Is it possible to reduce the amount of amniotic fluid. How amniotic fluid is renewed during pregnancy

Water is the natural environment for a developing fetus. In the process of formation, the baby swallows a liquid that is processed and poured back into the fetal bladder. The question arises: how amniotic fluid is renewed during pregnancy? Indeed, the composition includes many useful substances, the density does not change, and the child moves freely and is protected from overheating or hypothermia.

Functionality

The role of amniotic fluid in the development of the embryo is very large, because it is here that he will have to spend all 9 months. The comfortable presence of the fetus in the womb depends on the volume and quality, and the functional features are multifaceted and difficult to overestimate:

The exchange of substances between mother and child. The water contains nutrients that the baby swallows and then releases back, while there is a constant renewal.
The fetal bladder and its contents serve as a kind of shock absorber for minor shocks, protect against infections and prevent clamping of the umbilical cord.
There is no doubt about sterility, because amniotic fluid is renewed during pregnancy every three hours. The body constantly maintains the same composition, which can only change depending on the gestation period.
During the period labor activity amniotic fluid softens the period of contractions and promotes comfortable progress through the birth canal.

Throughout the entire gestation, the baby feels comfortable and moves freely, so the properties must be unchanged and correspond to the norm.

The contents of the shell is a transparent substance with an odor that resembles mother's milk. Many experts believe that it is precisely because of this property that the baby after birth accurately recognizes where the mother's breast is.

How and for what period amniotic fluid is renewed?

The baby is not just in the uterus, but also in the fetal bladder, which produces amnion at the cellular level. After the 20th week of pregnancy, when active growth begins, the kidneys and lungs of the child contribute to the production of amniotic water.

At the same time, the composition, which is unstable depending on the state of health of the mother, is very useful for the formation of the embryo. Here are the main components of nutrition (fats, proteins, carbohydrates), oxygen, immunoglobulin cells, as well as antigens. Since the baby lives in this substance, waste products (skin, hair) are not uncommon during tests.

Update amniotic fluid during pregnancy occurs quite often - every three hours. The walls of the amnion secrete fluid, which is subsequently swallowed by the fetus, approximately 20 ml in 60 minutes. The exchange is carried out by suction, through special tubules or through the placental membrane with the umbilical cord.

The quantity and composition, depending on the period and individual characteristics of the organism, is constantly changing. On average, the volume reaches from 0.6 to 1.5 liters. An excess of this indicator indicates polyhydramnios, and an underestimated one indicates oligohydramnios. Any of these extremes is a deviation from the norm and requires treatment.

Pathologies of the development of amniotic fluid

Any of the deviations from the norm indicates the formation serious pathologies that require immediate treatment:

Low water is characterized by the fact that the amnion is not updated in sufficient volume. A pregnant woman manifests a painful syndrome, since fetal movements occur in a smaller amount of fluid, while the size of the uterus does not correspond to the period of gestosis. Pathology threatens the normal formation of the child, a curvature of the spine may develop as a result of compression and an uncomfortable position.
Polyhydramnios is more common and is caused by an acute and chronic condition. In the acute form, the increase occurs very quickly, which can lead to the death of the fetus or, as a result of strong pressure, rupture of the uterus. The chronic form is characterized by a gradual increase in the volume of fluid, the uterus is in good shape and a “gurgling” is heard if you click on the stomach. The symptoms are quite bright, the woman feels pain, edematous reactions appear on the limbs. The baby begins to actively move in the womb, the heartbeat is practically not audible, and the function of nutrition and blood circulation is impaired.
Turbid fetal waters are diagnosed when ultrasound examination. The norm is a clear amniotic fluid, with a small amount of impurities of particles of skin and hair. In the early stages, this type of pathology is very dangerous, doctors often recommend terminating the pregnancy. In the second half of gestation, a change in state indicates the development of an infectious disease.

For diagnostic purposes, analyzes are carried out by amniocentesis (puncture of the fetal bladder), which allows you to determine genetic disorders, formation defects and malformations.

The detection of pathology in the early stages of gestation requires immediate treatment in a hospital, since the renewal of the composition during pregnancy should occur in accordance with generally accepted standards. At a late stage of gestation, a decision may be made to conduct caesarean section to save a child's life.

We continue talking about amniotic fluid, changes that can occur with them and methods for diagnosing any pathologies using them. We have already said earlier that during pregnancy and during childbirth, the color of amniotic fluid may change. Let's continue our conversation.

