Without amniotic fluid it is impossible for a baby to develop inside the womb. This is truly "living water", which gives the child a full life support.

Table big circuit
baby inside measurements
pain observation development
pregnant mother drinking

Amniotic fluid has an official name - amniotic fluid, from the Greek "amnion", in translation "- the shell of the fetus." What amniotic fluid looks like is clearly shown in the photo.

It is impossible to overestimate the importance of the functions of the amnion in the formation of the embryo. You need to know how long the baby will continue to live without amniotic fluid in order to fully realize the significance of the life-giving fluid: no more than 6 hours and a maximum of 12 hours.

Protects the fetus from infections

Amniotic fluid creates a sterile microenvironment for the child, blocking the influence of adverse factors. They are a shock absorber during mechanical external impact and a barrier to the penetration of viruses, microbes, infections. It is important to know how often the amniotic fluid is updated.

An amazing fact, but this happens several times a day - every three hours, and the composition changes depending on the stage of gestation.

Initially, amniotic fluid is similar to plasma, the fluid part of the mother's blood. Closer to delivery, the amniotic fluid contains a large volume of urination of the embryo.

The amniotic fluid provides the baby with oxygen and carbon dioxide. They have a rich composition, saturated with electrolytes, proteins, lipids, carbohydrates, enzymes, hormones, phospholipids, bioactive substances, vitamins, epithelial cells and hyperechoic inclusions (waste products of the baby).

The amount of amniotic fluid and components depends on the period of gestation, the weekly indicators can be seen in the table below.

Color changes and effects

Amniotic fluid may change color depending on the health of the mother and baby. It is necessary to know what color amniotic fluid is when leaking or when leaving, in order to understand whether there is a risk of pathology or not.

First you need to be able to determine how amniotic fluid flows and how it drains. When the water leaves, the bubble ruptures and a decent volume of liquid is poured out, about 200 ml. Many women confuse leakage with normal discharge, so they may not immediately realize that they are at risk.

Leakage threatens with premature effusion, which means premature birth. What to do in such a situation? Studies of this problem show that leakage is fairly easy to diagnose. You can purchase a test, an amnicator with an indicator, which is easy to use and used at home.

What amniotic fluid looks like when leaking, we advise you to look at the photo. If a problem is found, it is necessary to contact your doctor, take tests and undergo the prescribed examination.

The best medical centers

color staining

White or clear amniotic fluid without a strong odor is considered normal. But often there are cases of color changes that indicate the condition of the mother and child.

1. Yellow: A dirty or hazy yellowish color is considered normal when water breaks.
2. Yellow streaked with red or color pink: if the woman in labor is in good health, there is no anxiety. Veins warn that the uterus is ready for childbirth.
3. Red: signals a dangerous threat to mother and baby. Perhaps bleeding began in the child or in the mother, the blood could get into the amniotic fluid. This rarely happens, you should urgently call an ambulance.
4. Dark brown: This is evidence that a tragedy has occurred. In most cases, intrauterine death of the child occurred. In this case, they are trying to save the woman in labor, immediate placement in intensive care is necessary.
5. Green: Green amniotic fluid means the baby is in serious danger. This happens in situations where the amount of amniotic fluid turned out to be too small, or a bowel movement occurred inside the womb.

If meconium (original feces) enters the amniotic fluid, aspiration (inhalation) of the waste product by the baby may occur. This happens quite often, green amniotic fluid suggests that the baby needs help.

Provide free movement of the fetus

Quantitative characteristics

Without amniotic fluid, a child can stay in the womb for no more than 12 hours, this is as much as it is safe for the life of the baby.

The normal volume of amniotic fluid varies from 600 to 1500 ml. The amount of amniotic fluid affects the free movement and movement of the baby, normalizes metabolic processes, and protects the umbilical cord from compression.

The amount of amniotic fluid has different parameters, which depend on the week of pregnancy. For example, at week 10 - 30 ml., At week 18, an average of 400 ml, closer to 38 - from 1000 to 1500 ml.

There is a special table that shows the parameters corresponding to each week of the term.

With a significant deviation from the average value, tests and a full examination are prescribed.

The most common and safest examination is performed using ultrasound, but it does not give accurate results. Ultrasound is done for general characteristics mother and baby.

Reduce the force of shocks and pressure coming from outside

Biochemical, hormonal, immunological, cytological and other analyzes are taken during the examination by the method - amniocentesis. Early detection of chromosomal abnormalities is often required to prevent the birth of an affected child.

Amniocentesis is performed through a puncture of the amniotic sac. Contraindicated in genital infections, there is a risk of miscarriage. Every 1000th procedure ends tragically.

Consequences of deviations from the norm

With significant deviations from certain parameters corresponding to the healthy bearing of a child, there is a risk of pathologies in the mother and child.

The first complication is oligohydramnios. The reason is the weak production of amniotic fluid. It is quite rare, but can cause serious complications:

• difficult childbirth;
• premature delivery;
• presentation of the embryo;
• baby hypoxia.

The consequences of this pathology are anomalies and a delay in the growth and development of the child.

Perhaps the appearance of polyhydramnios, this is a significant excess of amniotic fluid. It happens chronic and acute.

1. In chronic cases, the mother feels well, drugs are prescribed to remove excess fluid. Additional individual recommendations regarding the diet, etc., which must be strictly observed.
2. In acute - the rapid arrival of amniotic fluid, accompanied by acute pain in the abdomen, severe swelling, shortness of breath. There is a need to place a pregnant woman in a hospital, as there is a risk of premature birth. If the flow of water does not stop, an amniocentesis is performed to remove excess fluid.

Another pathology is leakage: the cause in most cases is the infection of the genital organs. Leakage poses a risk premature birth. Sometimes they are difficult to notice, it is recommended to carry out a verification test.

