What affects the amount of amniotic fluid. Increased amount of amniotic fluid

Even if after the next examination you heard a formidable diagnosis: oligohydramnios, stop panicking! Insufficient amount of amniotic fluid is not a sentence, but just a symptom. In addition, there are various 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 bother you.

What is amniotic fluid?

Your body, like a watch, is adjusted to the bearing and birth of a child. Not only is the fetus protected by the placenta, it is always in the amniotic fluid, which both serves as food for it and protects it from external influences of infections. These amniotic fluid contain vitamins and hormones, salts and oxygen necessary for the growth of the baby. All of them enter the body of the child when he swallows the liquid.

Unfortunately, not only food can affect the 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 diagnosing, for example, oligohydramnios.

Low water - what is it?

Low water is a deviation from the normal amount of amniotic fluid in the direction of its decrease. There is a difference 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 is that such a deviation is quite rare, medical indicators range from 0.7 to 5.5%, and even 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, do not pose a 100% threat to the development of the baby, and it is even possible that a small amount of amniotic fluid in you is of a genetic nature.

amniotic fluid index table

The amount of amniotic fluid can be determined by the method of 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 an ultrasound

1. During ultrasound, the presence of a so-called free pocket is determined. This pocket is nothing but 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 IAI norm is determined by weeks, but please note that even during the day the data may fluctuate slightly.

The resulting figures in mm are verified according to 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:

Term pregnancy, weeks	Average normal indicator, mm	Probable hesitation, mm
16	121	73-201
17	127	77-211
18	133	80-220
19	137	83-225
20	141	86-230
21	143	88-233
22	145	89-235
23	146	90-237
24	147	90-238
25	147	89-240
26	147	89-242
27	156	85-245
28	146	86-249
29	145	84-254
30	145	82-258
31	144	79-263
32	144	77-269
33	143	74-274
34	142	72-278
35	140	70-279
36	138	68-279
37	135	66-275
38	132	65-269
39	127	64-255
40	123	63-240
41	116	63-216
42	110	63-192

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

Regular measurements

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

Why is low water dangerous?

Low water is a sign that a certain failure has occurred in your body. The causes of oligohydramnios during pregnancy, namely, these disorders are genetic, or external factors influenced the work of the placenta and the production of amniotic fluid, the specialist will establish, but the fact that such a condition can be dangerous is a fact.

Consequences

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

• There is a 50% risk premature birth;
• At term, there is a decrease or absence labor activity in 80% of pregnant women;
• Significantly increases the risk of abortion (up to 50%);
• In a third of pregnant women, oligohydramnios developed as a result 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 - 75%;
• In half of the cases with oligohydramnios, childbirth 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 to oligohydramnios during pregnancy on a genetic basis. If your mother or grandmother gave birth to small babies, while the stomach was small, you may have the same story;

You can not worry when the oligohydramnios is moderate, and the child feels fine. Another thing is if your relatives, as the consequences of oligohydramnios during pregnancy, had problematic childbirth, you must warn your doctor and geneticist about this.

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

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

Why is low water dangerous?

2 weeks after the 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 fill 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 in a smaller direction, 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 health of the child, a diagnosis of oligohydramnios can be made. The amount of fluid produced depends on the functional ability of the placenta, if these indicators are greatly reduced, the risk of delays in the development of the fetus, a violation of its heart rhythm, and also its death increases.

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

1. Moderate. It is fixed 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, enrich your diet with vitamins and minerals.
2. Expressed. It is fixed if the IAI is less than 2 cm, which corresponds to the volume of amniotic fluid up to 500 ml. Severe oligohydramnios requires inpatient drug treatment in a hospital setting. Without the application of the necessary measures to eliminate the pathology, this condition can seriously affect the development of the fetus, when there is a deformation of the skeletal system, pathologies of the limbs, fusion of the skin of the baby with the fetal membranes, disruption of the normal functioning of the central nervous system, lag in growth and development. Especially dangerous is oligohydramnios diagnosed in the first trimester of pregnancy, when pathology can cause serious damage to the health of the fetus and even lead to miscarriage.

If the child's vital signs begin to decline, the woman is given a caesarean section or insists on premature delivery. Severe oligohydramnios can cause the birth of children with a lack of body weight and injuries.

Why does oligohydramnios develop?

