What are the treatment options for low amniotic fluid during pregnancy?

Answers from Roger W. Harms, M.D.

Few effective treatments exist for low amniotic fluid (oligohydramnios).

During pregnancy, amniotic fluid provides a cushion that protects the baby from injury and allows room for growth, movement and development. Amniotic fluid also keeps the umbilical cord from being compressed between the baby and the uterine wall. In addition, the amount of amniotic fluid reflects the baby's urine output — which is an important measure of a baby's well-being.

Amniotic fluid normally decreases in the last weeks of pregnancy. Various factors can contribute to low amniotic fluid earlier in pregnancy, including:

  • Your water breaking early (premature rupture of the amniotic sac)
  • The placenta peeling away from the inner wall of the uterus — either partially or completely — before delivery (placental abruption)
  • Certain health conditions in the mother, such as chronic high blood pressure or high blood pressure accompanied by excess protein in the urine after 20 weeks of pregnancy (preeclampsia)
  • Use of certain medications, such as angiotensin-converting enzyme (ACE) inhibitors
  • Certain health conditions in the baby, such as restricted growth, a kidney or urinary tract problem, or a genetic disorder

If you're diagnosed with low amniotic fluid, your health care provider will carefully monitor your pregnancy to help prevent complications. He or she might recommend drinking more fluids — especially if you're dehydrated.

It's possible to temporarily increase the amount of amniotic fluid with a procedure known as amnioinfusion, in which saline is instilled into the amniotic sac. The effect is short-lived, however.

During prenatal care, amnioinfusion is usually done only to enhance ultrasound images. In this case, the saline is injected into the amniotic sac through a needle placed in the abdominal wall. Treatment will depend on what's detected through the ultrasound. Amnioinfusion might also be done during labor to relieve pressure on the umbilical cord. In this case, the saline is instilled into the amniotic sac through a catheter placed in the cervix. If the baby's heart rate drops too low or too often during labor or the umbilical cord is compressed, a C-section might be needed.

Aug. 20, 2011