If there is a suspicion, you should immediately get an appointment with a doctor. It is often recommended to stay in a hospital for preservation, adherence to strict bed rest and doctor's recommendations.

The composition is quite complex and varies depending on the timing of pregnancy.

It is impossible to ignore the symptoms of the manifestation of pathologies, as well as to show an independent initiative for treatment at home. Such actions threaten the health of the baby.

Possible severe complications in a child after birth:

• postpartum pneumonia;
• the occurrence of diseases of the eyes, kidneys, skin;
• belated development;
• various forms of cerebral palsy.

There are cases when a child choked on amniotic fluid during childbirth. If it is a healthy clean liquid, then there is no particular risk to the health of the baby. Usually the child simply burps up the liquid that he swallowed.

But if meconium is present in the waters, then this threatens with serious complications:

• postpartum bronchitis;
• the manifestation of infections of the gastrointestinal tract, the baby will suffer from diarrhea, vomiting and diarrhea;
• lack of appetite, backwardness of physical development;
• the rapid development of rickets, it is necessary to constantly monitor how much the baby weighs;
• during the first year there is a restless state, capriciousness.

In order to avoid all sorts of complications, it is necessary to constantly visit experienced doctors who will professionally eliminate problems and help you bear a healthy baby.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

Most of the time that the baby spends in the womb, he is under the protection of the placenta or, as it is also called, the amniotic sac. Amnion constantly produces amniotic fluid, in which the baby will be until the very moment of his birth. Such a liquid protects the baby from bacteria and viruses, creates favorable conditions for its development, allows it to stay warm and comfortable during the most important and crucial months of its life.

The temperature of the amniotic fluid is maintained by the body at a constant level and is about 37 ° C, provided that the woman is healthy. As for the amount of fluid, this indicator is constantly changing and directly depends on what week of pregnancy the expectant mother is in. It is also worth noting that the larger the baby becomes in the womb, the more fluid the amnion produces. The rate of amniotic fluid during pregnancy is 1-2 liters at the 36th week of the term, but in the following days this figure may decrease slightly, because during preparation for childbirth, the body begins to actively remove fluid.

Among the components of the amniotic fluid, you can find a wide variety of components, for example, proteins and carbohydrates, hormones and enzymes, fats and salts, various vitamins and glucose. Amniotic fluid also contains oxygen, carbon dioxide, immunoglobulin, baby waste products and many other substances. The composition of the liquid is always unstable and changes at least every 3 hours. In addition, the composition of the water also depends on the gestational age, because at different periods of development, the crumbs require different substances.

Why amniotic fluid is needed

The role of amniotic fluid in the process of growth and development of the fetus is difficult to overestimate, because thanks to the many functions that this substance performs, the child is not only under constant protection, but also has the opportunity to be born. Read more about the functions of amniotic fluid below:

1. One of the purposes of amniotic fluid is the metabolism between maternal and child organisms. Those components that the baby needs for his development and maintenance of life come to him precisely through the amniotic fluid. Processed food, being excreted from a tiny organism, also first enters the amniotic fluid, and only then is completely removed from the woman's body. The waste products that enter the liquid also include the upper scales of the epidermis, particles of the original lubricant, the hairs of the child and the components of the mother's blood.
2. The second important function of the amniotic fluid is its ability to protect unborn baby from all kinds harmful factors the surrounding world. Due to the constant temperature of the waters, the child in the womb will not be able to freeze, moreover, he is not afraid of physical influences such as blows, compressions, pressure. Amniotic fluid eliminates the risk of squeezing the umbilical cord, gives the baby the opportunity to move freely in the mother's abdomen.
3. The female body also made sure that the amniotic fluid was always absolutely sterile. Due to the fact that viruses, bacteria and other pathogens do not penetrate into them, the baby is reliably protected from diseases. Sterility is mainly maintained by constant renewal of the composition of the liquid, which occurs at least every 3 hours.
4. Amniotic fluid not only helps the baby grow and develop in a safe environment, but is also directly involved in the delivery process. Firstly, the so-called anterior waters, by their pressure on the uterus, provide a better opening of its cervix. Secondly, while the baby is trying to be born, the amniotic fluid protects him until the very moment of birth. Thirdly, during the passage of the child's birth canal, water plays the role of a lubricant, facilitating this process.

In addition to the above useful functions, amniotic fluid also has an important diagnostic value. After conducting certain water tests, the doctor can find out a lot of necessary information regarding the health of the child and the characteristics of his development. Thanks to diagnostics, it is possible not only to establish the sex of the baby and his blood type, but also to obtain information about possible hereditary diseases or other abnormalities, the development of which can be prevented even at the stage of pregnancy.

Volume, composition, degree of transparency, color and consistency - all these parameters of the amniotic fluid can be found with the help of the necessary tests. In addition, in the case of some pathologies, when emergency delivery is required, with the help of such a diagnosis, it is possible to establish the degree of readiness of the child for the birth. Based on the data obtained, a decision is made on the use of special medical equipment to support the life of the baby for a certain period.

Amniotic fluid pathologies

oligohydramnios during pregnancy

The condition when there is little amniotic fluid during pregnancy is called oligohydramnios. Such a pathology can occur if the amnion produces less fluid than is excreted from the body. It should be said that such a disease is not so common and accounts for no more than 1% of cases in the total number of pregnancies. Oligohydramnios is a serious problem that requires attention and timely treatment. If this phenomenon is not eliminated, certain complications may arise:

1. Firstly, the pressure of the amniotic fluid on the uterine canal is significantly reduced, which, in turn, leads to difficulties in the delivery process.
2. Secondly, oligohydramnios is fraught with such complications as premature birth. A child who was born before the due time will need special medical care.
3. Oligohydramnios is also dangerous because the baby is not able to move normally, which increases the risk of breech presentation of the fetus.
4. Hypoxia is considered a very frequent companion of this pathology - a lack of oxygen necessary for a child. Hypoxia results in growth retardation and fetal abnormalities.