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

1. Fetal movements are painful, interfering with normal sleep.
2. Drawing pains in the lower abdomen.
3. Weakness, dry mouth, constant feeling of nausea, not associated with toxicosis.
4. On palpation during a medical examination, parts of the body of the fetus are clearly palpable.

Now you know what oligohydramnios can threaten, and we will consider further the causes and treatment of this pathology.

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

1. Amniotic hydrorrhea or leakage of amniotic fluid due to a violation 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 fetal membranes.
3. Violation of the uniform distribution of blood circulation with.
4. Prolonged or delayed pregnancy. The 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 pathology of the kidneys of the fetus.
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. Transferred bacterial infections that were not treated and were in the birth canal of a woman can penetrate into the amniotic fluid.

Treatment methods for oligohydramnios

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

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

Before finally making a diagnosis, the doctor should refer the pregnant woman to a series of examinations:

1. Ultrasound with dopplerography to determine the IAI, 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 control the baby's heart rate and clarify the tone of the uterus.
3. A smear for suspected water leakage and the presence of STDs.

Survey data are necessary to assess the condition of the fetus, find out the causes of oligohydramnios during pregnancy and prescribe treatment that is adequate to the severity of the diagnosed pathology:

1. With oligohydramnios caused by obesity and pathologies of metabolic processes in the mother's body, it is necessary to comply proper diet, which includes 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 are prescribed that are allowed during pregnancy, and general strengthening therapy is carried out with vitamin-mineral complexes and immunomodulators.
3. With a pathology of the membranes, a woman is sent for treatment to a hospital and is constantly under the supervision of doctors. The main goal of doctors in this case is to maintain pregnancy and prevent infection of the 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 during post-term pregnancy will be eliminated by puncture of the fetal bladder and stimulation of labor.

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

Prevention of oligohydramnios with folk remedies

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

The site site advises:

1. To lower blood pressure, chokeberry juice is used, which is also rich in vitamins.
2. At inflammatory processes an infusion of lingonberry leaves will help.
3. If the last trimester of pregnancy coincided with the middle of spring, then you can drink a course of an excellent diuretic - birch sap.
4. For the treatment of inflammation of the genitourinary system, use an infusion of nettle leaves, succession, birch, yarrow, rose hips and mountain ash.

But remember, any folk remedy, even harmless at first glance, can cause not an improvement, but a worsening of the initial state. Therefore, the first step is to consult with your doctor.

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

Most of the time that the baby spends in the womb, he is under the protection of the placenta or, as it is also called, the amniotic sac. Amnion constantly produces amniotic fluid, in which the baby will be until the very moment of his birth. Such a liquid protects the baby from bacteria and viruses, creates favorable conditions for its development, allows it to stay warm and comfortable during the most important and crucial months of its life.

The temperature of the amniotic fluid is maintained by the body at a constant level and is about 37 ° C, provided that the woman is healthy. As for the amount of fluid, this indicator is constantly changing and directly depends on what week of pregnancy the expectant mother is in. It is also worth noting that the larger the baby becomes in the womb, the more fluid the amnion produces. The rate of amniotic fluid during pregnancy is 1-2 liters at the 36th week of the term, but in the following days this figure may decrease somewhat, because during the preparation for childbirth, the body begins to actively remove fluid.

Among the components of the amniotic fluid, you can find a wide variety of components, for example, proteins and carbohydrates, hormones and enzymes, fats and salts, various vitamins and glucose. Amniotic fluid also contains oxygen, carbon dioxide, immunoglobulin, baby waste products and many other substances. The composition of the liquid is always unstable and changes at least every 3 hours. In addition, the composition of the water also depends on the gestational age, because at different periods of development, the crumbs require different substances.

Why amniotic fluid is needed

The role of amniotic fluid in the process of growth and development of the fetus is difficult to overestimate, because thanks to the many functions that this substance performs, the child is not only under constant protection, but also has the opportunity to be born. Read more about the functions of amniotic fluid below:

