My wife has been diagnosed with oligohydramnios, with fluid levels at five and a half centimeters at seven months. With hospital bed rest and IV fluids, the level rose above seven. Ultrasounds did not show any obvious disorder. The doctor said that the level of fluid was mostly controlled by the baby, not my wife's fluid intake. If so, why did the IVs raise the fluid levels? Why does bed rest help with the levels?
Oligohydramnios, or low amounts of amniotic fluid, is defined in terms of "pockets." If it is between two and five, this is considered low. But there are changes in interpretation in the literature every day, it seems. Recently, I read that a two centimeter vertical pocket is considered normal, a one to two centimeter pocket is marginal and less than one centimeter is decreased. With low levels, there is an increased risk of fetal heart decelerations in labor. Your provider may induce labor at term to keep you from going overdue, when the risks would be even higher.
In labor, he or she may replace the fluid after artificial or spontaneous rupture by infusing warm saline into the uterus. This decreases the risk of fetal distress. Occasionally, when there has been a longstanding lack of fluid, the inhibition of fetal movement may cause fetal limb defects.
The lack of fluid is sometimes caused by fetal urinary tract problems, as the baby's urine is part of the make-up of the fluid; if the baby is not excreting properly, it is possible that this may be a cause of reduced fluid.
Oligohydramnios has also been associated with intra-uterine growth restriction and may be the first sign on ultrasound before the baby's growth problems can be detected.
It is believed that babies with very low levels (five and a half is just borderline, not very low) can experience a higher incidence of problems in labor related to decreased placental reserves. In women with oligohydramnios, it is particularly important to not smoke, get a very good diet, rest a bit more and observe and report any signs or symptoms of preterm labor.
Your wife should not feel guilty that her fluid intake was not adequate. That is what your doctor probably meant when he said that fluid intake is not related. But IV fluids will improve the movement of fluid into the amniotic sac.
Your provider will watch this condition closely, while looking for any signs of decreased fetal growth or preterm labor or placental inadequacy. He or she will probably do fetal movement counts, non-stress testing and biophysical profiles as she approaches term.
Her oligohydramnios may have no negative significance at all, but it is good that your provider is taking steps to monitor her and the baby. Sounds like you're in good hands.
Hope all goes very well for your family.