As a rule, it is not possible to notice such a pathology on your own, since oligohydramnios has almost no symptoms that are physically palpable. Occasionally, a woman with a similar problem may feel slight pain in the abdomen, but often this manifestation is simply absent. You can identify the disease with the help of ultrasound, which is why the timely delivery of tests and the passage of planned ultrasounds are so important for a pregnant woman.

If it is possible to detect oligohydramnios before a period of 28 weeks, an examination of the body of the expectant mother will allow you to find out the cause of the pathology and, if possible, eliminate it. So that the child does not suffer from a lack of oxygen, it is important to start treatment as soon as possible - this will allow gas exchange and uteroplacental blood flow to be established. In the process of therapy, the doctor monitors the condition of the baby and sometimes, in case of emergency, prescribes an early caesarean section.

Let us examine in more detail what are the causes of oligohydramnios during pregnancy:

• the presence of hypertension in the expectant mother;
• significant overweight pregnant;
• infections and inflammatory diseases;
• violations of the development of the placenta;
• inflammation in the pelvic organs;
• polycystic kidney disease of the fetus, anomalies in the development of its genitourinary system.

Polyhydramnios during pregnancy

Approximately as rare as oligohydramnios, the opposite pathology, polyhydramnios, can also occur. This problem occurs in 1-1.5% of pregnant women and is an excess of amniotic fluid relative to the norm.

Polyhydramnios is of two types:

1. Chronic polyhydramnios is characterized by the fact that the amount of amniotic fluid arrives gradually. If the pregnant woman is healthy and feels fine, the doctor may prescribe her diuretics - special medications that are responsible for removing fluid from the body. In addition, the doctor prescribes a certain diet, which involves reducing the amount of salt in the diet. It is important to follow all the recommendations of the doctor, because polyhydramnios can lead to unpleasant consequences. An excessively enlarged uterus oppresses the rest of the organs, disrupting their work. In addition, polyhydramnios sometimes causes circulatory disorders in female body, it complicates labor activity and can cause heavy bleeding after childbirth.
2. The second type of polyhydramnios is acute. It is characterized by a sudden increase in amniotic fluid that occurs over several hours. As a rule, such a disease makes itself felt by the following symptoms: abdominal pain, severe swelling, shortness of breath. With such a pathology, a woman needs hospitalization. While in hospital, the pregnant woman observes bed rest, which makes it possible to reduce the risk of preterm birth. If acute polyhydramnios is characterized by the incessant arrival of water and threatens the health of the woman and her baby, abdominal amniocentesis can be used as a remedy for the problem. During this operation, the placenta is pierced and excess fluid is removed to the outside.

Among the causes of pathology are the following:

• diabetes mellitus in a pregnant woman;
• the conflict of Rh blood of mother and baby;
• carrying twins;
• the child has a genetic disease;
• infection to the fetus in utero;
• disruption of the fetal bladder, which manifests itself in excessive production of amniotic fluid even on early dates pregnancy.

Leakage of amniotic fluid during pregnancy

Another pathology of amniotic fluid is their leakage. This condition is characterized by the appearance of copious liquid discharge from the female genital tract. From ordinary secretions, amniotic fluid is distinguished by transparency, colorlessness, a very liquid consistency, and the absence of odor. Often, leakage of amniotic fluid during pregnancy does not show any symptoms other than the aforementioned discharge. But the expectant mother may not pay attention to such manifestations, because during pregnancy, abundant vaginal discharge is the norm.

In the event that a woman suspects a similar pathology in herself, she should immediately see a doctor. The specialist will prescribe tests that will determine the nature and origin of the discharge, after which the leakage of water can be refuted or confirmed. By the way, in pharmacies you can find special tests with which such an analysis is carried out independently. But it is recommended to use this method only if it is absolutely impossible to consult a doctor for any reason. In addition, if the analysis gives a positive result, the pregnant woman one way or another will have to go to the hospital for inpatient treatment.

If a similar phenomenon has made itself felt after the 36th week of the term, doctors can stimulate childbirth, and the baby will be born prematurely for only 1 week. If the leakage of water happened in the early stages, the woman needs hospitalization in order to maintain the pregnancy for the maximum possible period. During hospitalization, strict bed rest should be observed. In some cases, when the period is too short and it is not possible to keep the pregnancy for a long time, the situation is fraught with abortion.

The most common causes of amniotic fluid leakage are genital tract infections. To avoid such a risk, it is very important to monitor your health, follow the rules of personal hygiene, engage only in safe sex and periodically take tests for the presence of pathogenic flora in the vagina.

Amniotic fluid green

Transparency, colorlessness, odorlessness and liquid consistency are characteristics of normal amniotic fluid. Slightly turbid amniotic fluid during pregnancy can be observed at the very end of the term and are also considered the norm, since their appearance is due to the presence of epidermal flakes and lubricant flakes that enter the liquid from the baby's body. But in the event that the amniotic fluid has acquired a greenish tint, we can talk about pathology. The green color of the amniotic fluid is often due to particles of the original feces, which the baby releases if he lacks oxygen. Hypoxia is considered one of the most dangerous conditions of the fetus, because it not only interferes with the normal development of a small organism, but sometimes causes irreparable consequences.