1. One of the purposes of amniotic fluid is the metabolism between maternal and child organisms. Those components that the baby needs for his development and maintenance of life come to him precisely through the amniotic fluid. Processed food, being excreted from a tiny organism, also first enters the amniotic fluid, and only then is completely removed from the woman's body. The waste products that enter the liquid also include the upper scales of the epidermis, particles of the original lubricant, the hairs of the child and the components of the mother's blood.
2. The second important function of the amniotic fluid is its ability to protect the unborn baby from all sorts of harmful factors in the outside world. Due to the constant temperature of the waters, the child in the womb will not be able to freeze, moreover, he is not afraid of physical influences such as blows, compressions, pressure. Amniotic fluid eliminates the risk of squeezing the umbilical cord, gives the baby the opportunity to move freely in the mother's abdomen.
3. The female body also made sure that the amniotic fluid was always absolutely sterile. Due to the fact that viruses, bacteria and other pathogens do not penetrate into them, the baby is reliably protected from diseases. Sterility is mainly maintained by constant renewal of the composition of the liquid, which occurs at least every 3 hours.
4. Amniotic fluid not only helps the baby grow and develop in safe environment, but also directly involved in the process of delivery. Firstly, the so-called anterior waters, by their pressure on the uterus, provide a better opening of its cervix. Secondly, while the baby is trying to be born, the amniotic fluid protects him until the very moment of birth. Thirdly, during the passage of the child's birth canal, water plays the role of a lubricant, facilitating this process.

In addition to the above useful functions, amniotic fluid also has an important diagnostic value. After conducting certain water tests, the doctor can find out a lot of necessary information regarding the health of the child and the characteristics of his development. Thanks to diagnostics, it is possible not only to establish the sex of the baby and his blood type, but also to obtain information about possible hereditary diseases or other abnormalities, the development of which can be prevented even at the stage of pregnancy.

Volume, composition, degree of transparency, color and consistency - all these parameters of the amniotic fluid can be found with the help of the necessary tests. In addition, in the case of some pathologies, when emergency delivery is required, with the help of such a diagnosis, it is possible to establish the degree of readiness of the child for the birth. Based on the data obtained, a decision is made on the use of special medical equipment to support the life of the baby for a certain period.

Amniotic fluid pathologies

oligohydramnios during pregnancy

The condition when there is little amniotic fluid during pregnancy is called oligohydramnios. Such a pathology can occur if the amnion produces less fluid than is excreted from the body. It should be said that such a disease is not so common and accounts for no more than 1% of cases in the total number of pregnancies. Oligohydramnios is a serious problem that requires attention and timely treatment. If this phenomenon is not eliminated, certain complications may arise:

1. Firstly, the pressure of the amniotic fluid on the uterine canal is significantly reduced, which, in turn, leads to difficulties in the delivery process.
2. Secondly, oligohydramnios is fraught with such complications as premature birth. A child who was born before the due time will need special medical care.
3. Oligohydramnios is also dangerous because the baby is not able to move normally, which increases the risk of breech presentation of the fetus.
4. Hypoxia is considered a very frequent companion of this pathology - a lack of oxygen necessary for a child. Hypoxia results in growth retardation and fetal abnormalities.

As a rule, it is not possible to notice such a pathology on your own, since oligohydramnios has almost no symptoms that are physically palpable. Occasionally, a woman with a similar problem may feel slight pain in the abdomen, but often this manifestation is simply absent. You can identify the disease using ultrasound, which is why timely testing and passing planned ultrasound so important for a pregnant woman.

If it is possible to detect oligohydramnios before a period of 28 weeks, an examination of the body of the expectant mother will allow you to find out the cause of the pathology and, if possible, eliminate it. So that the child does not suffer from a lack of oxygen, it is important to start treatment as soon as possible - this will allow gas exchange and uteroplacental blood flow to be established. In the process of therapy, the doctor monitors the baby's condition and sometimes, in case of emergency, prescribes an early caesarean section.

Let us examine in more detail what are the causes of oligohydramnios during pregnancy:

• the presence of hypertension in the expectant mother;
• significant overweight pregnant;
• infections and inflammatory diseases;
• violations of the development of the placenta;
• inflammation in the pelvic organs;
• polycystic kidney disease of the fetus, anomalies in the development of its genitourinary system.

Polyhydramnios during pregnancy

Approximately as rare as oligohydramnios, the opposite pathology, polyhydramnios, can also occur. This problem occurs in 1-1.5% of pregnant women and is an excess of amniotic fluid relative to the norm.

