Amniotic fluid is a remarkable substance that plays a crucial role in nurturing and protecting your baby during pregnancy. Found within the amniotic sac inside your uterus, it predominantly originates from your baby’s urine and contains a rich composition of proteins, carbohydrates, urea, and lipids. Let's explore its key functions in ensuring your baby's well-being and understanding scenarios when fluid levels may require attention.

The primary functions of amniotic fluid include:

• Acting as a cushion to protect your baby from external impacts and potential trauma.
• Preventing compression of the umbilical cord, thereby safeguarding the oxygen supply to your baby.
• Facilitating free movement to promote proper bone development.
• Maintaining infection resistance and regulating temperature within the womb.

Accurate measurement of amniotic fluid levels is performed using ultrasound techniques. This can involve identifying the largest pocket of fluid or summing up measurements from four quadrants—the latter known as the AFI (Amniotic Fluid Index).

Generally, a pocket at least 2 cm in vertical diameter is deemed adequate. An AFI above 25 cm is considered excessive, while below 5 cm during the third trimester may indicate insufficient fluid. The single pocket evaluation has been found to be more reliable, reducing false positives and requiring a pocket over 2 cm for adequacy.

Excess Amniotic Fluid: Polyhydramnios

If your amniotic fluid levels are high, a condition known as polyhydramnios, your uterus may expand more rapidly than usual. Affecting approximately one percent of pregnancies, possible causes include:

• Maternal Diabetes: Occurring in about 10% of diabetic mothers, related to glucose management challenges.
• Carrying Multiples: Unequal blood distribution between twins may elevate risks.
• Fetal Abnormalities: Rarely, swallowing issues prohibit fluid processing through the kidneys.
• Fetal Anemia: Potentially due to infection or Rh incompatibility, treatable via transfusions.

Insufficient Amniotic Fluid: Oligohydramnios

Low levels of amniotic fluid, or oligohydramnios, may occur due to a variety of reasons. Your healthcare provider may suspect this if fluid leaks prematurely or based on history with conditions like preeclampsia, slowed fetal growth, or diabetes. About 8% of pregnancies experience this in the third trimester, and it's seen in 12% of cases two weeks post-term. Contributing factors may be:

• Ruptured/Leaky Membranes: While possibly self-healing, a heightened infection risk exists.
• Placental Issues: Can hinder nutrient transfer, disrupting the baby's fluid recycling.
• Medical Conditions: Conditions like diabetes or high blood pressure can play a role.
• Carrying Multiples:
• Fetal Abnormalities: Non-functional kidneys or heart defects may be involved.

Remedy

In either instance of fluid imbalance, your doctor will usually confirm levels with an ultrasound, referencing the AFI scale. Levels beyond 25 cm indicate excess, while below 5 cm suggest deficiency during the third trimester.

If too much fluid is present, an amniocentesis may be performed to rule out genetic issues and gestational diabetes testing may be conducted. Continued monitoring through ultrasounds and stress tests will be key.

In cases of too little fluid, consistent monitoring will be essential until the time of delivery. Through awareness and the support of your healthcare team, you can navigate these conditions effectively.