how "real" a reason is low amniotic fluid? - Mothering Forums
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#1 of 9 Old 04-20-2007, 12:58 PM - Thread Starter
 
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not asking for me, but for someone i know...

her doctor wants to induce her at 37 weeks for low AF--it's hovered around 8 for several weeks, dipped down to 6.something, and back up to 8. (from what i recall, truly "low" is below 5 anyhow...so not sure what's up with hers being supposedly low.)

i know nothing about this issue and am just frankly curious. it seems odd to me that low AF is such a concern because, if you're not being constantly monitored with u/s, how would they ever know you had low AF? that is, if low AF is a huge danger, then wouldn't doctors and midwives want to monitor everyone in late pg for AF levels? i, for example, have not had an u/s since 22 weeks...so if i had "low" fluid, how would anyone ever know?

not worried that i do, just saying...it seems like one of those things where, if you are looking for problems (constant u/s), you find them.

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#2 of 9 Old 04-20-2007, 01:22 PM
 
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i, for example, have not had an u/s since 22 weeks...so if i had "low" fluid, how would anyone ever know?
I don't profess to know much about it either, but there are symptoms of low AF. If a baby isn't moving around as much or if Mama has had any leaking fluid (even specks that she just thought was a touch of pee), it can be cause for concern and a check. How acurate the check is, however, is a major problem for me (as would be determining that I'm low on AF even if I had a small-but-within-normal-range dip and declaring I need an induction at 37 weeks! .
But truly low AF could signal other problems, and the incidences of cord prolapse do theoretically increase with truly low AF. These 'truly low AF' problems are rare though, so in the absence of symptoms or well-below-normal estimations, for the most part it's just one of those 'better safe than sorry' things that - in many cases - turns out to be not-so-safe, IMHO.

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it seems like one of those things where, if you are looking for problems (constant u/s), you find them.
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#3 of 9 Old 04-20-2007, 01:48 PM
 
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I don't profess to know much about it either, but there are symptoms of low AF. If a baby isn't moving around as much or if Mama has had any leaking fluid (even specks that she just thought was a touch of pee), it can be cause for concern and a check. How acurate the check is, however, is a major problem for me (as would be determining that I'm low on AF even if I had a small-but-within-normal-range dip and declaring I need an induction at 37 weeks! .
But truly low AF could signal other problems, and the incidences of cord prolapse do theoretically increase with truly low AF. These 'truly low AF' problems are rare though, so in the absence of symptoms or well-below-normal estimations, for the most part it's just one of those 'better safe than sorry' things that - in many cases - turns out to be not-so-safe, IMHO.


Actually, cord prolapse is more common with too much amniotic fluid than too little. If there is an excess amount of fluid, the baby will most likely be floating and the incidence of cord prolapse is higher when the water breaks. Cord compression, however, is what is often of concern with too little fluid, along with the idea that if there is too little amniotic fluid, that must mean that the placenta is degrading.

I had a repeat section with my second for too little amniotic fluid (1.8 cm) and i still have no idea if i did the right thing

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#4 of 9 Old 04-20-2007, 01:52 PM
 
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Hm, I thought that low AF was pretty easily remedied by just drinking a lot of water. Maybe that's not true in severe cases? I don't have any experience with it, personally.
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#5 of 9 Old 04-20-2007, 02:21 PM
 
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Women who drank 2 liters within 2 hours and then waited 4 to 6 hours before the test had increased their AFI (amniotic fluid index) by 3.0+/-2.4 cm

-According to Anne Frye in Understanding Diagnostic Tests in the Childbearing Year

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#6 of 9 Old 04-20-2007, 05:24 PM
 
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Ultrasound is not reliable for predicting low amniotic fluid, either.

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#7 of 9 Old 04-20-2007, 05:27 PM
 
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it's totally subjective and NOT accurate. there are lower levels of fluid at the end of pregnancy anyway. it's when there are low levels mid-pregnancy or before term that we worry.

IMO, it's another bogus reason to control labor by the medical model (and even some midwives). The whole biophysical profile is pretty much iffy on its determination of baby's well-being.

What I find interesting is how many times they deem "low fluid" and then go on to artificially release a mother's membranes/water to get labor going.
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#8 of 9 Old 04-20-2007, 05:52 PM
 
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I am still very bitter about my second DS's birth.They were doing weekly NSTs on me because I was considered high risk due to pre pregnancy high blood pressure which was controlled very well by medication.I had been running late and hadn't had my usual breakfast and when they did the U/S part they found the fluid was low ( I think it was at 7) The supervising Dr breezed in galnced at my chart and said we have to induce (at 37 weeks and 6 days).I asked him if he was sure since I had no support system in place until two more days.He glanced back through my chart and said yes becuase there could be cord prolapse.he was going to allow me to make arrangements for my oldest since the baby showed nice movement but he wanted me to check in that night for an induction.I went ahead and did it but after reading more and talking to my regular Dr I am sooo angry.
My baby's head was so engaged in my pelvis that the only way he was going to move was further out, he was already at plus 1, no chance of cord prolapse.I should have been remeasured after drinking more fluids.I think he just felt that since I was there and "term" might as well rescue the baby.yeah, my son is healthy yada yada but I wonder how much happier he'd be if I'd followed his clock.
They did start the labor with breaking my water.

joy.gifme, herding 5 critters a cat and a dog. DS 11/01, DS 10/04, DD 2/06, DS 5/07 and DD 9/10

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#9 of 9 Old 04-21-2007, 05:43 AM
 
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I was induced for Low AFI, and I regret doing it - although it isn't a BIG regret, because i was only induced with the gel, not with pitocin, and I went into labour right away - which indicated to me that I was "ready" and would have gone on my own soon anyways.

However, in hindsight, it shouldn't have been a good reason to induce, and I was lucky I didn't get caught up in the cascade effect due to it.

In my case, my DD had, and still has a HUGE bladder. I don't know why i didn't put two and two together at the time. Previous to that, I had an ultrasound which showed an enormous bladder and I was rushed to a high-tech hospital for further tests because they were sure it was an obstruction. By time I got there, her bladder was half the size. I am sure now, in hindsight, that my low AFI readings corresponded more with the babies urinary habits, rather than anything dangerous and I should have said "lets wait x amount of time and see if its still decreasing or changes" to be sure. That's what I will do this time.

So if i were your friend, and my AFI were going up and down from 6 to 8, i would definitely fight induction.

Milkydoula, thanks for that tidbit - I'm totally going to drink 2 L of water before my next U/S.
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