Polyhydramnios is of two types:

1. Chronic polyhydramnios is characterized by the fact that the amount of amniotic fluid arrives gradually. If the pregnant woman is healthy and feels fine, the doctor may prescribe her diuretics - special medications that are responsible for removing fluid from the body. In addition, the doctor prescribes a certain diet, which involves reducing the amount of salt in the diet. It is important to follow all the recommendations of the doctor, because polyhydramnios can lead to unpleasant consequences. An excessively enlarged uterus oppresses the rest of the organs, disrupting their work. In addition, polyhydramnios sometimes causes circulatory disorders in the female body, it makes labor difficult and can cause heavy bleeding after childbirth.
2. The second type of polyhydramnios is acute. It is characterized by a sudden increase in amniotic fluid that occurs over several hours. As a rule, such a disease makes itself felt by the following symptoms: abdominal pain, severe swelling, shortness of breath. With such a pathology, a woman needs hospitalization. Being on inpatient treatment, the pregnant woman observes bed rest which makes it possible to reduce the risk of preterm birth. If acute polyhydramnios is characterized by the incessant presence of water and threatens the health of the woman and her baby, abdominal amniocentesis can be used as a remedy for the problem. During this operation, the placenta is pierced and excess fluid is removed to the outside.

Among the causes of pathology are the following:

• diabetes mellitus in a pregnant woman;
• the conflict of Rh blood of mother and baby;
• carrying twins;
• the child has a genetic disease;
• infection to the fetus in utero;
• disruption of the fetal bladder, which manifests itself in excessive production of amniotic fluid even on early dates pregnancy.

Leakage of amniotic fluid during pregnancy

Another pathology of amniotic fluid is their leakage. This condition is characterized by the appearance of copious liquid discharge from the female genital tract. From ordinary secretions, amniotic fluid is distinguished by transparency, colorlessness, a very liquid consistency, and the absence of odor. Often, leakage of amniotic fluid during pregnancy does not show any symptoms other than the aforementioned discharge. But the expectant mother may not pay attention to such manifestations, because during pregnancy, abundant vaginal discharge is the norm.

In the event that a woman suspects a similar pathology in herself, she should immediately see a doctor. The specialist will prescribe tests that will determine the nature and origin of the discharge, after which the leakage of water can be refuted or confirmed. By the way, in pharmacies you can find special tests with which such an analysis is carried out independently. But it is recommended to use this method only if it is absolutely impossible to see a doctor for any reason. In addition, if the analysis gives a positive result, the pregnant woman one way or another will have to go to the hospital for inpatient treatment.

If a similar phenomenon has made itself felt after the 36th week of the term, doctors can stimulate childbirth, and the baby will be born prematurely for only 1 week. If the leakage of water happened in the early stages, the woman needs hospitalization in order to maintain the pregnancy for the maximum possible period. During hospitalization, strict bed rest should be observed. In some cases, when the period is too short and it is not possible to keep the pregnancy for a long time, the situation is fraught with abortion.

The most common causes of amniotic fluid leakage are genital tract infections. To avoid such a risk, it is very important to monitor your health, observe the rules of personal hygiene, engage only safe sex and periodically take tests for the presence of pathogenic flora in the vagina.

Amniotic fluid green

Transparency, colorlessness, odorlessness and liquid consistency are characteristics of normal amniotic fluid. Slightly turbid amniotic fluid during pregnancy can be observed at the very end of the term and are also considered the norm, since their appearance is due to the presence of epidermal flakes and lubricant flakes that enter the liquid from the baby's body. But in the event that the amniotic fluid has acquired a greenish tint, we can talk about pathology. The green color of the amniotic fluid is often due to particles of the original feces, which the baby releases if he lacks oxygen. Hypoxia is considered one of the most dangerous conditions of the fetus, because it not only interferes with the normal development of a small organism, but sometimes causes irreparable consequences.

Possible reasons why amniotic fluid may turn green are described below:

1. If during the entire pregnancy the waters were normal and turned greenish already in the process of childbirth, very often this can cause stress for the baby. Experiencing childbirth, the baby sometimes secretes meconium, due to which the liquid acquires a characteristic shade.
2. As mentioned above, the cause of this pathology during pregnancy can be such dangerous state like fetal hypoxia. It is caused by over-term pregnancy. If the baby is in the womb for too long, the amniotic sac ages and does not perform its functions properly. Because of this, the baby experiences a lack of oxygen.
3. Sometimes a greenish tint in the amniotic fluid indicates an infection. This happens if the expectant mother has had a cold, flu, bronchitis, suffered an infection of the genitourinary system or some other inflammatory disease.
4. Very rarely, genetic diseases of the fetus can become the cause of an abnormal shade of amniotic fluid.

