The official medical name for amniotic fluid is amniotic fluid. It is a liquid biologically active medium that is in the membranes and covers the embryo.
Amniotic fluid function
Amniotic fluid is one of the factors in ensuring the life of the child in the womb. This biological environment is characterized by several functions at once:
- Providing nutrition to the fetus. This fluid is composed of many nutrients. In the first period after fertilization, they are absorbed through the skin of the child, and a little later - the baby independently swallows a certain amount of them.
- Maintaining appropriate pressure and temperature in the range of 37 about C.
- Providing a developing child with protection from external mechanical influences. Amniotic fluid significantly reduces pressure and tremors that come from the external environment.
- Support for sterility, which is to protect the child from a variety of infections. Amniotic fluid contains a lot of immunoglobulins. In addition, the absolute integrity of the fetal bladder plays an important role. Sterility is ensured by the constant renewal of amniotic fluid, which ends only after the birth of a child.
- Ensuring the free movement of the baby in the uterus.
- Muffling loud external noise.
The main indicators of amniotic fluid
Throughout the duration of pregnancy, the composition and number of amniotic fluid are very important. There are many cases where abnormal indicators indicate the formation and development of various pathologies. Thus, it is possible to timely diagnose and eliminate those, or to prepare accordingly for the necessary measures after the birth of the baby.
The Amniotic Fluid Index (IAI) is a number that indicates its volume in the amniotic fluid.
When conducting a specialist diagnosis, the following indicators are taken into account:
- Hue and transparency. The usual color of the liquid is light, transparent, with a small amount of impurities.
- Volume. The amount of fluid affected by gestational age. Therefore, the rate of amniotic fluid depends on the trimester of pregnancy. For example, the amniotic fluid index at 21 weeks (normal) is 88-143-233 ml, where the first indicator is the lower norm, and the second number is the average, the third is the upper limit. A daily increase in the amount of fluid by 40-45 ml lasts up to 32 weeks of pregnancy. After the amniotic fluid index at 32 weeks (average rate of 144 ml) reached its peak, the amount of water gradually decreases. On the eve of childbirth, it is only 500-1500 ml.
- Hormonal content.
- Biochemical and cytological compositions.
Amniotic fluid indicators
The most informative criterion of low water in our time is ultrasound. When conducting this study, the doctor determines the IAI and the multiplicity of the vertical pocket. If these indicators do not reach the limits of the norm for a given period of pregnancy, then in the conclusion, oligohydramnios is indicated.
The vertical pocket is the name of the longest section of free amniotic fluid that is located between the fetus and the anterior abdominal wall. In addition, the umbilical cord or limbs of the child are not allowed to be placed in this area of free fluid. The norm of the length of the vertical pocket is 5-8 cm, a little earlier using ultrasound only this indicator was established.
Amniotic fluid index
Now the amount of amniotic fluid is estimated using IAI. To do this, the doctor mentally divides the abdomen into 4 parts using 2 perpendicular features intersecting in the navel. After that, a maximum vertical pocket is measured in each of these zones. In order to get the final value of the amniotic fluid index, it is necessary to add all the indicators obtained.
The norms of the amniotic fluid index are calculated by weeks of pregnancy, starting from the 16th week. Their value is gradually increasing. The highest amniotic fluid index at 32 weeks is the norm from 77 to 169 ml. This is followed by a decrease in IAI.
IAJ norm table
The rates of the amniotic fluid index by week are presented in the table.
