Prof. Dr. Ali EKİZ

Prof. Dr. Ali EKİZ

Gynecology and Perinatology (Risky Pregnancy) Specialist

With over 15 years of professional experience, dozens of national and international research articles, and most importantly, his smiling face, Gynecology and Perinatology Specialist Prof. Dr. Ali EKİZ is with you.

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Lack of Water in Pregnancy (Oligohydramnios) and Polyhydramnios

What is Low Water (Oligohydramnios) and Excess Water (Polyhydramnios) During Pregnancy?

The fluid in which the baby is in the womb is called amniotic fluid. The main source of amniotic fluid is the baby’s urine. Usually from the ninth week onwards, babies’ kidneys begin to produce urine. When the baby starts urinating, he swallows the amniotic fluid that flows into the uterus. In this way, the balance of amniotic fluid is ensured. After the 16th week, amniotic fluid consists almost entirely of the baby’s urine.

Normally, urine is known as a harmful substance. The reason of this; The body excretes a significant portion of the toxin through urine. This situation is different in the womb. In the womb, the baby sends its toxins through the mother’s umbilical cord, not through urine.

At every ultrasound check, the baby’s amniotic fluid balance must also be measured. In some cases, this fluid may come out too much or too little. So, what does this situation indicate? What is water deficiency and excess water during pregnancy? What you need to know about the subject is with you in the rest of our article.

How Much Amniotic Fluid Should Be?

Amniotic fluid normally varies between 500 ml and 2000 ml, depending on the week of pregnancy. Amniotic fluid is formed by the baby’s urine, and balance is achieved by the baby’s regular swallowing of this fluid. Any abnormality in the production of amniotic fluid or in the baby’s swallowing causes an increase or decrease in amniotic fluid.

What are the Functions of Amniotic Fluid?

Amniotic fluid has many known functions. We can list these tasks as follows:

• Protects the baby against infections.

• It prevents the baby’s cord from being pinched.

• Protects the baby from possible traumas and impacts.

• It allows the baby to move freely in the mother’s womb. This is also important for the development of the baby’s musculoskeletal system.

• It maintains the intrauterine temperature.

• The baby both breathes and swallows amniotic fluid. In this way, amniotic fluid passes through the respiratory and digestive systems. This provides the development of the inner surface of the respiratory and digestive system.

What are the Causes of Low Amniotic Fluid (Oligohydramnios)?

If the amniotic fluid is below the expected measurement in ultrasound controls, it is called oligohydramnios, that is, low amniotic fluid. There are some factors that can cause a decrease in amniotic fluid. We can list these elements as follows:

• Developmental delay in the baby,

• Gestational blood pressure (preeclampsia),

• Excess of the day (overdue pregnancies),

• Kidney diseases that affect urine production in the kidney

• Anomalies that prevent the urine produced in the kidney to go out

• Opening of the amniotic fluid sac before birth,

• Some problems specific to multiple pregnancy (TTTS),

• Chronic placental insufficiency,

If one or more of these conditions is present, the baby’s water needs to be checked frequently.

What Happens When Amniotic Fluid Decreases?

The decrease in amniotic fluid, especially in the early period, may prevent lung development in the baby. In addition, babies with reduced water have a higher risk of developmental delay and infection.

Decreased water in the baby may be a sign of not making enough urine. This may indicate that there is a problem with the baby’s oxygenation and that the baby is experiencing stress in the womb.

What to Do When Amniotic Fluid Decreases?

In case of a situation such as decreased amniotic fluid, pregnant women should be evaluated by a perinatology specialist. With this examination, the reason for the scarcity of water is investigated.

For example, the main purpose of water shortages due to the rupture of the membrane around the baby, that is, the early arrival of water, is to try to keep the baby inside as much as possible.

As another example, a baby with underdeveloped kidneys will have no water at all. Since there is no chance of surviving a baby whose both kidneys are not developed, termination of pregnancy is preferred.

In babies who cannot urinate due to a stenosis after the bladder, it is possible to treat them with surgery in the womb. This surgery is called vesicoamniotic shunt.

What are the Causes of Excess Amniotic Fluid (Polyhydramnios)?

If the measurements of the amniotic fluid are more than expected in the ultrasound examination, it is called polyhydramnios, that is, excess amniotic fluid. There are some factors that can cause an increase in amniotic fluid. We can list these elements as follows:

• Diabetes in the expectant mother is the most common cause

• Any reason that may affect swallowing in the baby can cause polyhydramnios (brain anomalies, cleft palate and mouth tumors can be given as examples)

• Non-development of the esophagus (esophageal atresia)

• Absence of duodenum development (Duodenal atresia)

• Problems specific to identical twins (TTTS)

• Idiopathic. (Diseases of unknown cause)

If one or more of these conditions is present, the baby’s water needs to be checked frequently.

What Happens in Case of Excess Amniotic Fluid?

Excess amniotic fluid causes the uterine wall to regress. Therefore, premature birth may begin. In addition, due to the excessive growth of the abdomen, the expectant mother may experience problems such as shortness of breath, abdominal pain and tenderness.

In case of excess amniotic fluid, sudden discharge of water when the membranes are opened may cause cord prolapse. This situation is very dangerous for the baby.

What Should Be Done When Amniotic Fluid Increases?

In case of excess amniotic fluid during pregnancy, chromosomal anomalies or congenital anomalies should be examined in detail. For this reason, detailed ultrasound and anomaly screening should be performed by a perinatologist.

If there is excess amniotic fluid during pregnancy, frequent and close monitoring is usually done. In some cases, water reduction with medication may be tried. In cases of severe water excess that causes shortness of breath to the mother, water can be reduced surgically called amniodrainage.


You can make your appointment with Perinatology (Risky Pregnancy) Specialist Prof. Dr. Ali Ekiz via the WhatsApp button.

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