Green waters can be dangerous for a child if he swallows contaminated fluid. If such a phenomenon was found in later dates pregnancy, a woman may be given a caesarean section. If such a pathology was detected in the early stages, the causes of the condition should first be identified and measures taken to eliminate them. Since the amniotic fluid is often updated, it will be enough to eliminate the causes of the pathology in order to correct the situation.

In the event that the pregnant woman's green waters have departed, the delivery process should be started as soon as possible in order to eliminate the risk of oxygen starvation and the associated consequences.

Amniotic fluid tests during pregnancy

There are several ways to assess the condition of amniotic fluid during pregnancy, the simplest of which is considered to be ultrasound. This procedure does not harm the health of the woman and her fetus, but is the least informative. With the help of ultrasound, you can only visually determine the transparency of the liquid and determine its amount. For more detailed information, other studies are being conducted, which we will consider in more detail:

1. Amniocentesis is a complex procedure in which fluid is taken directly from the amniotic sac. To do this, the woman's stomach is pierced with a special tool and a small amount of amniotic fluid is drawn out. The procedure is performed under local anesthesia. Then this material is sent for research, where immunological, biochemical, cytological and hormonal analyzes are carried out. Depending on the location of the amniotic sac, doctors determine the puncture site, and during the procedure, an apparatus for ultrasound diagnostics is used. Amniocentesis is performed if there is a conflict between the Rh blood of the mother and the child, as well as if there are suspicions of chromosomal pathologies, hypoxia, and genetic diseases. Such an analysis is also carried out when the age of the future woman in labor exceeds 40 years, and also in the case when it becomes necessary to determine the maturity of the child's lungs. Amniocentesis is not used if a woman has any inflammation in her body, if the pregnant woman suffers from pathologies in the development of the uterus or from diseases of the genitourinary system. If there is a threat of miscarriage, the procedure should also be abandoned.
2. Amnioscopy is another method for determining the state of the amniotic fluid. During the procedure, the doctor inserts an amnioscope into the cervix and examines the lower pole of the placenta and amniotic fluid. Using the procedure, you can set the amount of amniotic fluid, examine its color and identify the presence of hypoxia in the fetus.

Amniotic fluid during pregnancy. Video

The protection of the baby in the mother's abdomen, its stable growth and proper development is provided by amniotic fluid during pregnancy. The enlarged uterus contains a fetal bladder filled with a special liquid substance. It is the "home" for the baby for the entire long period of pregnancy, almost from the very conception. Therefore, it is especially important to monitor the condition of this fluid and correct emerging deviations in time.

Formation and functions of amniotic fluid

The Greek concept "amnion", denoting the membrane of the fetus, gave the name of the amniotic fluid - a nutrient medium for the intrauterine development of the child. Immediately after the fertilized egg enters the uterus and attaches to it from the inside, a chorion is formed at the attachment site (in the future it will become the placenta). With the help of the umbilical cord, the chorion is connected to the amnion - the fetal bladder. Inside the amnion, real magic happens - a baby develops from several cells after the allotted time. Reliable protection is provided by thin and elastic, but very strong bladder walls.

The fetus is in the amnion filled with amniotic fluid or amniotic fluid

The amnion is filled with a fluid, the sterility of which is achieved by regular renewal. How is amniotic fluid renewed during pregnancy? Until the middle of the term, they are produced by the cells of the fetal bladder, and after the 20th week they are mainly formed by the kidneys of the child. At the end of pregnancy, the fluid is updated 8 times a day.

Amniotic fluid provides comprehensive protection for the baby:

• Due to the content of immunoglobulins, the baby is reliably protected from all kinds of infections.
• In the event of an accidental fall of the mother, the shock is cushioned by the presence of liquid, and no harm is done to the child.
• The umbilical cord remains free and is not pinched.

The temperature inside the bubble is constant at 37 degrees Celsius. Until about the third trimester, the baby can even make swimming movements, as long as there is enough space for this.

Characteristics of the waters

More than 95% of the composition of the amniotic fluid is water. The rest is made up of vitamins, trace elements, even particles of the skin and hair of the fetus. Toward the end of pregnancy, when the child masters urination, urine also appears in the composition of the liquid. But due to frequent renewal, the composition of the liquid remains unchanged. There is an opinion that the smell of the liquid is similar to breast milk, which is why a newborn baby unmistakably finds the mother's breast.

The amount of amniotic fluid increases from week to week, reaching a maximum two weeks before the planned date of delivery.