Possible reasons why amniotic fluid may become green tint are described below:

1. If during the whole pregnancy the waters were normal and turned greenish already in the process of childbirth, very often this can be the cause of stress for the baby. Experiencing childbirth, the baby sometimes secretes meconium, due to which the liquid acquires a characteristic shade.
2. As mentioned above, the cause of this pathology during pregnancy can be such a dangerous condition as fetal hypoxia. It is caused by over-term pregnancy. If the baby is in the womb for too long, the amniotic sac ages and does not perform its functions properly. Because of this, the baby experiences a lack of oxygen.
3. Sometimes a greenish tint in the amniotic fluid indicates an infection. This happens if the expectant mother has had a cold, flu, bronchitis, suffered an infection of the genitourinary system or some other inflammatory disease.
4. Very rarely, the cause of an abnormal shade of amniotic fluid can be genetic diseases fetus.

Green waters can be dangerous for a child if he swallows contaminated fluid. If such a phenomenon was found in later dates pregnancy, a woman may be given a caesarean section. If such a pathology was detected in the early stages, the causes of the condition should first be identified and measures taken to eliminate them. Since the amniotic fluid is often updated, it will be enough to eliminate the causes of the pathology in order to correct the situation.

In the event that the pregnant woman's green waters have departed, the delivery process should be started as soon as possible in order to eliminate the risk of oxygen starvation and the associated consequences.

Amniotic fluid tests during pregnancy

There are several ways to assess the condition of amniotic fluid during pregnancy, the simplest of which is considered to be ultrasound. This procedure does not harm the health of the woman and her fetus, but is the least informative. With the help of ultrasound, you can only visually determine the transparency of the liquid and determine its amount. For more detailed information, other studies are being conducted, which we will consider in more detail:

1. Amniocentesis is a complex procedure in which fluid is taken directly from the amniotic sac. To do this, the woman's stomach is pierced with a special tool and a small amount of amniotic fluid is drawn out. The procedure is performed under local anesthesia. Then this material is sent for research, where immunological, biochemical, cytological and hormonal analyzes are carried out. Depending on the location of the amniotic sac, doctors determine the puncture site, and during the procedure, an apparatus for ultrasound diagnostics is used. Amniocentesis is performed if there is a conflict between the Rh blood of the mother and the child, as well as if there are suspicions of chromosomal pathologies, hypoxia, and genetic diseases. Such an analysis is also carried out when the age of the future woman in labor exceeds 40 years, and also in the case when it becomes necessary to determine the maturity of the child's lungs. Amniocentesis is not used if the woman has any inflammation in her body, if the pregnant woman suffers from pathologies in the development of the uterus or from diseases of the genitourinary system. If there is a threat of miscarriage, the procedure should also be abandoned.
2. Amnioscopy is another method for determining the condition amniotic fluid. During the procedure, the doctor inserts an amnioscope into the cervix and examines the lower pole of the placenta and amniotic fluid. Using the procedure, you can set the amount of amniotic fluid, examine its color and identify the presence of hypoxia in the fetus.

Amniotic fluid during pregnancy. Video

All structures of the unified system "mother - placenta - fetus" take an active part in the formation and exchange of amniotic fluid: the mother's body; amnion (cells lining the fetal membrane); fetus (the kidneys of the fetus in the last stages of pregnancy produce an average of 600-800 ml of urine per day, which is released into the amniotic cavity, while in 1 hour the fetus swallows 20 ml of water on average; the skin of the fetus up to 24 weeks of pregnancy is also involved in metabolic water processes, absorbing some of them until it becomes keratinized, after which the skin becomes impermeable to the amniotic fluid).

Compound amniotic fluid during pregnancy changes. If in the early stages the amniotic fluid in its chemical composition is similar to the plasma (liquid part of the blood) of the mother, then by the end of pregnancy it contains fetal urine in large quantities. The amniotic fluid contains oxygen, carbon dioxide, electrolytes present in the blood of the mother and fetus, proteins, lipids, carbohydrates, enzymes, hormones, vitamins, biologically active substances, phospholipids, blood coagulation factors, epithelial cells desquamated from the skin of the fetus, vellus hair , secrets of the sebaceous glands of the fetus, droplets of fat, etc. The concentration of one or another component of amniotic fluid depends on the duration of pregnancy.

Volume amniotic fluid increases towards the end of pregnancy, reaching a maximum value at 38 weeks, then, closer to childbirth, it may decrease slightly. Normally, at 37-38 weeks of gestation, the volume of amniotic fluid is 1000-1500 ml, while at 10 weeks it was only 30 ml, and at 18 weeks - approximately 400 ml. With a post-term pregnancy, a decrease in the amount of amniotic fluid is noted, with various pathologies of pregnancy, a change in volume can occur both upward and downward.

Why is amniotic fluid needed?

Amniotic fluid not only provides the exchange of substances between the fetus and mother, but also performs the function mechanical protection you , protecting the fetus from external influences, also protecting the body of the fetus from being squeezed by the walls of the uterus and being a shock absorber in cases of mother's falls, that is, the amniotic fluid smooths out the push or blow transmitted to the fetus during blows to the stomach or falls. Of course, that the "degree of protection" in this case is not great, that is, when hitting a large force, the integrity of the fetal bladder can be broken.

The fetal bladder contributes to the opening of the cervix during childbirth, playing a role hydraulic wedge during the first stage of labor (during the opening of the cervix). It also protects the fetus from infection by being physiological barrier on the path of infection, which can enter the uterine cavity from the vagina and cervix.

Diagnostic methods using amniotic fluid

For the diagnosis of the course of pregnancy, the quantity, color, transparency of amniotic fluid, their hormonal, biochemical, cellular composition, etc. are of great importance. In the arsenal of doctors there are various diagnostic methods.

ultrasound. Much attention is paid to ultrasound amount of amniotic fluid , since a relationship was found between this parameter and the pathology of pregnancy: post-term pregnancy, preeclampsia (it is manifested by an increase in blood pressure, edema, the presence of protein in the urine), fetal hypoxia (a state of oxygen starvation of the fetus in the womb). The amount of water is estimated by the size of free areas of amniotic fluid (the so-called "pockets" or "packages").

