Signs

Oligohydramnios has few specific symptoms. Its manifestations may accompany other pregnancy pathologies. A lack of amniotic fluid can be suspected based on a set of symptoms. Characteristic signs of oligohydramnios:

aching pain in the lower abdomen, reminiscent of menstruation;
dry mouth and nausea, especially in the morning;
general weakness, similar to the condition of influenza or acute respiratory infections;
lack of appetite;
low fetal motor activity;
liquid discharge from the vagina (when the membranes rupture);
uterine size lags behind the norm;
pain when the fetus moves;
restless sleep.

Why is oligohydramnios dangerous during pregnancy?

Oligohydramnios can cause many different complications. When a woman has little amniotic fluid during pregnancy, the baby begins to experience too much pressure from the walls of the uterus, which compress the amniotic sac. As a result, the fetus takes on an uncomfortable and unnatural position, which is fraught with the development of the following pathologies in the baby:

curvature of the spine;
clubfoot;
deformations and dislocations of the hips;
fetal hypoxia and developmental delay (hypotrophy).

For a woman, oligohydramnios is dangerous due to miscarriage and the development of complications during childbirth. With a reduced volume of amniotic fluid, the cervix may not dilate enough during delivery. Labor is weak, contractions are painful, but not strong. After childbirth, oligohydramnios can cause bleeding in a woman. If the pathology was discovered late and there are irreversible developmental disorders of the child, doctors may insist on early termination of pregnancy.

Diagnostics

A doctor may suspect oligohydramnios during a gynecological examination based on the subjective sensations of the pregnant woman. The signs of this pathology are:

low motor activity of the fetus (less than 10 movements throughout);
lag in the height of the uterine fundus and abdominal circumference from normal values at a certain stage of gestation;
amniotic fluid index (AFI) according to ultrasound examination is below normal.

The last criterion is the main one in the process of diagnosing oligohydramnios. To calculate the amniotic fluid index, the uterus is conventionally divided into four sections. Next, the following calculations are made:

Determine how deep the amniotic fluid is in each of the selected sections. To do this, measure the free space between the fetus and the wall of the uterus in centimeters.
Next, the resulting numbers are summed and divided by 4. This will be the amniotic fluid index.
If the obtained value is within 5-8 cm, this indicates a sufficient amount of amniotic fluid. Moderate oligohydramnios during pregnancy is diagnosed when the AFI value is 2-5 cm, severe oligohydramnios is diagnosed when the figure is less than 2 cm.

To prescribe adequate treatment for a woman, the doctor needs to find out the cause of oligohydramnios. To do this, he prescribes a number of additional studies:

Dopplerography;
tests for biochemical markers of chromosomal diseases, including Down syndrome, Marfan syndrome, Edwards syndrome;
a swab on the water if there is a suspicion of leakage;
general blood and urine tests;
fetal cardiotocography to determine its condition;
tests and smears for bacteria and sexually transmitted infections.

Treatment

The treatment regimen depends on the cause of the pathology. If it is a viral infection, then antiviral drugs are prescribed and additional restorative therapy is carried out. The latter consists of taking vitamin complexes and agents that improve blood flow. Other treatments for oligahydramnios:

If the pathology was caused by obesity or metabolic disorders in the body, then treatment is carried out in an outpatient clinic. It consists of maintaining proper nutrition, consuming or intramuscularly administering vitamins.
In case of pathologies of the amniotic sac, doctors focus all their efforts on maintaining the pregnancy and preventing infection of the child. Treatment in such cases is carried out exclusively in a hospital.
If oligohydramnios is associated with postterm pregnancy, then doctors puncture the amniotic sac and use special medications to stimulate labor.
In the early stages, when malformations incompatible with life are detected, doctors decide to terminate the pregnancy.
Severe oligohydramnios in combination with fetal hypoxia are eliminated by cesarean section. This method is used even in premature pregnancy, since the fetus suffers from oxygen starvation.

If oligahydromnios was detected late in pregnancy (from 27 to 40 weeks), then the woman is hospitalized in the antenatal department. She is prescribed intravenous administration of the following drugs:

Chimes, which improves blood circulation in the placenta;
Actovegin, which ensures the delivery of oxygen to the fetus;
vitamins B and C;
maintaining normal blood pressure and sugar levels.

During therapy, the child’s condition is constantly monitored using cardiotocography and Doppler. The latest study allows the assessment of placental insufficiency. If the child’s health worsens, doctors urgently perform a caesarean section. If oligahydramnios is detected before 28 weeks, doctors recommend termination of pregnancy, since its outcome is very difficult to predict. This applies to pathological oligohydramnios. For many women, functional pain goes away on its own within a month. Hospitalization is required in the following cases:

with placental abruption;
severe fetal hypoxia;
hypertonicity of the uterus;
pronounced form of oligohydramnios.

A mandatory part of therapy is the correct organization of lifestyle. A woman should avoid overwork, stress and physical activity. The patient should be provided with bed rest. Doctors recommend following a special diet with the following basic principles:

eat several times a day (more than 5) in small portions;
choose natural, minimally processed products;
give up fast food;
reduce the amount of sugar and salt in the diet;
exclude fried, salty, herbs and spices, products with flavors, dyes and preservatives;
It is good to thermally process seafood, fish and meat, do not eat them half-cooked;
do not drink strong tea and coffee;
replace sweets with fruits;
refrain from blue cheese, raw eggs, unboiled milk.

Childbirth with oligohydramnios

In the case of oligohydramnios, the size of the uterus does not correspond to the norm for a certain week of gestation. As a result, the woman’s brain does not receive the appropriate signal about the need to begin labor, because the cervix does not dilate. In this case, doctors puncture the amniotic sac. Then, to artificially stimulate labor, the woman is given special drugs. If oligohydramnios is extremely severe, then specialists decide to give birth by caesarean section.

Prognosis and prevention

If oligohydramnios is identified in a timely manner, it can be corrected with medication. If the woman follows all the doctor’s recommendations, unpleasant consequences can be avoided. Pregnant women in such cases successfully carry the fetus to term until 37-38 weeks and give birth to a healthy baby. Exceptions are cases of oligohydramnios due to chromosomal abnormalities or congenital pathologies of fetal development. In such cases, the child may not survive or may be born with certain abnormalities.

The prognosis is most unfavorable when oligohydramnios is detected in the 2nd or 3rd trimester of pregnancy in combination with intrauterine growth retardation. In this case, the child’s death, growth retardation or functional immaturity are possible. To avoid oligohydramnios, a woman is recommended to:

even before pregnancy, undergo a full examination and cure diseases of the internal organs;
register with a gynecologist in a timely manner and take the necessary tests;
exclude physical activity, stress and other negative factors during pregnancy;
eat a balanced diet;
take a walk in the fresh air every day;
take vitamin complexes prescribed by your doctor.

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