At 38 weeks, the volume of amniotic fluid is approximately 1-1.5 liters. Further, the amount of water decreases, and by the time they are born, about 800 ml remain.

Various pathologies of pregnancy can affect the decrease or increase in the amount of amniotic fluid.

Normally, amniotic fluid should be clean and clear. If a suspension appears in the waters, this most often indicates infection.

Diagnosis of the condition of a pregnant woman and a child using amniotic fluid

The state of the amniotic fluid is one of the main indicators of the normal or pathological course of pregnancy, as well as the condition of the unborn child. The amount and homogeneity of water can be estimated by ultrasound examination, which every woman must undergo at least three times during pregnancy.

If necessary, the analysis of amniotic fluid can determine the sex of the child and his blood type. In addition, the suspicion of the presence of genetic abnormalities in the fetus can be confirmed or refuted by analyzing the amniotic fluid.

If it is necessary to determine whether the child is ready for birth, amniotic fluid is also taken for analysis. Based on the results of the analysis, an emergency delivery by caesarean section can be performed. Also, fluid analysis makes it possible to find out about the readiness of the respiratory system of the newborn for independent work.

Possible problems

Unfortunately, pregnancy does not always go smoothly. There are cases when violations of the quantitative or qualitative composition of the amniotic fluid provoke the occurrence of various pathologies.

Polyhydramnios.

This condition is said when the amount of amniotic fluid exceeds one and a half liters. This condition can be caused by kidney problems in the mother, infectious diseases, cardiovascular pathologies of the mother, or congenital diseases of the child. In the case of multiple pregnancies, polyhydramnios is also quite common.

With polyhydramnios, the amount of amniotic fluid exceeds 1.5 liters

Polyhydramnios is found, usually in the second or third trimester of pregnancy. If polyhydramnios occurred suddenly against the background of the previous normal state, delivery should be carried out immediately.

Low water.

The opposite situation is when the amount of water does not exceed 500 ml. Oligohydramnios can be caused by hypertension in a pregnant woman, inflammatory diseases of the female genital organs, overweight future mother or disorders in the urinary system of the fetus. The condition is dangerous with the risk of hypoxia (oxygen starvation) of the child, therefore, appropriate treatment aimed at enhancing the production of amniotic fluid should be carried out immediately.

Oligohydramnios can also have a negative impact on the process of childbirth - the fetal bladder will not be able to press on the cervix with sufficient force, so its slow opening will lead to weakness in labor.

With oligohydramnios, the risk of premature birth is doubled, and babies, due to lack of space, are much more likely to take the wrong position in the uterus, not having time to turn into head presentation in time.

Oligohydramnios often makes itself felt with abdominal pain in a future mother - the child does not have enough space, and his every movement is difficult and painful. Reducing the amount of amniotic fluid can lead to clamping of the umbilical cord, as a result - to oxygen starvation and even death of the fetus.

Water leakage.

In a normal state, the fetal bladder remains intact throughout pregnancy, and the outpouring of water indicates the beginning of active labor. However, there are times when water starts to flow prematurely. Such a situation, or even the slightest suspicion of it, requires an urgent examination by a doctor, since a decrease in the amount of amniotic fluid can seriously harm the health of the child in case of untimely assistance.

You can check if water is leaking using special tests

A sign of water leakage is a sharp increase in fluid released when changing body position. You can accurately determine the leakage of water using pharmacy tests. If the condition is confirmed, it is necessary to contact the maternity hospital as soon as possible - perhaps this is a signal of the onset of premature birth.

Water of an atypical color.

In the normal state, the waters are transparent in color, and there are no impurities in them. True, towards the end of pregnancy, impurities inevitably appear - these are epidermal cells and vellus hair of the fetus. This state of the water is quite normal and does not threaten the development of the child. However green color and turbidity of the waters may indicate a serious pathology - fetal hypoxia. In this case, with a lack of oxygen, the muscles of the anus contract reflexively, and meconium is released into the amniotic fluid.

Another cause of premature meconium excretion is the aging of the placenta as a result of prolonged pregnancy. In this case, the placenta ceases to fully supply the fetus with oxygen, as a result of which the child develops oxygen starvation. The muscles of the anus contract again, and meconium is excreted.

Ingestion of amniotic fluid mixed with meconium by a baby negatively affects its development, so green waters require immediate medical attention.