Ultrasound can also assess homogeneity (uniformity) amniotic fluid.

The presence of suspended matter in the water most often indicates infection.

Amnioscopy. This is an examination of the lower pole of the fetal bladder and amniotic fluid using a special device that is inserted into the cervical canal through the vagina. Such a study allows you to evaluate the color of amniotic fluid and their amount. With fetal oxygen deficiency, the amniotic fluid becomes green due to the admixture of meconium (original feces). Amnioscopy is carried out, as a rule, at the end of pregnancy, when the cervix is ​​already preparing for childbirth and may miss the optical apparatus - the amnioscope.

Amniocentesis(from the Greek words "amnion" - the fetal membrane and "centesis" - piercing). This is a puncture (puncture) of the fetal bladder, the purpose of which is to take amniotic fluid for diagnostic studies: biochemical, hormonal, immunological, cytological, in order to have an idea about the condition of the fetus and determine the further management of pregnancy. The indications for this procedure are: rhesus conflict ; in this case, the content of bilirubin in the amniotic fluid is determined (it increases as the concentration of bilirubin secreted by the kidneys of the fetus increases, which serves as an indicator of the severity of the process); the study also determines the blood type of the fetus, the amount of antibodies to the Rh factor; suspected fetal chromosomal pathology; suspicion of chronic fetal hypoxia (oxygen deficiency); the need to determine the maturity of the lungs of the fetus when there is a question about early birth; this determines the concentration of phospholipids in the amniotic fluid and their ratio.

Amniocentesis is done under ultrasound control, through the anterior abdominal wall or the anterior or posterior fornix of the vagina: the puncture site is selected based on the location of the placenta. Before the operation, the bladder is emptied to avoid injury, the skin is treated with an antiseptic solution, local anesthesia is made with a novocaine solution, then the anterior abdominal wall, uterine wall and fetal bladder are punctured with a long thick needle; 15 ml of water is drawn into the syringe. The procedure is invasive (i.e. accompanied by a puncture of the abdominal wall, uterine wall, introduction into the uterine cavity), it can lead to various complications (mainly miscarriage or premature birth, amniotic fluid rupture, infection of the fetal membranes, injury to the vessels of the fetus and as a result of this - internal bleeding, injury of the bladder or intestines of the mother). AT modern conditions these complications are very rare, due to the introduction of ultrasound - control, compliance with the rules of asepsis and antisepsis.

Amniocentesis is not performed with the threat of miscarriage or premature birth, with the location of the placenta or myomatous node on the anterior abdominal wall, malformations of the uterus, the results of smears and bakposev from the vagina and cervical canal, indicating the presence of an inflammatory process. After the operation, a therapeutic regimen is recommended for several days (up to 1 week), for prophylactic purposes, drugs that relax the uterus are prescribed, and if necessary, antibiotics.

oligohydramnios during pregnancy

Oligohydramnios is a reduction in the amount of amniotic fluid to 500 ml or less as a result of an imbalance between their absorption and production. Most often, this condition is observed in younger pregnant women with high blood pressure in the third trimester of pregnancy and in women with an increased risk of developing fetal malnutrition (lagging behind the size of the fetus from normal for this period).

First of all, if you suspect oligohydramnios, it is necessary to exclude congenital malformations of the fetus, especially if it is detected in the second trimester (up to 28 weeks) of pregnancy, because sometimes severe oligohydramnios can be combined with such defects as polycystic kidney disease or their absence. Oligohydramnios, as well as polyhydramnios, can be a sign of intrauterine infection of the fetus, so it is necessary to conduct an examination for hidden

that infection. Oligohydramnios can occur against the background of a decrease in the excretion of urine by the fetus into the amniotic cavity during chronic hypoxia, which is observed with intrauterine growth retardation. In 40% of women with oligohydramnios, there is a lag in the size of the fetus from the norm. Due to a sharp decrease in the volume of amniotic fluid, compression of the umbilical cord (compression between the fetus and the walls of the uterus) may occur, which can lead to acute oxygen deficiency and fetal death; extremely rarely, adhesions (fusions) are formed between the walls of the uterus and the skin of the fetus.

Since in oligohydramnios the fetal bladder is “flat”, it does not perform the function of a hydraulic wedge, does not contribute to the opening of the cervix, as a result, there is a danger of weakness in labor activity. Due to the violation of the active motor movements of the fetus in the uterine cavity, the frequency of breech presentation increases, and, as a result, in some cases, caesarean section operations. More often, weakness of labor activity and intrauterine hypoxia of the fetus lead to operational childbirth with oligohydramnios. Oligohydramnios can be primary (observed with whole membranes) and secondary, or traumatic (as a result of damage to the membranes with a gradual outflow of water, which sometimes goes unnoticed by a woman: amniotic fluid is mistaken for whites).

Diagnosis of oligohydramnios is mainly based on an ultrasound examination. However, during the examination, the doctor may pay attention to the fact that the height of the fundus of the uterus and the circumference of the abdomen are behind normal for a given period of pregnancy, the motor activity of the fetus is reduced, the uterus is dense on palpation, parts of the fetus and heartbeat are clearly defined. During vaginal examination during childbirth, a “flat” fetal bladder stretched over the fetal head is determined.

If oligohydramnios is detected before 28 weeks of pregnancy, a comprehensive examination of the pregnant woman is carried out to determine possible cause and evaluation of the fetus. If fetal malformations are detected, pregnancy is terminated for medical reasons. When oligohydramnios is combined with intrauterine hypoxia and fetal growth retardation, appropriate therapy is carried out until 33-34 weeks of pregnancy, and if the treatment is ineffective and the fetus's condition worsens, early delivery. During childbirth, a “flat” fetal bladder is opened to prevent weakness of labor activity.