If the water is dark brown.
If dark brown amniotic fluid is found during pregnancy and childbirth, this indicates serious problems that should be of great concern to both doctors and the woman herself. In almost 90% of cases, this color of amniotic fluid indicates the presence of intrauterine fetal death. And in the presence of such odes, the question is no longer about saving the fetus, but about saving the life of the pregnant woman, since such a condition is also dangerous for her. But in today's time, when diagnostic methods are actively practiced and a woman's health is carefully monitored, such situations are very rare, therefore, we simply will not talk in detail about this option. With regular monitoring by a gynecologist, such problems are detected in a timely manner, in advance, and then the situation simply does not reach such a state of amniotic fluid.

Amniotic fluid is red or reddish in color.
The presence of red amniotic fluid indicates a serious danger not only for the baby in the mother's stomach, but also for herself. Often, a red or pink hue of the amniotic fluid will occur when blood enters the fetal bladder in the presence of bleeding in both the mother in the body and the fetus. You can judge for yourself how dangerous this situation is for the mother and her child. If you find amniotic fluid of this color in yourself, you should immediately take a horizontal position and under no circumstances, do not move. And your relatives should, without delay, call an ambulance and immediately take you to the hospital. When calling an ambulance, it is imperative to inform the dispatcher receiving the call that the amniotic fluid that has passed from the pregnant woman is red or with blood.

In such cases, an intensive care team immediately leaves for pregnant women, which is equipped with all the drugs and devices necessary to provide assistance. Assistance upon the arrival of an ordinary ambulance in this case may be inferior, since the situation is urgent and the bill can go literally for minutes. It is strictly forbidden to try to deliver a pregnant woman to the maternity hospital on your own, even if the maternity hospital is literally 3-5 minutes drive from the house. With any careless movement, irreparable things can happen and this can lead to the death of the mother and child from bleeding. It is important to remember that we are talking about two people at once, therefore, do not take risks. It is worth noting the fact that such situations rarely occur, usually with serious injuries after an accident or after burning, severe injuries and blows to the stomach. Usually pregnancies end happily.

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When talking about pregnancy and amniotic fluid, the question of oligohydramnios cannot be omitted. The state of moderate oligohydramnios during pregnancy is not very common, usually by the end of pregnancy no more than 5% of expectant mothers suffer from this condition. Oligohydramnios in pregnant women is called the amount of amniotic fluid insufficient for the full development of the fetus. We have already said what important functions amniotic fluid performs and why there should be a strictly specified amount of them. The composition of the amniotic fluid can remain relatively constant, their complete renewal will occur approximately every three hours. If the process of production of amniotic fluid and from suction is disturbed, then the amount of amniotic fluid may exceed the norm or be insufficient. With a deficiency of amniotic fluid, a state of oligohydramnios occurs.

It is worth noting that the fact of oligohydramnios in itself will not be any disease, it is just one of the symptoms. And then the consequences of low water will be primarily the consequences of the causes that caused it. The presence of moderate oligohydramnios by the end of pregnancy may also be of a physiological nature, and then it will not pose any danger. However, on the other hand, if oligohydramnios begins in the early stages of pregnancy, and later developed to severe, oligohydramnios by the middle or third trimester of pregnancy can lead to sad outcomes.

Reasons for the development of oligohydramnios.
The development of oligohydramnios during pregnancy can be formed as a result of many reasons and in different dates pregnancy. So, the tendencies towards oligohydramnios, which have shown themselves from the very early dates pregnancies may indicate the presence of severe congenital pathologies in the fetus. This type of oligohydramnios, the causes of which may be pathologies in the structure of the fetus itself, unfortunately, are unfavorable in terms of prognosis for the course of pregnancy and childbirth. Usually this is a congenital absence or kidney anomalies incompatible with life, and such a pregnancy is often recommended to be terminated for medical reasons, since after birth the baby simply cannot live without kidneys.

Also, another well-known reason for the formation of oligohydramnios is an increase in blood pressure in a future mother. Usually, this condition is formed by the end of pregnancy, and the mechanisms of its occurrence are determined by violations of the functions of the placenta. This occurs as a result of impaired blood flow due to the fact that the mother has high blood pressure and the small vessels in the placenta come into a state of spasm. Slight oligohydramnios can be normal in the presence of over-pregnancy, which is associated with the physiological process of aging of the placenta. No less rare is relative oligohydramnios in one fetus from twins. This is associated with shunting syndrome (blood shunting) in the placenta from one baby to another. This is often referred to as the syndrome of feto-fetal transfusion or "stealing" of one fetus by another. Usually, violations in the vast majority of cases are insignificant and do not threaten the development of any of the children.

