Getting to Know Oligohidramnios One of the Causes of Premature Labor

Oligohidramnios or oligohydramnios is a condition when amniotic fluid is at too low a level, and can cause disruption during labor until the death of the baby. Amniotic fluid plays an important role in protecting the baby from shocks and infections, helps maintain temperature in the uterus, prevents pressure on the umbilical cord that interferes with oxygen supply to the baby, helps the respiratory system and digestion of the fetus, and allows the baby to move for the development of bones and muscles. Oligohidramnios or lack of amniotic fluid in the body can inhibit the various functions above, causing fetal defects, pressure on the umbilical cord, can even cause death. In addition, very low amniotic fluid risks causing uterine contractions or infant movements that can compress the umbilical cord. The amniotic sac is formed 12 days after fertilization occurs with the amniotic fluid that supports the baby's life in the womb. In the second trimester, babies begin to breathe and swallow this amniotic fluid for life. At 34-36 weeks' gestation, an average pregnant woman carries about 1 liter of amniotic fluid in her womb. After that, this fluid will slowly decrease until delivery time arrives. Therefore, the availability of amniotic fluid in normal levels is important to support fetal development. The doctor can measure the normal or absence of amniotic fluid levels by evaluating the amniotic fluid index via ultrasound.

What is Oligohidramnios?

Oligohidramnios is a condition when amniotic fluid is at too low levels as indicated by:

• The amniotic fluid index shows fluid levels less than 5 cm at the end of the second trimester.
• At 32-36 weeks' gestation, the amount of amniotic fluid is less than 500 mL.

Meanwhile, amniotic fluid that is in too high levels is called polyhydramnios. Oligohydramnios can be triggered by many things such as placental disorders, congenital abnormalities in the fetus, leakage of the amniotic sac, labor past the estimated date, premature rupture of membranes, diabetes, preeclampsia, hypertension, dehydration, and chronic hypoxia. Oligohidramnios can occur at any time, but is most common in the third trimester of pregnancy. In addition, people who contain more than one child or twins are also more at risk of oligohydramnios. Oligohidramnios can cause complications in about 12% of pregnancies aged 41 weeks and over. The risk of miscarriage in pregnancy will increase if pregnant women experience oligohydramnios. About 80-90% of pregnancies with oligohydramnios are reported to have miscarriages due to congenital defects in the fetus. If this condition is diagnosed just before the last trimester of pregnancy, the risk of preterm birth and the possibility of having to be born with a Caesar procedure will be higher.

Some Steps for Handling Oligohidramnios

Handling of oligohydramnios depends on the baby's condition, gestational age, and the presence or absence of complications during pregnancy. Handling is done by:

• The fetus needs close monitoring through USG to see its activities and conditions.
• Pregnant women will be advised to consume lots of fluids.
• In certain cases, such as stunted growth of the baby in the womb or preeclampsia, oligohydramnios may need to be managed through induced labor if the gestational age is nearing delivery.
• During labor, the doctor may give amniotic fluid through a catheter that is inserted into the uterus to reduce the risk of pressure on the umbilical cord.
• Consideration for childbirth by Caesarean section.

By checking the content regularly, the risk of oligohydramnios can be detected early and proper treatment can be sought immediately by a doctor. However, consult a midwife or doctor immediately if the baby feels not so active as usual during pregnancy.