In severe forms of placental insufficiency and intrauterine fetal malnutrition, drip intra-amniotic administration of amino acid solutions is possible after preliminary removal of an amount of fluid equal to that administered. Attempts are also being made to paraplacental oxygenation of the fetus during childbirth to treat chronic fetal oxygen deficiency by introducing oxygenated amniotic fluid into the amniotic cavity. These methods have not yet found wide application and require further research.

Polyhydramnios during pregnancy

Not only a decrease in the amount of amniotic fluid is bad, but also its increase. Polyhydramnios is considered to be the volume of water exceeding 1500 ml. Most often this happens in multiple pregnancy, diabetes in the mother, Rh-conflict pregnancy, intrauterine infection, fetal abnormalities.

With anomalies (malformations) of fetal development, the process of swallowing water by the fetus is disrupted, as a result of which the balance between their production and excretion changes. On examination, the height of the fundus of the uterus and the circumference of the abdomen exceed the normal for this period of pregnancy.

The fetus actively swims in the amniotic fluid, which can cause the umbilical cord to wrap around the neck and torso. If polyhydramnios is suspected, the doctor clarifies the diagnosis with the help of ultrasound, while excluding intrauterine infection, fetal malformations. Due to the strong stretching of the membranes with severe polyhydramnios, an untimely discharge of amniotic fluid may occur. Preterm birth is also possible. premature detachment normally located placenta, prolapse of small parts of the fetus (handles, legs) and the umbilical cord during the outpouring of water (therefore, after the outpouring of water, a vaginal examination is mandatory). If fetal malformations that are incompatible with life are detected, an abortion is performed. If the cause of polyhydramnios was intrauterine infection, treatment is carried out taking into account the identified pathogen. Childbirth with polyhydramnios may be accompanied by weakness of labor activity due to a strong stretching of the uterus, resulting in a decrease in its contractility and excitability. Based on the foregoing, it often becomes necessary to open the fetal bladder. This is done very carefully, the water is released slowly, after which a vaginal examination is performed to exclude the prolapse of the arms, legs, umbilical cord loops. In the postpartum period, reducing drugs are introduced to prevent postpartum hemorrhage, since the overstretched uterus does not contract well.

How is the outpouring of water

Normally, amniotic fluid is poured out in the first stage of labor (until the cervix is ​​fully dilated, but not before the cervix is ​​4 cm dilated). At the height of one of the contractions, the bubble becomes tense and bursts. As a result, the anterior waters are poured out, which are located between the head of the fetus and the membranes of the fetal bladder. “Born in a shirt,” they say about children who were born with a whole fetal bladder. In modern conditions, if a woman gives birth not at home, but in a hospital, this is very rare (an exception is rapid labor), since if the cervical dilatation is complete, and the bladder is still intact, then obstetricians open it themselves: at birth "in a shirt" fetal membranes block the access of oxygen to the fetus. The outpouring of water before the onset of labor (before contractions) is considered prenatal or premature, and if the waters poured out with regular contractions, but with insufficient opening of the cervix, they talk about early outpouring of waters. In these cases, it is necessary to monitor the duration of the anhydrous period: it should not exceed 12 hours, since with a long anhydrous period, the likelihood of infection of the membranes, uterus, and fetus increases. Therefore, in the event of an outpouring of amniotic fluid at home, a woman must immediately go to the maternity hospital. With prenatal rupture of amniotic fluid, a glucose-vitamin-hormonal background is usually created; for this intravenous and intramuscular injection of glucose, vitamins, hormones that prepare the birth canal. If contractions do not start, labor induction is carried out with drugs intravenously using a dropper. In case of ineffectiveness of such therapy, a caesarean section is performed.

O high rupture of membranes they say when the fetal bladder breaks not in the lower pole, but above. If there is any doubt whether it is water or just liquid leucorrhea from the vagina (a typical situation with a high lateral rupture of the membranes), you need to go to your doctor, after placing a “control” diaper to show the nature of the discharge. In doubtful cases, a vaginal swab is taken for the presence of amniotic fluid or an amnitest is performed .

If the leakage of amniotic fluid is confirmed, but there are no contractions, the doctor decides on the further management of the pregnancy, depending on its duration. Until 34 weeks, obstetricians do everything possible to prolong the pregnancy, since the lungs of the fetus are immature and respiratory disorders may be found in the newborn after delivery. The woman is under constant supervision (body temperature is measured, a study of the content of leukocytes in the blood, a clinical blood test, ultrasound, CTG - a study of the cardiac activity of the fetus, a study of secretions from the genital tract for infections), the expectant mother is prescribed strict bed rest in stationary conditions, with necessary - antibacterial therapy, drugs that accelerate the maturation of the lungs of the fetus. If there are no conditions for prolonging pregnancy, a surfactant is used to prevent and treat respiratory disorders in newborns. In the absence of signs of infection and a sufficient amount of water in the fetal bladder by ultrasound, pregnancy can be extended up to 34 weeks. If, as a result of the study, it is found that the uterus tightly covers the fetus, and there are no waters, it is impossible to wait more than 2 weeks even in the absence of signs of infection (however, this situation is extremely rare). With a period of 34 weeks or more, with leakage of water, a woman is prepared for the upcoming birth.

Thus, the amniotic fluid is not only the habitat of the baby, but also helps to diagnose various "malfunctions" during pregnancy. Your doctor will monitor their number and, in case of deviation from the norm, will take the necessary measures.

Amnitest is a method by which the presence of α-microglobulin, which is not normally found in the vagina, is determined in the discharge from the vagina.

A sterile tampon is placed in the vagina for 5-10 minutes, then the result is determined using the test strip by the express method. If there is placental α - microglobulin in the contents of the vaginal secretion, a control strip appears in the test strip window.

