The highlight of your first ultrasound scan will undoubtedly be a glimpse of that little life within you.
Your gynaecologist will point out to you where the amniotic sac is, and you’ll be able to see your developing baby inside that sac, surrounded by amniotic fluid. This is made up of water, together with nutrients, hormones, as well as antibodies to fight off infection.
The fluid comes from various sources, including foetal urine, foetal skin, foetal lung fluid, plus membranes and the placenta that is surrounding your baby. After 20 weeks, amniotic fluid is mostly made of your baby’s pee.
By the time your baby is full term, the total volume of fluid would be around 2.8 litres.
Why amniotic fluid is important
Amniotic fluid is essential in protecting bubba during pregnancy. It acts as a cushion. protecting your baby from any injury or impact that may occur―such as if you should slip and fall, or if another person crashes into your belly.
It keeps bubba warm and allows him to move freely while preventing the umbilical cord from getting compressed. Amniotic fluid also allows muscles and bones to grow healthily.
When your baby swallows this fluid, it also helps to develop his digestive system.
As your pregnancy progresses, the fluid even helps your baby to practise breathing, and aids in the development of his lungs and respiratory system. When your baby swallows this fluid, it also helps to develop his digestive system.
SmartParents expert and consultant ob-gyn, Dr Christopher Chong explains that your doctor will usually monitor your amniotic fluid levels via ultrasound scans. “The four quadrants of the womb are measured for water pockets ― this is added up to form the amniotic fluid index, or AFI. If the levels are more than 8cm, they are normal. 5 to 8cm means it is borderline, and below 5cm, it is low. Decreased foetal movements, usually seen in ultrasound scans, A sign of low fluid levels would be he notes.
Reasons for low amniotic fluid levels
Your low amniotic fluid levels could be due to several reasons, such as a bacterial infection, or the amniotic sac may be torn. In this case, the fluid may be leaking, so you may observe it as a form of discharge.
Other reasons for low amniotic fluid levels include kidney or urinary tract defects in the baby (because the baby isn’t producing enough urine), placenta insufficiency or bleeding, high blood pressure and preeclampsia, gestational diabetes, or a multiple pregnancy.
“There is a connection of the foetus with the outside world and an infection can set in.”
Because of low amniotic fluid levels, Ding Zhi Ying, mum to Johnson, 2, was put on bedrest when she was 30 weeks pregnant. “My water bag was slowly leaking ― I could feel that I was having increased discharge, and my underwear would be wet, but I knew it wasn’t pee,” she recalls.
Ding also noticed that the water would leak a lot more when she was standing or walking, as compared to when she was lying down. Instructed to keep hydrated, she was also given steroid injections to help develop her baby’s lungs, in case she delivered early.
Johnson arrived at week 35 completely healthy. “It was quite scary because I had to keep monitoring the water levels, and making sure there was no infection,” Ding says. “Thankfully, he was okay.”
Risks of low amniotic fluid levels
Low fluid levels could lead to problems with the foetus’ growth, says Dr Chong, so an early delivery may be required. “The issue is to balance the pros and cons between delivering a premature baby with organ and functional problems, and keeping the baby in the womb but risking slow growth.”
Low fluid levels can cause complications such as birth defects, like hip dysplasia, or a club foot, because the baby’s organs and limbs are overly compressed in utero.
If the water bag is leaking, or if the water bag has broken, an infection can set in, says Dr Chong. Other problems include a higher risk of low birth weight, miscarriage or still birth.
So, don’t hesitate to see your gynae if you suspect that your amniotic fluid is leaking,
If your water bag bursts, you may feel water running down your thighs. “It can be a gush, or just some wetness in the vagina,” says Dr Chong. Your gynae can use an amnicator to confirm that the amniotic fluid is leaking, or if it’s urine.
Dr Chong explains that treatment is possible if the root cause of the low amniotic fluid level is a medical condition or an infection. Otherwise, if there is a structural defect, such as a tear in the water bag, resting and not moving around may help.
“But usually, like a burst balloon, there may be no turning back,” he says. “Drinking more water doesn’t help.”
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