Is it possible to avoid problems

Amniotic fluid is a nutrient medium that ensures the development of the child in the womb until the very birth. Any violations and deviations require close attention and medical supervision. Most pathologies of amniotic fluid are successfully corrected in a hospital with the help of medicines and vitamins. The patient must maintain complete calm, both physical and mental. ABOUT physical activity and an active lifestyle will have to be forgotten for a while.

It will not be superfluous to remind you of the need to visit a doctor observing pregnancy. It is constant monitoring that allows you to avoid many problems that negatively affect the normal course of pregnancy.

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Water is the first thing a child is introduced to. Even in the womb, he swims in a fluid called amniotic. What amniotic fluid looks like and what is the norm by week (table) of pregnancy you will learn from the article.

Why amniotic fluid is needed

Amniotic fluid is necessary for the normal development of the child in the womb, they are needed for

• protecting the child from loud sounds, shocks (water - absorbs noise and is a shock absorber during shocks);
• maintaining a comfortable temperature (amniotic fluid has a temperature of 37 degrees);
• protection from external threats (the bladder with amniotic fluid is sealed, which allows you to protect the child from external influences);
• feeding the baby (water does not allow the bladder to shrink, preventing clamping of the umbilical cord);
• freedom of movement of the baby (in the 1-2 trimester, the baby can move freely, swim in the amniotic fluid).

At birth, leaving the native environment, the child experiences stress, which water helps to relieve. When the birth ligament is washed off a newborn baby, he relaxes. This is very important to prepare for a new stage of his life.

The composition and rate of amniotic fluid

The membranes of the fetus begin to form after the fertilized egg attaches to the wall of the uterus. Then a complex process starts. From the fetal membranes (amnion and chorion), a protective bubble is formed with a sterile liquid inside. As the fetus grows, the bubble increases.

Amniotic fluid is formed due to the "leakage" of maternal blood plasma. In the later stages, the child himself, his lungs, and kidneys are already involved in the production and renewal of the amniotic fluid.

Amniotic fluid consists of water (97%) with proteins dissolved in it, mineral salts (calcium, sodium, chlorine). It can also detect skin cells, hair, aromatic substances.

There is an opinion that the smell of amniotic fluid is similar to the smell of mother's milk, so a newborn baby can easily find his mother's breast, because he drank a liquid similar to milk in the womb.

Norm and pathology

The normal amount of amniotic fluid by the end of pregnancy is 600-1500 ml. For a number of reasons, these figures may deviate from the norm up or down. Then doctors talk about polyhydramnios or oligohydramnios.

Oligohydramnios is diagnosed when the expectant mother has less than 500 ml of amniotic fluid. The reason for the decrease in the amount of water lies in the insufficient development of the endometrium (water membrane) or a decrease in its secretory ability. Other causes of pathology include

1. anomalies in the development of the genitourinary system of the child;
2. maternal hypertension;
3. inflammatory diseases of a woman;
4. metabolic disorders, obesity;
5. fetoplacental insufficiency.

Oligohydramnios in one fetus during the bearing of twins is explained by the uneven distribution of blood in the placenta.

With oligohydramnios, there are severe pains in the abdomen, painful movements of the child, the uterus is reduced, the size of its bottom does not correspond to the gestational age.

With polyhydramnios, the secretory function of the aqueous membrane is increased. Polyhydramnios can lead to:

1. diabetes mellitus, infectious and viral diseases of the mother;
2. diseases of the heart, kidneys;
3. incompatibility of the Rh factor in the blood of mother and child;
4. multiple pregnancy(polyhydramnios in one fetus, oligohydramnios in another);
5. placental disease.

Signs of polyhydramnios are heaviness in the abdomen, swelling of the legs, breathing and blood circulation become difficult, the child's movements become too active.

Oligohydramnios and polyhydramnios are dangerous pathologies. To eliminate them, the help of a specialist is required. At the slightest suspicion, you should consult a doctor.

Deviations in the color of amniotic fluid

Normal amniotic fluid is colorless and clear. The consistency is similar to water, odorless. Most often, expectant mothers are concerned about the change in the color of amniotic fluid.

You can judge the color of amniotic fluid during their outflow, which occurs during childbirth. In most cases, if the pregnancy is full-term, the water is clear or hazy yellow. This is their normal color, it does not pose a danger. The task of a woman after the outpouring of water is to get to the maternity hospital within 2-3 hours.

Amniotic fluid may be of a different color.