During pregnancy, an amniotic sac forms in the uterus, which will produce amniotic fluid. This fluid protects your baby. A decrease in amniotic fluid is called oligohydramnios or oligohydramnios. A decrease in amniotic fluid can lead to problems, so it is very important to keep the amount of fluid normal with the help of medical or folk remedies. This article provides some tips on this topic.

Steps

Increasing amniotic fluid with medication

The type of treatment is selected depending on the duration of pregnancy. Therefore, the choice of treatment by the doctor will be based on the gestational age. Doctors usually prescribe one of the following treatments along with water rehydration.

• If your pregnancy is still in its early stages, then the doctor will carefully monitor your condition and fluid levels. A non-stress test or a contractile stress test can be done to analyze the child's activity. Your doctor may recommend one of the following treatments.
• If you have oligohydramnios in the last trimester, your doctor may recommend delivery by caesarean section, since a decrease in the amount of amniotic fluid just before delivery can be dangerous for both mother and baby.

1. Injection with amniotic fluid. This injection is a syringe filled with leaked amniotic fluid, which the doctor injects back into the uterus, into the amniotic sac. This method can improve the condition of the pregnant woman. This procedure is very similar to an amniocentesis (amniotic fluid test), but instead of taking a sample of the amniotic fluid, the doctor injects the leaked fluid into the amniotic sac.

   • This procedure is often used as a short-term solution to oligohydramnios because after a few weeks the fluid level may drop again. However, doctors have chosen to use this method because it helps them find the problem that is causing the amniotic fluid to drop.

2. Administer liquid intravenously. Some pregnant women are admitted to the hospital for additional intravenous fluid therapy. This method is used if conventional means (for example, drinking plenty of water) are not able to increase the amount of amniotic fluid. If you have tried to increase the fluid on your own, but there is no change, then you will most likely be given fluid intravenously.

   • You will be discharged as soon as your amniotic fluid levels return to normal.
   • Keep in mind that sometimes intravenous therapy has to be taken until delivery.

3. Catheter to increase amniotic fluid. Amnioinfusion is the introduction of Ringer's solution or normal saline into the amniotic sac using a catheter. With this procedure, the level of amniotic fluid will increase, so that the baby and the umbilical cord will be better protected.

   • The amount of saline injected will depend on how low the amniotic fluid level is.

4. Talk to your doctor about having a shunt placed in your body. Shunts are used to move fluid from one place in the body to another. In this case, the shunt directs fetal urine to your amniotic sac if the cause is low level amniotic fluid is chronic fetal uropathy (kidney problems that reduce amniotic fluid).

   Talk to your doctor about stopping ACE inhibitors if you are prescribed them. ACE inhibitors are drugs that help lower high blood pressure by stopping the conversion of angiotensin I to angiotensin II in your body. In general, these drugs are harmless, but they should not be taken during pregnancy because they can reduce the amount of amniotic fluid.

What is low water?

1. What is amniotic fluid for? The most important function of amniotic fluid is to protect the baby while he is in the womb. It plays the role of a pillow, protecting the child from shock. But it also performs other functions:

   • Keeps baby warm.
   • Plays the role of a lubricant. Sometimes some babies are born with webbed fingers and toes due to insufficient amniotic fluid.
   • Ensures the proper development of the lungs of the kidneys.
   • Helps the child move freely, which in turn allows him/her to develop limbs.

2. We get acquainted with the symptoms of a decrease in amniotic fluid. Oligohydramnios is a condition that occurs when there is a severe decrease in amniotic fluid (below 300 ml). If you suspect the development of oligohydramnios, be sure to talk to your doctor. If you think that a similar problem may appear in the future, you should familiarize yourself with the following signs:

   • Leakage of amniotic fluid.
   • Your belly is smaller than it should be during gestation.
   • The feeling that the child began to move less.
   • When urinating, less urine is excreted.
   • Visible lack of amniotic fluid, when examined by ultrasound.

3. You should be familiar with the risk factors that can lead to a decrease in amniotic fluid. Some of the more common causes are described below:

   • The baby is small for his gestational age.
   • You have high blood pressure during pregnancy (a condition called preeclampsia).
   • The placenta partially or completely exfoliates from the uterine wall even before the onset of childbirth. This condition is known as placental abruption.
   • If you have identical twins and they share a placenta, sometimes your amniotic fluid levels may decrease. This happens when one of the twins receives more blood through the placenta than the other.
   • In the presence of certain diseases, such as lupus.
   • Overwearing. If your pregnancy reaches more than 42 weeks, you have a higher risk of low amniotic fluid levels due to decreased function of the placenta. Amniotic fluid begins to decrease at 38 weeks of gestation.

Protecting the baby in the mother's belly, its stable growth and proper development provide amniotic fluid during pregnancy. The enlarged uterus contains a fetal bladder filled with a special liquid substance. It is the "home" for the baby for the entire long period of pregnancy, almost from the very conception. Therefore, it is especially important to monitor the condition of this fluid and correct emerging deviations in time.

Formation and functions of amniotic fluid

The Greek concept "amnion", denoting the membrane of the fetus, gave the name of the amniotic fluid - a nutrient medium for the intrauterine development of the child. Immediately after the fertilized egg enters the uterus and attaches to it from the inside, a chorion is formed at the attachment site (in the future it will become the placenta). With the help of the umbilical cord, the chorion is connected to the amnion - the fetal bladder. Inside the amnion, real magic happens - a baby develops from several cells after the allotted time. Reliable protection is provided by thin and elastic, but very strong bladder walls.

The fetus is in the amnion filled with amniotic fluid or amniotic fluid

The amnion is filled with a fluid, the sterility of which is achieved by regular renewal. How is amniotic fluid renewed during pregnancy? Until the middle of the term, they are produced by the cells of the fetal bladder, and after the 20th week they are mainly formed by the kidneys of the child. At the end of pregnancy, the fluid is updated 8 times a day.