The reasons for the formation of oligohydramnios among pregnant women can also be the presence of chronic, chronic or latent sexual infections that have not been previously treated or treated incorrectly, and which has passed into a latent, sluggish current state. AT individual cases the reasons for oligohydramnios among pregnant women are factors unknown to doctors. Theories are put forward that there may be a violation of the functions of the amniotic fluid-producing epithelium of the region of the fetal bladder itself. Because of what, in one case or another, there is oligohydramnios, it is far from always possible to establish. However, it is always necessary to look for the causes of oligohydramnios in pregnant women especially carefully, because oligohydramnios is only a symptom of this, and the very reason that caused it can become dangerous for the mother and her baby.

Manifestations and symptoms of oligohydramnios during pregnancy.
Manifestations of oligohydramnios during pregnancy, the symptoms of which can be detected by the pregnant woman herself, will be very pronounced and severe. In such cases, there should be very, very little amniotic fluid so that the pregnant woman herself can think that something is not happening in pregnancy in the way it should be. This is extremely rare and usually occurs with very severe pathologies. If the manifestations of oligohydramnios are moderate, and at the same time the woman is not bothered by any manifestations of pathology, external manifestations may not be. Only with a pronounced decrease in the amount of amniotic fluid, minor signs may appear, which will make it possible to assume that something is wrong with the amount of amniotic fluid.

If a pregnant woman has severe oligohydramnios, there is extremely little amniotic fluid so that her baby can move calmly inside the uterus. This leads to the formation of painful for the mother and distinct movements of the fetus. Women complain to the doctor that the child kicks hard and often, and his movements cause pain or severe discomfort. Often occurring in women, moderate oligohydramnios practically does not manifest itself in any way, has no dangerous symptoms and can only be diagnosed by ultrasound.

Tomorrow we will continue the conversation.

Around the baby in the womb is a constant amniotic fluid, which is vital for its safety and development. These waters are the protection of the fetus from mechanical shocks, infections, temperature changes, they are important for the formation of the processes of respiration and digestion, as well as for the development of the bones and muscles of the baby. What is polyhydramnios? This is when too much amniotic fluid accumulates in the uterus, this diagnosis occurs in 1% of all pregnancies.

Types of polyhydramnios

Relative - not dangerous if the doctor is sure that the pregnant woman does not have any infection. It is most common in women who are expecting a large child.

Idiopathic - polyhydramnios, the cause of which has remained unclear.

Moderate - the size of the vertical pocket is 8-18 cm.

Pronounced - the size of the vertical pocket is above 18cm, and more than 24cm.

Borderline, a tendency to polyhydramnios - when the level is at the borderline between the norm and the elevated level. Observation is required.

Acute - when the amount of water increases at a high speed. Quite dangerous for the life of the fetus, if no action is taken by the doctors.

Chronic - the amount of fluid is above normal, but stable.

Causes of polyhydramnios during pregnancy

Experts say that it is possible to find out the causes of polyhydramnios only in 2 cases out of 3. It turns out that one third of pregnant women with this diagnosis have idiopathic polyhydramnios (without apparent reason). Why does a woman have this problem?

Uncontrolled diabetes mellitus in a woman.
Multiple pregnancy. In most cases, it happens that one child receives more blood and nutrients than another, which leads to complications.
Anomalies in the development of the fetus. In this case, it can be difficult for the baby to swallow and process the amniotic fluid. This occurs due to cleft lip or palate, hydrocephalus, problems with the gastrointestinal tract, nervous system or heart.
Fetal anemia.
Cardiovascular disease in pregnancy.
Incompatibility of blood of mother and child.
Problems in the work of the placenta.

Signs and Diagnosis

If we are talking about a mild form, then usually a woman does not feel any suspicious abnormalities.

If the case is severe, then there is shortness of breath, swelling in the lower abdomen and rare trips to the toilet in a small way.

Polyhydramnios is usually diagnosed after an ultrasound. It can be prescribed unscheduled if the gynecologist suddenly noticed some signs - high blood pressure, a urinary tract infection suddenly appeared, the stomach became larger than normal and edema appeared.

Treatment Methods

If polyhydramnios is acute, then an amniotomy will be prescribed to remove excess water. If it is chronic, then it will be better to prolong the pregnancy until the due date and prescribe complex therapy.

Is it possible to recover at home folk remedies? I strongly recommend that you follow the doctor's instructions and do not use any herbal remedies or homeopathy. There are a number of drugs that are used depending on the cause of polyhydramnios, we will discuss them in detail below. BUT folk remedies leave for the treatment of colds.

