In the early part of the second trimester, your baby
starts to swallow amniotic fluid and eventually excrete
it as urine, which is then swallowed again; the full
volume of this fluid is recycled every few hours.
Baby hence plays a key role in determining the amount
of fluid that should be contained within the sac.
However sometimes things can go wrong - either too
much or too little fluid accumulates in the sac. Both
situations then go on to become problematic pregnancies!
Too
much fluid (Polyhydramnios)
Excess fluid has its own share of problems. If your
uterus is larger than it should be for its time,
you experience unusual pain in the abdominal region,
you suffer increased back pain, have shortness of
breath and swelling in your lower limbs, your doctor
will do an ultrasound to confirm or rule out this
possibility. An ultrasound is the only way to check
on your fetus since it becomes difficult to feel
the baby through all the fluid.
What
causes it...
For mild polyhydramnios, the cause cannot be determined
but for the more severe version the reasons are
several:
• Maternal diabetes
• Carrying more than one baby
• Placental problems
• Baby has certain abnormalities
• Baby is not able to swallow the fluid
A high resolution ultrasound to check for abnormalities
and possibly an amnio to test for genetic disorders
will be arranged. Regular ultrasounds and nonstress
tests becomes mandatory for the remaining part of
your pregnancy and even during labor to keep track
of mum's and baby's health
What it can lead to...
• Premature labor
• Umbilical cord prolapse (c-section is imminent)
• Baby is not able to stabilize its position
due to too much room
• Premature membrane rupture
• Placental abruption when water breaks (c-section
is imminent)
• Postpartum hemorrhage or heavy bleeding
after delivery
Possible solutions
1. Maternal diabetes can be sorted
out by controlling glucose level.
2. Temporary solution is to drain
off some of the excess fluid by abdominal amniocentesis
but the procedure needs to be repeated
3. If baby does indeed have swallowing
problems, your baby may need to undergo corrective
surgery to rectify the problem soon after its birth
Too little Fluid (Oligohydramnios)
Insufficient fluid has serious repercussions. It
most commonly happens in the final trimester, more
so if the woman is overdue. If your uterus is smaller
than it should be for its time, your doctor is able
to feel your baby very easily, a scan to check on
fluid levels and baby will be arranged by your doctor.
What causes It...
The problem, the stage of your pregnancy and the level
of fluid will determine your baby's situation. Insufficient
fluid may indicate that baby is having problems with
its kidneys and bladder and secondly it could also
mean your placenta is not functioning to capacity.
The causes are several:
• Chronic high blood pressure
• Maternal diabetes
• Lupus
• Preeclampsia
• You had a baby with restricted growth previously
• You are leaking fluid
• Placental problems e.g. partial abruption
• Fetal problems such as poor growth or genetic
abnormality
• or if you are past your due date (you will
need to be induced)
What it can lead to...
• If you are near term, labor will be induced;
low levels of fluid in the last weeks are often given
as reasons for inducing labor
• If your pregnancy has not progressed enough,
the next step will largely depend on how your baby
is faring.
• If you have a severe condition, for example
preeclampsia or if your baby is not coping well, you
will need to deliver early.
• Otherwise it is considered safer to wait until
baby is more mature before inducing the labor
• Baby will be monitored closely via ultrasounds
and nonstress tests; you will be advised to do fetal
kick counts and to drink plenty of fluids
• If fluid level is very low, warm saline solution
will be pumped steadily into the sac through your
cervix to reduce cord complications
• For very low level of fluids, you may be given
epidural to cope with the very painful contractions
• C-section may be the inevitable route if your
baby is not able to cope with the pressures of labor
