Amniotic Fluid Disorders Treatment in Jaipur | AmniocentesisTreatment in Jaipur

In the womb, the baby is surrounded with amniotic fluid. Initially, it is comprised of water produced by the mother, but it is gradually replaced by fetal urine.Amniotic fluid contains nutrients, hormones, and infection-fighting antibodies that are vital for the baby. Levels of amniotic fluid are highest around 34- 36 weeks of pregnancy after which the levels decrease as birth nears.

Functions of Amniotic fluid are:

• The fluid acts as a shock absorber, cushioning the baby from outside pressures and protecting the fetus.
• It insulates the baby, keeping it warm and maintaining the temperature.
• The amniotic fluid contains antibodies, which help in fighting against infection.
• It helps in development of Lungs, digestive system and musculo-skeletal system.
• Amniotic fluid acts as a lubricant and helps in smooth movements of the baby.
• Amniotic fluid prevents the umbilical cord from being compressed. Umbilical cord transports food, oxygen and blood from the placenta to the growing fetus.

Disorders of amniotic fluid

1. Oligohydramnios

Oligohydramnios is present when the amniotic fluid index (AFI) is less than 5 cm on ultrasound. It may result after rupture of water bag and leaking of fluid or from other medical conditions like high blood pressure, diabetes, lupus, twin or higher order pregnancies, problems with placenta and other unknown reasons.

Oligohydramnios is of concern more during the first 6 months of pregnancy. There is a higher risk of birth defects, loss of pregnancy, preterm birth, or neonatal deaths.

In the last trimester, oligohydramnios increases the risk of growth restriction, labor complications and increased chances of cesarean delivery.

Investigations:

• Non-stress test (NST): To check the baby’s heart rate and movements.
• Biophysical profile: This is an ultrasound scan that checks the baby’s movements, muscle tone, breathing and amniotic fluid levels. This is followed up with a non-stress test.
• Daily fetal movement count.
• Color Doppler: This is an ultrasound to check the flow of blood in the baby.
  In some cases, when AFI is very less, your doctor might advice for induction of labor in order to protect the mother or the child. There is a high chance of umbilical cord compression during labor. Amnioinfusion may be required during labor and some cases may land up in a cesarean delivery due to fetal distress.

Polyhydramnios

When there is too much amniotic fluid and AFI is more than 25 centimeters it is called as polyhydramnios.

Causes:

Fetal disorders that can lead to polyhydramnios include:

• duodenal or esophageal atresia, gastroschisis, and diaphragmatic hernia
• anencephaly, spina bifida, meningocoele, meningomyelocoele
• achondroplasia, a bone growth disorder
• infection
• fetal lung abnormalities
• hydrops fetalis,
• twin-to-twin transfusion syndrome, where one child gets more blood flow than the other

Maternal disorders – Uncontrolled maternal diabetes and other medical disorders.

Complications include:

• preterm labor
• premature rupture of membranes
• placental abruption
• stillbirth
• postpartum hemorrhage
• fetal malposition
• cord prolapse

Investigations: Testing for maternal diabetes and frequent ultrasounds to monitor the levels of amniotic fluid.

Mild cases might resolve on their own. Severe cases require reduction with amniocentesis or indomethacin. This reduces the amount of urine the baby produces.