Amniotic fluid volume plays a key role in the baby’s development. In truth, the amount of fluid performs a delicate balancing act that furthers the baby’s normal growth.
Known technically as the amniotic fluid index (AFI), this ratio becomes problematic in about 7% of pregnancies. Ideally, the amount of amniotic fluid level should not be too high or too low; the fetus’ well-being depends on it.
Not being able to keep amniotic fluid within the normal range may present serious health problems for the mother and her baby.
But with close supervision with high-risk pregnancy specialists, this balancing act can be managed effectively. Pregnant women in the Los Angeles area seek the expert counsel of Dr. Steve Rad, a double-board certified Obstetrician-Gynecologist with sub-specialty training in Maternal-Fetal Medicine (MFM).
Dr. Rad and his team at the Los Angeles Fetal and Maternal Care have decades of managing pregnancy complications. They are among the very best high-risk pregnancy specialists in Los Angeles. The team is also available to provide expert second opinions.
What is amniotic fluid?
The fetus lives in a casing called the amniotic membrane (sac) during development. This sac is filled with roughly 18 ounces of amniotic fluid.
The fluid protects the baby and aids in the development of muscles, limbs, lungs, and digestive systems. Amniotic fluid is produced soon after the amniotic sac forms at about 12 days after conception. It is first made up of water that is provided by the mother, and then around 20 weeks of fetal urine becomes the primary substance.
Amniotic fluid contains nutrients, hormones, and antibodies to help protect the baby from injury.
If the measurement of amniotic fluid is too low, it is called oligohydramnios. If the measurement of amniotic fluid is too high, it is called polyhydramnios.
Amniotic fluid loss is called oligohydramnios. About 8% of pregnant women have low amniotic fluid, with 4% of those diagnosed with oligohydramnios.
This condition is most prevalent during the third trimester. If an expectant mother is past her due date by more than two weeks, she may be at risk for low amniotic fluid levels — fluids are naturally reduced by half at 42 weeks gestation.
As many as 12% of pregnancies develop oligohydramnios complications if they go past 41 weeks.
Why amniotic fluid is low
- Difficulty with the development of the kidneys or urinary tract can result in limited urine production
- The placenta fails to provide sufficient blood and nutrients to the baby, which stops recycling fluid
- A tear in the amniotic sac allows fluid to leak out of the cervix
- Late delivery (more than 42 weeks) results in declining placental function
- Complications with the mother such as preeclampsia, diabetes, and hypoxia
- Chronic high blood pressure
Risks of low amniotic fluid
The amount of risk with oligohydramnios depends on when it occurs in the pregnancy.
During the second trimester, when the baby begins to breathe and swallow, the amniotic fluid provides room for the baby to move around.
If the condition occurs during the second half of pregnancy, problems can include:
- Preterm birth
- Labor complications such as cord compression, meconium-stained fluid, and cesarean delivery
- Intrauterine growth restriction (IUGR)
- Congenital birth defects
- Increased risk of fetal heart rate abnormalities
Low amniotic fluid treatments
The two main treatments for the low amniotic fluid center around the baby’s gestational age.
When the pregnancy is in its first trimester, doctors typically monitor the mother’s fluid levels during prenatal visits. Often the physician will administer a non-stress test or contraction stress test to monitor the baby’s movement.
For women close to full-term pregnancy, the typical action is to deliver the baby.
Other treatments for oligohydramnios include:
- Replacing amniotic fluid using an intrauterine catheter with saline solution in a procedure called amnio-infusion
- Injecting saline by injection using amniocentesis
- Hydrating the mother with oral or IV fluids
Polyhydramnios (more commonly called hydramnios) is when there is too much amniotic fluid. Amniotic fluid excess occurs in 3% to 4% of all pregnancies.
What causes polyhydramnios in pregnancy?
Hydramnios is usually caused by overproduction of fluid, or the fluid is not being used. Critical factors causing this condition include:
- Maternal diabetes
- Fetal gastrointestinal abnormalities that block fluid.
- Fetal swallowing issues due to the central nervous system or birth defects
- Problems with baby’s heart rate
- Infection acquired during pregnancy
Oligohydramnios’ consequences can be much more dire if detected during the first half of pregnancy.
Risk factors for polyhydramnios
- The uterus can become enlarged and cause a premature rupture of the amniotic sac or preterm labor.
- Placental abruption
- Postpartum hemorrhage
Treatments for polyhydramnios
- Close monitoring of amniotic fluid.
- Medication to decrease fetal urine production.
- Amniocentesis to check for birth defects
- Early delivery.
More about Dr. Rad
Perinatologist Dr. Rad and his world-class Maternal-Fetal Medicine (MFM) obstetrics and gynecology team at Los Angeles Fetal and Maternal Care understand your High-Risk OB and infertility needs before, during, and after birth. We provide compassionate care and help you understand your pregnancy, answer questions, and provide emotional support to safely navigate your pregnancy.
Dr. Rad has undergone rigorous training with highest honors at prestigious institutions such as the David Geffen School of Medicine at UCLA, the University of Southern California, Cedars-Sinai Medical Center, and UCSF Medical Center as well as centers internationally.
Call (844) 473-6100 or schedule your consultation online. We are currently accepting new patients.
We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, Newport Beach, Irvine, and Downtown Los Angeles. We also offer in-home prenatal care and a fly-in program for out-of-town and international patients. Dr. Rad even travels to patients who need him throughout the U.S. and around the world.
If you can’t make it to Dr. Rad, he also offers virtual consultations worldwide.