IZH norm table| Pregnancy Lines (weeks) | The lower limit of normal | Mean | Upper limit of normal |
| sixteen | 73 | 121 | 201 |
| 17 | 77 | 127 | 211 |
| 18 | 80 | 133 | 220 |
| 19 | 83 | 137 | 225 |
| twenty | 86 | 141 | 230 |
| 21 | 88 | 143 | 233 |
| 22 | 89 | 145 | 235 |
| 23 | 90 | 146 | 237 |
| 24 | 90 | 147 | 238 |
| 25 | 89 | 147 | 240 |
| 26 | 89 | 147 | 242 |
| 27 | 85 | 156 | 245 |
| 28 | 86 | 146 | 249 |
| 29th | 84 | 145 | 254 |
| thirty | 82 | 144 | 258 |
| 31 | 79 | 144 | 263 |
| 32 | 77 | 143 | 269 |
| 33 | 74 | 142 | 274 |
| 34 | 72 | 140 | 278 |
| 35 | 70 | 138 | 279 |
| 36 | 68 | 135 | 279 |
| 37 | 66 | 132 | 275 |
| 38 | 65 | 127 | 269 |
| 39 | 64 | 123 | 255 |
| 40 | 63 | 116 | 240 |
| 41 | 63 | 110 | 216 |
| 42 | 63 | 110 | 192 |
If these indicators do not correspond to specific lines of pregnancy, polyhydramnios or oligohydramnios occurs.
Low water during pregnancy
Low water is a rather unpleasant and very common phenomenon during pregnancy. If the deviation of the amount of amniotic fluid from the norm of the amniotic fluid index is insignificant by weeks, they are diagnosed with moderate oligohydramnios. In order to adjust it, you can use a diet, proper nutrition and a healthy lifestyle. After a while, the amount of water returns to normal and in no way affects the condition of the child.
The diagnosis of “pronounced water shortage” is made in the case when the deviation from the norm of the amniotic fluid index for weeks is smaller. With this diagnosis, urgent hospitalization and inpatient treatment are needed. This is due to the high probability of disastrous consequences for the child.
If the amniotic fluid index at 20 weeks (normal) is in the range of 86-230 ml, and the ultrasound results indicate a much smaller real volume of amniotic fluid, if untreated, this can provoke the underdevelopment of vital organs, skeleton bone deformation, and the development of various fetal pathologies. Therefore, it is very important to start treatment for severe oligohydramnios in time.
When they determined a low amniotic fluid index at 34 weeks (the norm is on average 142 ml), in addition, there are already pronounced deviations in the development of the child - the question often arises of abortion, since treatment in this case is meaningless and will not bring any results.
Reasons for the development of oligohydramnios
There are many reasons for the formation of low water. The main ones are:
- underdevelopment of the membranes or decreased water secretion;
- abnormal development of the fetus (its kidneys, skeleton);
- increased blood pressure in the expectant mother, especially with significant deviations from the norm;
- bacterial infections that penetrate not only through the genital tract, but also directly into the amniotic fluid;
- multiple pregnancy, with uneven development of the placenta, which gives a different blood flow to each fetus;
- repotting;
- impaired metabolism in the body of a woman, especially in the presence of excess weight.
Features of the treatment of oligohydramnios
Even moderate oligohydramnios cannot be treated independently. Only on the basis of pre-made tests, the doctor can assess the cause of the anomaly, the severity of the disease, the condition of the fetus and prescribe a course of treatment.
If there is obesity, impaired metabolism, you will need to follow a diet, eat right, use vitamins and medicines, which improve the blood supply to the placenta. Therapy of moderate polyhydramnios can be performed on an outpatient basis. A pronounced stage is treated only in a hospital. Regardless of the form of the disease, there is a need to limit motor activity and the amount of physical activity, compliance with bed rest.
During treatment, it will be necessary more often than usual to do an ultrasound and dopplerography to timely determine changes in the organisms of the pregnant and the baby.
If the results of ultrasound showed a low index of amniotic fluid at 33 weeks (the norm is an average of 143 ml) or later, when the baby is ready to be born, the doctor may prescribe an early delivery.
When this fact is discovered, one should not be depressed. Still fixable - mild stages are treatable. If you have oligohydramnios during previous pregnancies, you should definitely inform your doctor about this. In this case, he will be able to timely detect and fix this problem.