Amniotic fluid provides comprehensive protection for the baby:

• Due to the content of immunoglobulins, the baby is reliably protected from all kinds of infections.
• In the event of an accidental fall of the mother, the shock is cushioned by the presence of liquid, and no harm is done to the child.
• The umbilical cord remains free and is not pinched.

The temperature inside the bubble is constant at 37 degrees Celsius. Until about the third trimester, the baby can even make swimming movements, as long as there is enough space for this.

Characteristics of the waters

More than 95% of the composition of the amniotic fluid is water. The rest is made up of vitamins, trace elements, even particles of the skin and hair of the fetus. Toward the end of pregnancy, when the child masters urination, urine also appears in the composition of the liquid. But due to frequent renewal, the composition of the liquid remains unchanged. There is an opinion that the smell of the liquid is similar to breast milk, which is why a newborn baby unmistakably finds the mother's breast.

The amount of amniotic fluid increases from week to week, reaching a maximum two weeks before the planned date of delivery.

At 38 weeks, the volume of amniotic fluid is approximately 1-1.5 liters. Further, the amount of water decreases, and by the time they are born, about 800 ml remain.

Normally, amniotic fluid should be clean and clear. If a suspension appears in the waters, this most often indicates infection.

Diagnosis of the condition of a pregnant woman and a child using amniotic fluid

The state of the amniotic fluid is one of the main indicators of the normal or pathological course of pregnancy, as well as the condition of the unborn child. You can evaluate the amount and homogeneity of waters on an ultrasound examination, which every woman must undergo at least three times during pregnancy.

If necessary, the analysis of amniotic fluid can determine the sex of the child and his blood type. In addition, the suspicion of the presence of genetic abnormalities in the fetus can be confirmed or refuted by analyzing the amniotic fluid.

If it is necessary to determine whether the child is ready for birth, amniotic fluid is also taken for analysis. Based on the results of the analysis, an emergency delivery by caesarean section can be performed. Also, fluid analysis makes it possible to find out about the readiness of the respiratory system of the newborn for independent work.

Possible problems

Unfortunately, pregnancy does not always go smoothly. There are cases when violations of the quantitative or qualitative composition of the amniotic fluid provoke the occurrence of various pathologies.

Polyhydramnios.

This condition is said when the amount of amniotic fluid exceeds one and a half liters. This condition can be caused by kidney problems in the mother, infectious diseases, cardiovascular pathologies of the mother, or congenital diseases of the child. In case of multiple pregnancy polyhydramnios is also quite common.

With polyhydramnios, the amount of amniotic fluid exceeds 1.5 liters

Polyhydramnios is found, usually in the second or third trimester of pregnancy. If polyhydramnios occurred suddenly against the background of the previous normal state, delivery should be carried out immediately.

Low water.

The opposite situation is when the amount of water does not exceed 500 ml. Oligohydramnios can be caused by hypertension in a pregnant woman, inflammatory diseases of the female genital organs, overweight future mother or disorders in the urinary system of the fetus. The condition is dangerous with the risk of hypoxia (oxygen starvation) of the child, therefore, appropriate treatment aimed at enhancing the production of amniotic fluid should be carried out immediately.

Oligohydramnios can also have a negative impact on the process of childbirth - the fetal bladder will not be able to press on the cervix with sufficient force, so its slow opening will lead to weakness in labor.

With oligohydramnios, the risk of preterm birth is doubled, and babies, due to lack of space, are much more likely to take the wrong position in the uterus, not having time to turn into head presentation in time.

Oligohydramnios often makes itself felt with abdominal pain in a future mother - the child does not have enough space, and his every movement is difficult and painful. Reducing the amount of amniotic fluid can lead to clamping of the umbilical cord, as a result - to oxygen starvation and even death of the fetus.

Water leakage.

In a normal state, the fetal bladder remains intact throughout pregnancy, and the outpouring of water indicates the beginning of active labor. However, there are times when water starts to flow prematurely. Such a situation, or even the slightest suspicion of it, requires an urgent examination by a doctor, since a decrease in the amount of amniotic fluid can seriously harm the health of the child in case of untimely assistance.

You can check if water is leaking using special tests

A sign of water leakage is a sharp increase in fluid released when changing body position. You can accurately determine the leakage of water using pharmacy tests. If the condition is confirmed, it is necessary to contact the maternity hospital as soon as possible - perhaps this is a signal of the onset of premature birth.

Water of an atypical color.

In the normal state, the waters are transparent in color, and there are no impurities in them. True, towards the end of pregnancy, impurities inevitably appear - these are epidermal cells and vellus hair of the fetus. This state of the water is quite normal and does not threaten the development of the child. However, the green color and turbidity of the waters may indicate a serious pathology - fetal hypoxia. In this case, with a lack of oxygen, the muscles of the anus contract reflexively, and meconium is released into the amniotic fluid.

Another cause of premature meconium excretion is the aging of the placenta as a result of prolonged pregnancy. In this case, the placenta ceases to fully supply the fetus with oxygen, as a result of which the child develops oxygen starvation. The muscles of the anus contract again, and meconium is excreted.

Ingestion of amniotic fluid mixed with meconium by a baby negatively affects its development, so green waters require immediate medical attention.

Is it possible to avoid problems

Amniotic fluid is a nutrient medium that ensures the development of the child in the womb until the very birth. Any violations and deviations require close attention and medical supervision. Most amniotic fluid pathologies are successfully corrected in a hospital setting with the help of medications and vitamins. The patient must maintain complete calm, both physical and mental. You will have to forget about physical activity and an active lifestyle for a while.

It will not be superfluous to remind you of the need to visit a doctor observing pregnancy. It is constant monitoring that allows you to avoid many problems that negatively affect the normal course of pregnancy.