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| |    Complications Related to Amniotic Fluid by Elisa Ross, MD reviewed and revised by Marjorie Greenfield, M.D. Amniotic fluid provides the baby with a protective cushion of warm water to float in while he is developing. Occasionally, however, problems will develop with the level of amniotic fluid, or an analysis of the fluid reveals other concerns. Increased amniotic fluid Sometimes an ultrasound will show that more amniotic fluid is present than was expected, a condition known as polyhydramnios. The mother-to-be or her practitioner may notice the increased size of the uterus as well, due to the increased fluid volume. Most of the time a cause for polyhydramnios can't be found and the pregnancy progresses normally. Some conditions are associated with too much amniotic fluid, however. Depending on the exact situation and the ultrasound findings, the healthcare provider may evaluate for diabetes in the mother, larger-than-normal fetal size, fetal circulatory problems, or conditions associated with a fetus' difficulty swallowing the amniotic fluid. Decreased amniotic fluid Conversely, an ultrasound sometimes will reveal less amniotic fluid than expected, which is known as oligohydramnios. The most obvious cause for this is the leakage of the fluid. (The opposite isn't always true, however--some pregnancies in which the membranes have ruptured will not show a decrease in fluid.) If oligohydramnios is seen on ultrasound, it very often will resolve itself by the next time an ultrasound is performed. Some fetal positions make it appear that there is less fluid than there really is. If the low fluid persists and the possibility of leakage has been ruled out, the ultrasonographer will evaluate the fetal growth and anatomy and possibly the placental functioning. Babies who are on the small side often have less fluid than their normal-sized counterparts. In some cases, the baby might grow at a slower rate because her parents are small or because she's destined to be a petite person. It's important, however, that your practitioner evaluate a small-for-gestational-age baby, because some birth defects are associated with slow growth and low fluid level. In rare situations, a baby gets less than the expected amount of fluid and nutrition because the placenta is not functioning particularly well. If that's the case, specialized testing is available to help decide if the baby needs to be born early. Because amniotic fluid is recycled through the baby's urinary tract, a blockage near the baby's kidneys or bladder may result in less fluid being released by the fetus. Signs of these blockages often can be seen on an ultrasound. Finally, sometimes decreased fluid signals the need for delivery; other times it's a sign that labor is impending. Meconium in the fluid Occasionally, meconium (stool) will be found in a baby's amniotic fluid. This is quite common once the due date is passed. While meconium is unlike regular stools in that it has no odor and no germs, it still can pose problems if it gets into a baby's lungs. (It can cause irritation, which interferes with the baby's breathing.) Therefore, every effort is made at delivery to remove any meconium-stained fluid from the baby's mouth and throat so that her first breath won't draw the fluid down into her lungs. We used to think that meconium in the fluid was a sign that the baby had been stressed, but now it seems that it's usually just a demonstration that her intestinal tract is working--she was ready to poop and didn't know she were supposed to wait until after birth!
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