What does an obstetrician-gynecologist usually prescribe?

Actovegin, Curantil. These funds are prescribed to everyone in a row, with the slightest deviation from the norm. To use them or not for prevention is the decision of every woman. Here are interesting data on each of the drugs: Curantil and Actovegin.
Antibacterial drugs (Amoxiclav, Ampicillin, Wilprafen, Rovamycin, Cefazolin). Some of them are prohibited during pregnancy, but their use is possible if the benefit exceeds possible risk. In most cases, polyhydramnios reveals the infection that led to it. It is necessary to take tests and determine which antibiotic these bacteria have an increased sensitivity to. This method is an order of magnitude more effective than just drinking a randomly selected drug for prevention.
Wobenzym. The drug of animal and vegetable origin. It is used in complex therapy with antibacterial drugs.
Diuretics (Canephron, Hypothiazid).
Indomethacin. Decongestant and anti-inflammatory drug. Helps to normalize fluid levels.
Vitamins.

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Water is the first thing a child is introduced to. Even in the womb, he swims in a fluid called amniotic. What amniotic fluid looks like and what is the norm by week (table) of pregnancy you will learn from the article.

Why amniotic fluid is needed

Amniotic fluid is essential for normal development child in the womb, they are needed for

protecting the child from loud sounds, shocks (water - absorbs noise and is a shock absorber during shocks);
maintaining a comfortable temperature (amniotic fluid has a temperature of 37 degrees);
protection from external threats (the bladder with amniotic fluid is sealed, which allows you to protect the child from external influences);
feeding the baby (water does not allow the bladder to shrink, preventing clamping of the umbilical cord);
freedom of movement of the baby (in the 1-2 trimester, the baby can move freely, swim in the amniotic fluid).

At birth, leaving the native environment, the child experiences stress, which water helps to relieve. When the birth ligament is washed off a newborn baby, he relaxes. This is very important to prepare for a new stage of his life.

The composition and rate of amniotic fluid

The membranes of the fetus begin to form after the fertilized egg attaches to the wall of the uterus. Then it starts difficult process. From the fetal membranes (amnion and chorion), a protective bubble is formed with a sterile liquid inside. As the fetus grows, the bubble increases.

Amniotic fluid is formed due to the "leakage" of maternal blood plasma. On the later dates the child himself, his lungs, and kidneys are already involved in the production and renewal of amniotic fluid.

Amniotic fluid consists of water (97%) with proteins dissolved in it, mineral salts (calcium, sodium, chlorine). It can also detect skin cells, hair, aromatic substances.

There is an opinion that the smell of amniotic fluid is similar to the smell of mother's milk, so a newborn baby can easily find his mother's breast, because he drank a liquid similar to milk in the womb.

Norm and pathology

The normal amount of amniotic fluid by the end of pregnancy is 600-1500 ml. For a number of reasons, these figures may deviate from the norm up or down. Then doctors talk about polyhydramnios or oligohydramnios.

Oligohydramnios is diagnosed when future mother less than 500 ml of amniotic fluid. The reason for the decrease in the amount of water lies in the insufficient development of the endometrium (water membrane) or a decrease in its secretory ability. Other causes of pathology include

anomalies in the development of the genitourinary system of the child;
maternal hypertension;
inflammatory diseases of a woman;
metabolic disorders, obesity;
fetoplacental insufficiency.

Oligohydramnios in one fetus during the bearing of twins is explained by the uneven distribution of blood in the placenta.

With oligohydramnios, there are severe pains in the abdomen, painful movements of the child, the uterus is reduced, the size of its bottom does not correspond to the gestational age.

With polyhydramnios, the secretory function of the aqueous membrane is increased. Polyhydramnios can lead to:

diabetes mellitus, infectious and viral diseases of the mother;
diseases of the heart, kidneys;
incompatibility of the Rh factor in the blood of mother and child;
multiple pregnancy(polyhydramnios in one fetus, oligohydramnios in another);
placental disease.

Signs of polyhydramnios are heaviness in the abdomen, swelling of the legs, breathing and blood circulation become difficult, the child's movements become too active.

Low water and polyhydramnios - dangerous pathologies. To eliminate them, the help of a specialist is required. At the slightest suspicion, you should consult a doctor.

Deviations in the color of amniotic fluid

Normal amniotic fluid is colorless and clear. The consistency is similar to water, odorless. Most often, expectant mothers are concerned about the change in the color of amniotic fluid.

