I recently lost a baby at five months due to inadequate amniotic fluid. My doctors said it probably wouldn't happen again, but none gave me a reason for its occurrence. Why did this happen to me?
Oligohydramnios is the term that refers to a decreased amount of amniotic fluid. We don't know the cause of this. It has not been linked to a specific genetic defect, although it accompanies many types of defects. It may have been helpful to run a chromosome analysis on the baby you lost to check for any genetic anomalies.
Problems in the digestive and or urinary system are often associated with oligohydramnios. The baby's urine is part of the make-up of the fluid, and if a baby is not excreting properly, it is possible that this may be a cause of reduced fluid.
Oligohydramnios has also been associated with intrauterine growth restriction and may be detectable on ultrasound before the baby's growth problems actually show up on ultrasound.
During pregnancy, fluid is produced at the rate of about a cup an hour. Research has not uncovered the true cause of oligohydramnios, but the fetus may play a part.
Occasionally, when there is a longstanding lack of fluid, the inhibition of fetal movement can cause fetal limb defects.
If it was an isolated factor, not associated with chromosome problems, the condition will not necessarily repeat itself with a future pregnancy. A skilled ultrasound technologist/radiologist may be able to look at the scan even now and try to determine what difficulty may have been present.
As providers, we walk a line between ordering unnecessary tests and under utilizing technology which may prove beneficial. Oligohydramnios may not show itself until the mid point in the pregnancy. If uterine size and other parameters of fetal well being were being met, there would be no need to order an ultrasound. Sometimes, if we feel an ultrasound is needed for dating or for a survey of fetal development, we actually wait until about 16 to 20 weeks to do it.
I would recommend that you consult a perinatologist, an obstetrician specializing in high-risk pregnancy. He or she would review the ultrasound and provide recommendations for your next pregnancy. I would also recommend a visit to a genetic counselor.
I wish you luck with your next pregnancy and I hope you are getting the help you need to deal with this grief.