1. In red dots. A slight admixture of blood in a fluid of a normal (light or hazy yellow) color is considered normal, as it indicates the opening of the cervix.
2. Green color. The original feces of the child stain the greenish or marsh color of the water. The child experiences oxygen starvation, swallowing such water is dangerous for the development of pneumonia in the baby.
3. Red. Dangerous color, indicates internal bleeding in the mother or fetus. The most correct decision is to take a horizontal position, urgently call an ambulance.
4. Dark brown. This color indicates the death of the fetus, you should immediately consult a doctor.

If the color of the amniotic fluid changes, the mother and child may be in danger. Therefore, it is better not to get to the maternity hospital on your own, it is worth calling an ambulance, reporting the color of the waters.

Water research methods

To date, there are several ways to obtain information about the state of the amniotic fluid before the onset of the birth process. All methods are divided into invasive (requiring direct material sampling) and non-invasive (not requiring penetration into the uterine cavity).

The only non-invasive method is ultrasound. This study can provide information about the amount of amniotic fluid, allows you to diagnose oligohydramnios or polyhydramnios.

The remaining methods of research (invasive) are associated with high risks, therefore, they are carried out according to serious indications.

1. Amnioscopy. Inspection of amniotic fluid with an amnioscope. This device is a tube with a light fixture at the end. Examination of the expectant mother is carried out on a gynecological chair by inserting the device into the cervix. The doctor pays attention to the color, consistency of the water. Examination is possible after 37 weeks if fetal hypoxia is suspected, Rhesus conflict.
2. Amniocentesis. Unlike amnioscopy, amniocentesis is performed after 16 weeks of pregnancy, when the fluid volume reaches 150 ml. a needle is inserted into the amniotic cavity under ultrasound control, a small amount of fluid is taken. Amniocentesis requires serious indications: suspicion of genetic diseases or intrauterine infections, Rh conflict, insufficient oxygen supply, chronic diseases of the mother.

Invasive diagnostic methods are associated with the risks of abortion, premature rupture of amniotic fluid, miscarriage, placental abruption. Only a doctor can prescribe the procedure.

Amniotic fluid rates by week of pregnancy

With increasing gestational age, the amount of amniotic fluid increases. Approximate calculations look like this:

• 30 ml at 10-11 weeks;
• 100 ml for 13-14;
• 400 ml for 17-20;
• 1200ml for 36-38;
• 600-800 a few days before delivery.

The amount of amniotic fluid is individual for each expectant mother, the above calculations are approximate, so doctors do not measure the amount of amniotic fluid in milliliters, using the definition of "amniotic fluid index". It is measured using an ultrasound machine starting at 16 weeks. The rules look like this:

• 73-201 mm (average 121) at 16 weeks;
• 77-211 (127) at 17;
• 80-220 (133) at 18;
• 83-230 (137) at 19;
• 86-230 (143) at 20;
• 88-233 (143) at 21;
• 89-235 (145) at 22;
• 90-237 (146) at 23;
• 90-238 (147) at 24;
• 89-240 (147) at 25;
• 89-242 (147) at 26;
• 85-245 (156) at 27;
• 86-249 (146) at 28;
• 84-254 (145) at 29;
• 82-258 (145) at 30;
• 79-263 (144) at 31;
• 77-269 (144) at 32;
• 74-274 (143) at 33;
• 72-278 (142) at 34;
• 70-279 (140) at 35;
• 68-279 (138) at 36;
• 66-275 (135) at 37;
• 65-269 (132) at 38;
• 64-255 (127) at 39;
• 63-240 (123) at 40;
• 63-216 (116) at 41;
• 63-192 (110) at 42.

These figures can be seen in the medical card, in parentheses are the average figures for each stage of pregnancy. Only a doctor can correctly decipher the data, since the norms of the amniotic fluid index depend on the individual characteristics of the body.

Leakage of amniotic fluid

You can determine the leakage of amniotic fluid at home. There is a special test pad for this. The method is quite popular, but such a gasket is quite expensive (400-600 rubles), and the result is not always reliable. So a positive result can show not only leaking water, but also inflammatory diseases.

An accurate result can be obtained in the hospital after examining the discharge.

The most informative way to determine the leakage of water is amniocentesis. A safe dye is injected into the fetal bladder with a needle, and a swab is placed in the pregnant woman's vagina. Staining the swab will show leakage of amniotic fluid. This method is used in special cases when the child's life is at risk.