You can judge the color of amniotic fluid during their outflow, which occurs during childbirth. In most cases, if the pregnancy is full-term, the water is clear or hazy yellow. This is their normal color, it does not pose a danger. The task of a woman after the outpouring of water is to get to the maternity hospital within 2-3 hours.

Amniotic fluid may be of a different color.

In red dots. A slight admixture of blood in a fluid of a normal (light or hazy yellow) color is considered normal, as it indicates the opening of the cervix.
Green color. The original feces of the child stain the greenish or marsh color of the water. The child experiences oxygen starvation, swallowing such water is dangerous for the development of pneumonia in the baby.
Red. Dangerous color, indicates internal bleeding in the mother or fetus. The most correct decision is to take a horizontal position, urgently call an ambulance.
Dark brown. This color indicates the death of the fetus, you should immediately consult a doctor.

If the color of the amniotic fluid changes, the mother and child may be in danger. Therefore, it is better not to get to the maternity hospital on your own, it is worth calling an ambulance, reporting the color of the waters.

Water research methods

To date, there are several ways to obtain information about the state of the amniotic fluid before the onset of the birth process. All methods are divided into invasive (requiring direct material sampling) and non-invasive (not requiring penetration into the uterine cavity).

The only non-invasive method is ultrasound. This study can provide information about the amount of amniotic fluid, allows you to diagnose oligohydramnios or polyhydramnios.

The remaining methods of research (invasive) are associated with high risks, therefore, they are carried out according to serious indications.

Amnioscopy. Inspection of amniotic fluid with an amnioscope. This device is a tube with a light fixture at the end. Examination of the expectant mother is carried out on a gynecological chair by inserting the device into the cervix. The doctor pays attention to the color, consistency of the water. Examination is possible after 37 weeks if fetal hypoxia is suspected, Rhesus conflict.
Amniocentesis. Unlike amnioscopy, amniocentesis is performed after 16 weeks of pregnancy, when the fluid volume reaches 150 ml. a needle is inserted into the amniotic cavity under ultrasound control, a small amount of fluid is taken. Amniocentesis requires serious indications: suspicion of genetic diseases or intrauterine infections, Rh conflict, insufficient oxygen supply, chronic diseases of the mother.

Invasive diagnostic methods are associated with the risks of abortion, premature rupture of amniotic fluid, miscarriage, placental abruption. Only a doctor can prescribe the procedure.

Amniotic fluid rates by week of pregnancy

With increasing gestational age, the amount of amniotic fluid increases. Approximate calculations look like this:

30 ml at 10-11 weeks;
100 ml for 13-14;
400 ml for 17-20;
1200ml for 36-38;
600-800 a few days before delivery.

The amount of amniotic fluid is individual for each expectant mother, the above calculations are approximate, so doctors do not measure the amount of amniotic fluid in milliliters, using the definition of "amniotic fluid index". It is measured using an ultrasound machine starting at 16 weeks. The rules look like this:

73-201 mm (average 121) at 16 weeks;
77-211 (127) at 17;
80-220 (133) at 18;
83-230 (137) at 19;
86-230 (143) at 20;
88-233 (143) at 21;
89-235 (145) at 22;
90-237 (146) at 23;
90-238 (147) at 24;
89-240 (147) at 25;
89-242 (147) at 26;
85-245 (156) at 27;
86-249 (146) at 28;
84-254 (145) at 29;
82-258 (145) at 30;
79-263 (144) at 31;
77-269 (144) at 32;
74-274 (143) at 33;
72-278 (142) at 34;
70-279 (140) at 35;
68-279 (138) at 36;
66-275 (135) at 37;
65-269 (132) at 38;
64-255 (127) at 39;
63-240 (123) at 40;
63-216 (116) at 41;
63-192 (110) at 42.

These figures can be seen in the medical card, in parentheses are the average figures for each stage of pregnancy. Only a doctor can correctly decipher the data, since the norms of the amniotic fluid index depend on the individual characteristics of the body.

Leakage of amniotic fluid

You can determine the leakage of amniotic fluid at home. There is a special test pad for this. The method is quite popular, but such a gasket is quite expensive (400-600 rubles), and the result is not always reliable. So a positive result can show not only leaking water, but also inflammatory diseases.

An accurate result can be obtained in the hospital after examining the discharge.

The most informative way to determine the leakage of water is amniocentesis. A safe dye is injected into the fetal bladder with a needle, and a swab is placed in the pregnant woman's vagina. Staining the swab will show leakage of amniotic fluid. This method is used in special cases when the child's life is at risk.

