Throttle body is a condition where there is not enough amniotic fluid (its amount does not exceed 500 ml). Usually, the diagnosis of oligohydramnios is between 32 and 36 weeks of gestation. What are the causes and symptoms of oligohydramnios? What is the risk of having too little amniotic fluid? How is the treatment of oligohydramnios like?

Małowodzie(Latinoligohydramnion , Eng.oligohydramnios ) is a state in which the volume of amniotic fluid is not enough. Most often, this situation affects women between 32 and 36 weeks of pregnancy. Then the approximate amount of amniotic fluid does not exceed 500 ml, which corresponds to 5-6 cm of the AFI index. For comparison, the correct amount at this stage of pregnancy is between 500 and 2000 ml. Almost a quarter of the situation results from the premature outflow of the amniotic fluid, therefore the exclusion of this pathology is obligatory in the diagnostic and therapeutic process.

What is amniotic fluid?

The amniotic fluid is a natural blend of costume substances from both the mother and the developing fetus. Apart from the cellular elements of the amniotic cells, it contains protein substances, fats and active enzymes. The amniotic fluid is exchanged at the same time intervals as every 2 hours. The mechanism of the formation of amniotic fluid is not fully understood, and the volume itself is closely related to the gestational age. The highest value falls on 30-36 t.c. and then successively decreases as you get closer to delivery. The amniotic waters are essential for the proper development of the fetus, thanks to their presence its well-being is preserved. They are primarily the most important for the proper development of the respiratory system. Accordingly, the sooner the amount of amniotic fluid is reduced, the worse the development of the elements of this system. The amniotic fluid also provides excellent conditions for maintaining physical activity, and absorbs the movements made by the fetus.

When are we talking about oligohydramnios?

As mentioned above, the correct amount of amniotic fluid in the third trimester of pregnancy should not exceed 2000 ml, but also should not be less than 500 ml. The function of the amniotic fluid is invaluable. They provide excellent cushioning for the developing child. They protect them against shocks, bumps or abrasions caused by making movements. They also guaranteemaintaining the temperature inside the uterus at a constant level.

Each patient suspected of having an abnormal amount of amniotic fluid should be under close supervision. In the early stages of pregnancy, a low amount of amniotic fluid coexists with fetal hypotrophy, i.e. abnormal growth. It can also be associated with hypoxia, which of course significantly increases perinatal mortality. It is a medical error to diagnose oligohydramnios in the perinatal period, because during this period the amount of amniotic fluid physiologically decreases.

What does the breaking of amniotic fluid mean?

Small water and other obstetric pathologies

The most common obstetric pathologies with concomitant oligohydramnios:

  • urinary tract defects, the most common of which is an obstruction at the level of the kidney itself or the pathways leading out of urine from the kidneys
  • PROM - premature rupture of the amniotic bladder
  • complications of twin pregnancy, TTTS - fetal transfusion syndrome
  • abnormal / disturbed maternal-placental flow, which may be a consequence of arterial hypertension or hypovolemia, i.e. a decrease in the volume of blood circulating within the placenta

Symptoms of oligohydramnios

The first symptom of a reduced amount of amniotic fluid is the reduced size of the uterus, in other words it is not in line with the gestational age. It happens that expectant mothers notice weaker weight gain. Another very important symptom is weaker movements of the fetus. This is natural as the reduced amount of amniotic fluid restricts the baby's movements. Patients with oligohydramnios feel more wet during the outflow of the amniotic fluid, which requires more frequent changes of the insole.

Treatment of oligohydramnios

Treatment of the reduced amount of amniotic fluid is initially based on adequate hydration of the patient. The delivery of a few liters of fluid a day should improve the situation, but not always. In extreme cases, the recommended form of treatment isamnioinfuzja . It is a procedure that involves the supply of a saline solution, which is to imitate the amniotic fluid. The entire procedure takes place after prior preparation of the operating field, under ultrasound supervision. With the help of a thin puncture needle, it is passed to the fetal bladder and the appropriate amount of fluid is administered. The treatment is usually repeated often, even every day. During the first injection, an appropriate port is inserted, which is used to deliver fluid without the need for an additional prick. The catheter is equipped with a special bacteriological filter to protect against infections.

Complications of oligohydramnios

Complicationsthe reduced amount of amniotic fluid affects, first and foremost, the child. Unfortunately, proper development may be hampered. The most common types of deformities are the result of maintaining a compulsory body posture. It happens:

  • clubfoot
  • limb contractures
  • flat face
  • abnormal heart rhythm as a consequence of the load on the fetal circulatory system
  • fetal hypotrophy
  • respiratory problems

In the most severe situations, intrauterine fetal death occurs.

Category:

Pregnancy