How much amniotic fluid is normal at 39 weeks

You may feel more winded than usual, as if you can't fully expand your lungs. You may also have unusual abdominal discomfort, increased back pain , and extreme swelling in your feet and ankles.

Your baby may be in breech or another abnormal position. If you have these symptoms, your practitioner will send you for an ultrasound. The sonographer will measure the largest pockets of amniotic fluid in four different sections of your uterus and add them together to see where you rate on the amniotic fluid index AFI.

A normal measurement for the third trimester is between 5 and 25 centimeters cm. A total of more than 25 cm is considered high. Experts don't know what causes many cases of polyhydramnios, particularly mild ones. The most common causes of polyhydramnios are:. Maternal diabetes You can end up with high fluid levels if you have diabetes and you're having trouble managing it properly.

That's because you're probably carrying a large baby as a result of your diabetes. Polyhydramnios is diagnosed in about 10 percent of pregnant diabetics, usually in the third trimester. Carrying twins or multiples You're at risk for high fluid levels if you're carrying twins or multiples because, again, they will produce more fluid than a single baby.

Polyhydramnios is especially likely in the case of twin-to-twin transfusion syndrome, in which one twin has too little amniotic fluid while the other has too much. Genetic abnormalities Babies with very high fluid levels are more likely to have a genetic abnormality such as Down syndrome. Fetal abnormalities In rare cases, a baby will have a medical problem or birth defect that causes him to stop swallowing fluid while his kidneys continue to produce more.

This may include any condition that makes it hard for him to swallow, such as pyloric stenosis , a cleft lip or palate, or some kind of blockage in the gastrointestinal tract.

Certain neurological problems, such as with a neural tube defect or hydrocephaly, can keep the baby from swallowing as well. Fetal anemia In even rarer cases, polyhydramnios can be a sign that the baby has severe anemia caused by an Rh blood incompatibility or an infection such as fifth disease. In both cases, the problem can be treated with a blood transfusion in utero.

A baby with fifth disease may recover without treatment. Infection during pregnancy. Some maternal infections, such as toxoplasmosis and syphilis , can lead to polyhydramnios.

Removing a sample of the fluid through amniocentesis can provide information about the sex, health, and development of the fetus. Placental anatomy and physiology. Gabbe's Obstetrics: Normal and Problem Pregnancies. Philadelphia, PA: Elsevier; chap 1. Gilbert WM. Amniotic fluid disorders. This may involve taking medication, monitoring your blood sugar, or making more frequent visits to your doctor.

Preexisting causes may create other issues during your pregnancy, too, so managing the cause is a win-win. But some doctors will still prescribe it in the case of low amniotic fluid. Resting in bed or on the couch except to go to the bathroom or shower may help improve blood flow to the placenta, which in turn helps increase amniotic fluid. Find that perfect Netflix show to binge on and let those around you wait on you hand and foot.

This may sound scary, but there are a couple of bonuses to extra monitoring: One, you get to see your baby more often! And two, your doctor will be able to treat any issues sooner than later.

Some research — only in animals, though — shows a modest negative effect on amniotic fluid levels when mom consumes a high fat diet. Fancy being on the safe side? You may want to just steer clear. While there are internet sites or videos claiming to have natural solutions, low amniotic fluid is a serious medical condition that can have a severe impact on your baby if not treated properly. It should be treated and monitored by your doctor.

Second of all, your doctor may recommend delivering your baby early. While this may cause mixed emotions in you, the outcomes for babies born in the last month of pregnancy are excellent. The risks of continuing a pregnancy without enough amniotic fluid, on the other hand, are high. They may include stillbirth , cord compression, or meconium aspiration. Your doctor will advise you of the benefits and risks of early delivery, but many, many babies are born preterm or early term and have absolutely no adverse effects.

You just get to hold your precious bundle that much sooner! Some signs that warrant an immediate call to your doctor include feeling your baby move less than usual or fluid leaking from your vagina.

If you do have low amniotic fluid, there are a number of treatments including delivery that can help keep your little one safe and healthy.

Polyhydramnios is another name for having too much amniotic fluid. The position of the baby can also affect the accuracy of the results. Nabhan and Abdelmoula ; Gilbert In a Cochrane review, researchers combined the results from 5 randomized controlled trials with more than 3, women. In these studies, women were randomized to either the AFI method or the single deepest pocket method.

Researchers found that when the AFI is used to measure amniotic fluid, women were 2. The researchers concluded that the single deepest pocket measurement has fewer risks and should be the preferred way to measure amniotic fluid Nabhan and Abdelmoula What is the clinical significance of low amniotic fluid when a mother reaches 37 or more weeks?

In the U. Image Source robenjoyce. However, this belief is not accurate. In early studies on amniotic fluid and outcomes, researchers included babies with congenital defects , women with pre-eclampsia or intrauterine growth restriction IUGR , and women who were post-term past 42 weeks in their samples. These women and babies are more likely to have low amniotic fluid, and they are also much more likely to have poor outcomes. So although early researchers found that babies born to women with low amniotic fluid had higher perinatal mortality rates Chamberlain, Manning et al.

There is no evidence that isolated oligohydramnios at term is a risk factor for poor outcomes. However, induction for isolated oligohydramnios leads to higher Cesarean rates.

In a systematic literature review, I found 5 studies from the last 10 years. I will discuss the 3 highest quality studies here. For results from all 5, you can see my findings summarized in this Google document table here.

After controlling for the fact that some women were induced and some women were having their first baby, the researchers found no association between Cesarean for non-reassuring heart rate and amniotic fluid. This means that the inductions were probably responsible for the higher Cesarean rates in the low amniotic fluid group. However, when the researchers controlled for gestational age, they found that the association between low birth weight and low amniotic fluid remained significant.

This means that women with low amniotic fluid were 2 times more likely to have a baby that is born beneath the 10th percentile. These babies may have had undiagnosed fetal growth restriction IUGR , which is a separate risk factor for poor outcomes.

So what is the evidence for induction because of low amniotic fluid without any other complications at term? There is no evidence that inducing labor for isolated oligohydramnios at term has any beneficial impact on mother or infant outcomes. Based on the lack of evidence, any recommendation for induction for isolated oligohydramnios at term would be a weak recommendation based on clinical opinion alone.

In summary, this is what I found about low amniotic fluid in an uncomplicated pregnancy at term weeks :. Are women in your local areas being induced for isolated oligohydramnios at term? Are consumers and clinicians aware of this evidence?

What is the standard of practice for evaluating amniotic fluid in your local facilities, AFI or Single Deepest Pocket? How do you discuss this in your classes and with your patients, clients and students?