We do not remember what happened to us before birth, but, apparently, we were fine. First, heat: amniotic fluid always keeps at around 37.C. Secondly, it is quiet: the liquid absorbs shocks well and drowns out the noise coming from the outside world. Thirdly, calmly, because thanks to the absolute tightness of the bubble (some compare it to a ship that “delivers” the baby to its destination), nothing superfluous gets into it. In addition, there are s in the amniotic fluid that protect the little man well from possible troubles. And the amniotic fluid can also be compared with a kind of buffer that protects the baby from pressure from the outside world and makes sure that the main means of communication with the mother - the umbilical cord is not pinched. In addition, the child is not deprived of freedom of movement (especially in the early stages). He swims in the amniotic fluid, and this trains the muscles well. It consists of proteins, carbohydrates, fats and hormones, in general, everything that feeds the baby for nine months.

Experts note that during the first bath after birth (its purpose is to wash off the original lubricant), children relax perfectly, feeling themselves in a familiar environment. And this is very important before you start completely new life in a completely different world - the world of fresh air.

How are formed

When a fertilized egg attaches to the 5th wall of the uterus and begins to divide, three components of a complex mechanism appear: membranes, placenta and umbilical cord, in fact, the embryo ( future baby). Membranes - two thin shells - are a sealed bubble with an absolutely sterile liquid inside. By the end of the second week of pregnancy, the bubble completely fills the uterus, and up to 14 weeks, the amniotic fluid seeps into the baby's body through the skin. Then it skin are enriched with keratin and become thicker, and from that moment on, water enters through other channels. For example, in the digestive tract: the baby absorbs liquid and removes it from the body along with urine. Over time, the volume of water processed by him reaches several liters per day, despite the fact that there is always about one liter of fluid in the uterus. Where does it come from?

Amniotic fluid is formed by sweating blood plasma from the mother's blood vessels. In late pregnancy, the baby's lungs begin to take part in the production of amniotic fluid. By the end of the term, its amount reaches 1-1.5 liters, and every three hours it is completely renewed, with one third being processed by the baby.

Almost 97% of the amniotic fluid is water, in which a variety of nutrients are dissolved: proteins, mineral salts (calcium, sodium, chlorine). In addition, it can detect skin cells, hair and aromatic substances - alkaloids. There is an opinion that the smell of amniotic fluid is similar to the aroma of mother's milk, which allows a newly born baby to accurately determine where the mother's breast is. By the way, in the West, in some maternity hospitals, newborns do not wash their hands so that they can suck their fingers, “flavored” with amniotic fluid, to the smell of which they are so used to.

System start

Amniotic fluid is a living environment, thanks to being in which many vital functions begin to work in a child. The kidneys of the little one begin to work due to the fact that he swallows water, processes and removes them along with urine (in bladder the baby is detected already at the 9th week of pregnancy). Over time, the child, like a fish, begins to “inhale” the liquid, doing the first and very important exercise for the lungs, preparing them for breathing in a normal atmosphere. During childbirth, the lungs contract, the rest of the amniotic fluid comes out, and immediately after that, the baby takes his first breath.

Due to the fact that the child is always in the amniotic fluid, a white greasy coating appears on his skin, the so-called primordial lubricant. On the day of delivery, after a rupture of the membranes (regardless of whether this happens naturally or artificially), fluid enters the birth canal and washes them, which helps the baby move forward. If the baby lies head down, then at the beginning of childbirth, only those waters that are in front are poured out, while the rest protect him further, and come out only with the birth of the baby. There is an assumption that there are substances in the amniotic fluid that give a signal for the onset of labor, but since this mechanism has not yet been fully understood, it is impossible to say about their existence with complete certainty. Only one thing is known for sure: at the end of pregnancy, it begins to put pressure on the cervix, which helps it to open up.

Required volume

Amniotic fluid is secreted by the cells of the fetal bladder, and after 20 weeks, it is mostly formed by the kidneys of the fetus. By the end of pregnancy, the baby absorbs about 4 liters of amniotic fluid every day, swallowing them. In the gastrointestinal tract, they are absorbed and then excreted through the urinary tract. From the fetal bladder, excess water is removed through special tubules and pores along with the urine of the fetus, epidermal scales and secretion products of the sebaceous glands of the skin. The composition of amniotic fluid is constantly changing depending on the state of health of the mother and child and on the gestational age. Amount of amniotic fluid must be defined. Doctors set the norm in the range from 600 to 1500 ml. If it exceeds 1.5 liters, then a condition called m arises. When the amount of amniotic fluid is less than 0.5 liters, they speak of oligohydramnios.

