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Causes of Little Amniotic Water in Pregnant Women and Treatment

There are about 4 percent of pregnant women who experience a little amniotic fluid before delivery. This condition is very dangerous, because amniotic water is needed to protect and support the development of the fetus in the womb. Ideally, the volume of amniotic fluid at 12 weeks gestation is around 60 milliliters (mL). As the fetus develops, the amniotic fluid volume will also continue to increase until the gestational age reaches 34-38 weeks. After that, the amount will decrease. Not all pregnant women have a normal volume of amniotic fluid during pregnancy. There are some pregnant women whose amount of water is too little or is also called oligohydramnios. This condition most often occurs in the last trimester of pregnancy, but does not rule out the lack of amniotic fluid occurring at an earlier gestational age.

Causes of Little Amniotic Water

Amniotic fluid contains nutrients, hormones, and cells forming the immune system produced by the mother. However, at 20 weeks gestation, the composition of amniotic water will be more dominated by fetal urine. Therefore, abnormalities in the fetal urinary system can also affect the volume of amniotic fluid. The following are some of the factors that can cause a small amount of amniotic fluid:

1. The fetal urinary system is not fully developed

One of the causes of slight amniotic fluid is the fetal urinary system is not fully developed. If the urinary system and kidney fail to develop, the fetus will only produce a little urine. In fact, urine is a major component of amniotic fluid when gestational age enters the second trimester.

2. Placental disorders

Placental disorders, such as placental abruption, cause blood flow and nutrient intake for the fetus to be blocked. This makes the fetal urine production disrupted, so the amount of amniotic fluid becomes small.

3. Premature rupture of membranes

A small tear in the amniotic sac can cause the amniotic fluid to leak out of the uterus. If premature rupture of membranes is left, then the amniotic water volume will decrease or even run out completely, causing interference to the fetus.

4. Complications of twin pregnancy

Little amniotic fluid can also occur if a pregnant woman contains more than one fetus in her womb. Because, in identical twin pregnancies, pregnant women are at risk of experiencing complications from twin to twin transfusion syndrome (TTTS). This complication makes twin fetuses share placenta which allows one of them to receive a little amniotic water.

5. Taking certain medicines

Pregnant women who are taking high blood pressure classes of angiotensin-converting enzyme inhibitors (ACE inhibitors) can also cause a small amount of amniotic fluid. Drugs that fall into the ACE inhibitor group include ramipril, captopril, and lisinopril. In addition to the above factors, certain diseases suffered by pregnant women, such as hypertension, diabetes, or lupus, can also increase the risk of pregnant women having a small amount of amniotic fluid.

Little Amniotic Water Handling

Handling a little amniotic fluid (oligohydramnios) will usually be done according to gestational age. But before giving treatment, the doctor will conduct a series of examinations, including pregnancy ultrasound, to determine the condition of the fetus in the womb. If a little amniotic fluid occurs late in pregnancy, the doctor will usually recommend that the baby be born soon. This is intended to prevent complications in infants. Meanwhile, if a little amniotic fluid occurs in mid-pregnancy, the doctor will suggest the following treatments:
  • Amnio infusion, which is adding fluid into the amniotic sac.
  • Increase fluid intake during pregnancy.
  • Total rest (bed rest).
If not treated promptly, a little amniotic fluid can cause several serious complications, including premature birth, miscarriage, low birth weight babies, and Potter syndrome. To minimize the risk of slight amniotic fluid during pregnancy, you need to increase your fluid intake during pregnancy, maintain your diet, and not smoke. In addition, you also need to do regular checks to the obstetrician to monitor the condition of the womb and the fetus.

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