Much depends on this volume. Waters provide free movement of the crumbs, participate in metabolism, protect the umbilical cord from being squeezed between the wall of the uterus and the baby. During childbirth, the lower part of the fetal bladder, filled with water, helps the normal opening of the uterus. When it is fully opened, the waters pour out. This process indicates the imminent birth of the baby.

Without amniotic fluid, the baby can be in your ikk for no more than 6 hours. The baby will feel the increase or decrease in the amount of amniotic fluid immediately. And the first thing he will feel is discomfort. But you can protect your baby from discomfort. Try not to get sick during pregnancy, watch your blood pressure and be sure to tell your doctor about everything that worries you. This will help to quickly recognize the problem and prevent complications.

Polyhydramnios

Polyhydramnios (polyhydramnios) occurs in 0.5-1.5% of all pregnancies. If the baby's movements have become less active, and you hear a distinct gurgling in your hiccup, it is possible that the amount of amniotic fluid has exceeded the norm. Hurry to the antenatal clinic, where the doctor will compare your gestational age and the size of the uterus. With polyhydramnios, it becomes tense.

Why does it happen

Polyhydramnios does not mean that you are drinking too much liquid. The causes of the disease can be infections or, diabetes mellitus, incompatibility of blood according to the Rh factor of the mother and baby, or multiple, with intrauterine infection, abnormalities in the development of the fetus. In no case do not panic and do not worry! Together with your doctor, you will prevent dangerous consequences.

What do you feel

With polyhydramnios, you may be disturbed by vomiting, a feeling of heaviness and pain below a. Sometimes accompanied by edema. An enlarged uterus can put pressure on neighboring organs and interfere with their normal functioning. As a result of high mobility, the fetus may take incorrect positions. In very rare cases, doctors resort to early delivery. Volume a at the level of the navel with polyhydramnios reaches 100-120 cm or more. Childbirth with polyhydramnios is most often premature, they are accompanied by an early outpouring of amniotic fluid. Due to overstretching of the uterus, weakness of labor activity, postpartum hemorrhage and other complications may occur. In some cases, in order to avoid a threat to the life of the mother, with severe polyhydramnios, impaired respiratory function and fetal circulation, there is a need for early delivery. But if there is no threat to your health, then you can carry the baby as intended. Another nuisance is that due to overstrain of the skin, numerous (stretch marks) form on e. Do not forget to lubricate problem areas with special creams from the series for pregnant women.

What happens to the baby

With polyhydramnios, it is much more difficult for a doctor to assess the condition of the crumbs, to feel his body and listen to the heartbeat. In this situation, there is a high probability of developing malformations of the nervous system and the gastrointestinal tract of the baby. With anomalies (malformations) of fetal development, the process of swallowing water by the fetus is disrupted, as a result of which the balance between their production and excretion changes. On examination, the height of the fundus of the uterus and the circumference a exceed the normal for this period pregnancy. The fetus actively swims in the amniotic fluid, which can cause the umbilical cord to wrap around the neck and torso.

How to treat

It is possible that you will have to lie down to save. In the hospital, you will be prescribed drugs that will increase urination, vitamin therapy, and other means to regulate amniotic fluid. The doctor will constantly monitor the development of your crumbs to prevent any trouble. If suspected, the doctor clarifies the diagnosis with the help, while excluding intrauterine infection, fetal malformations.

There are two forms of polyhydramnios: acute and chronic.

In chronic polyhydramnios, the amount of water increases gradually. If at the same time the condition of the pregnant woman remains satisfactory, then the doctor conducts outpatient treatment: limits the use of table salt, prescribes diuretics - drugs that stimulate the excretion of fluid from the body.

Acute is much less common than chronic. In this case, the amount of amniotic fluid increases dramatically within a few hours or days. In this condition, there is a sharp increase in the size of the uterus, in some cases, a woman has pain in e, shortness of breath, pronounced. The condition of a pregnant woman may worsen so much that she needs emergency help. Note that this condition often causes premature birth. To confirm the diagnosis, methods are also used to detect malformations of intrauterine development of the fetus (the content of alpha-fetoprotein in the amniotic fluid is determined).

In acute polyhydramnios, a woman is hospitalized and assigned to bed rest. In case of severe shortness of breath and pain in e, abdominal amniocentesis is performed (piercing the fetal bladder through the anterior abdominal wall). The fluid is released slowly, at a rate of 500 ml / h, because the rapid removal of even a small amount of amniotic fluid can be complicated by placental abruption and premature birth.

oligohydramnios

Do you feel pain when the baby moves? Contact your doctor and he will prescribe an additional examination. Usually, the appearance of oligohydramnios (oligohydramnios) is explained by a decrease in the excretory capacity of the cells of the fetal bladder. This pathology is observed in 0.3-0.4% of all births, but with congenital malformations of the fetus, it can occur 10 times more often.

The outcome of the disease largely depends on the time of its occurrence. Most dangerous in the second and third trimesters. It is at this time that the baby needs space so that he can actively move.

Doctors explain the transferred viral or exacerbating chronic diseases. Often this problem occurs in women who smoke. In addition, it may be a consequence of metabolic disorders, diseases of the genital organs, hypertension. Regular tests will help doctors detect the problem early and fix it.

With oligohydramnios, complications of pregnancy and childbirth often occur: primary weakness of labor activity develops, and the frequency of bleeding increases. Frequency breech presentation fetus increases to 13%.

Oligohydramnios is a reduction in the amount of amniotic fluid to 500 ml or less as a result of an imbalance between their absorption and production. Most often, this condition is observed in younger pregnant women with increased arterial m in the third trimester of pregnancy and in women with an increased risk of developing fetal malnutrition (lagging behind the size of the fetus from normal for a given period).

First of all, if you suspect it is necessary to exclude congenital malformations of the fetus, especially if it is detected in the second trimester (up to 28 weeks) of pregnancy, because sometimes the expressed can be combined with such defects as polycystic kidney disease or their absence. Oligohydramnios, as well as, can be a sign of intrauterine infection of the fetus, so it is necessary to conduct an examination for latent infection. Oligohydramnios can occur against the background of a decrease in the excretion of urine by the fetus into the amniotic cavity during chronic hypoxia, which is observed with intrauterine growth retardation. In 40% of women with m, there is a lag in the size of the fetus from the norm. Due to a sharp decrease in the volume of amniotic fluid, compression of the umbilical cord (between the fetus and the walls of the uterus) may occur, which can lead to acute oxygen deficiency and fetal death; extremely rarely, adhesions (fusions) are formed between the walls of the uterus and the skin of the fetus.

Since it is “flat” with oligohydramnios, it does not perform the function of a hydraulic wedge, does not contribute to the opening of the cervix, as a result, there is a danger of weakness in labor activity. Due to the violation of the active motor movements of the fetus in the uterine cavity, the frequency of breech presentations increases, and, as a result, in some cases, cesarean section operations. More often, weakness of labor activity and intrauterine hypoxia of the fetus lead to operational childbirth with oligohydramnios. Oligohydramnios can be primary (observed with whole fetal membranes) and secondary, or traumatic (as a result of damage to the fetal membranes with a gradual outflow of water, which sometimes goes unnoticed by a woman: a lagging behind normal for a given period of pregnancy, reduced physical activity fetus, the uterus is dense on palpation, the parts of the fetus and the heartbeat are clearly defined. With a vaginal examination during childbirth, a "flat" stretched over the fetal head is determined. Most likely, doctors will fight the disease, against which a complication has developed. To avoid intrauterine growth retardation of the child, you will be corrected for placental insufficiency. If detected before 28 weeks of pregnancy, a comprehensive examination of the pregnant woman is carried out to determine possible cause and evaluation of the fetus. If fetal malformations are detected, pregnancy is terminated for medical reasons. When oligohydramnios is combined with intrauterine hypoxia and fetal growth retardation, appropriate therapy is carried out until 33-34 weeks of pregnancy, and if the treatment is ineffective and the fetus's condition worsens, early delivery. During childbirth, a “flat” fetal bladder is opened to prevent weakness of labor activity.

I remember this taste

Food preferences are laid down in the early stages of human development, in fact, even before birth. As American researchers have established, love for garlic or citrus fruits manifests itself from the very first taste sensations of a child. Future food addictions are determined by what was included in the mother's diet during pregnancy and lactation. For example, if a woman loves carrots and consumes them regularly, then the baby will eat a bright vegetable with pleasure.

Important

To be aware of what is happening in your e and whether it is convenient for the baby there, be sure to do tests on time. Follow all doctor's instructions. Monitor status amniotic fluid will help:

Fetal and dopplerometry;

Fetal CTG (cardiotocography);

blood test for intrauterine infection;

a blood test for Rh antibodies if you have negative blood (serological conflict);

blood test and smear for TORCH infection.

As we can see, and and are quite serious conditions. Nevertheless, constant monitoring makes it possible to recognize these pathological conditions in the early stages of development, to carry out medical supervision of a woman, and thereby save the mother and child.