[yellowdart]

I had my 28 weeks appointment on Wednesday and they thought I was measuring large (but it's hard to tell, since I had a pretty pudgy belly before pregnancy too), so the midwife ordered an ultrasound for this morning. At the ultrasound they decided I've got borderline low fluid (8.2 cm AFI, in the 2nd percentile for gestational age). Baby and placenta looked great - they checked kidneys, cord flow, everything. The midwife later checked my cervix and determined there was no fluid leak.

I'll go back in a week for another check. A "high risk" OB came in to talk to me about low fluid. Mine isn't dangerously low, but it's pretty low and they want to keep monitoring it. I asked if drinking more water could help and he said it wouldn't make any difference (!). Afterwards, the midwife told me to drink tons of water.

So, here I am drinking tons of water. I've also read that maybe I should try to increase my salt? Anyone else have ideas for improving AFI? Has anyone gone through this? Does this make it less likely I can have a nice uncomplicated birth?

 

[corrabelle]

My friend had this problem and she was told to drink more water, more frequently etc. Her fluid level didn't go up much, but it never went down to a danger point-it rather maintained itself and everything was fine. They continued to monitor the baby on a by-weekly basis for the duration of the pregnancy, and she had a healthy, normal, natural birth.

She was later told by her ob (after she worried for 4 months!) that the ultrasound isn't always very accurate at measuring (just like the weight of the baby).

Keep us posted, i'm interested to know what comes of this.

 

[yellowdart]

Thanks for the nice response. It's really nice to read about good outcomes.

So, I had a recheck US yesterday which found that my fluid's back up to 10.71, which is just fine. Probably all the water made a difference, and it could just have been a bad measurement last week too. Whatever, I'm happy! I'll try to keep up my gallon-a-day habit for at least the rest of the pregnancy, though. It's not really that hard.

 

[by-the-lake]

Like the good news! Keep it up!

 

[mama2mad]

Glad for the good report!

I was going to say in my last preg I had low fluid (6.8 iirc). I had the u/s done at a high risk ob and he pushed that I needed to drink lots of water, that how hydrated (or dehydrated) you are has a pretty big impact on your fluid levels. they had me wait 2wks for another u/s and when I went back it was around 12!!

I figure upping the amt of water you drink is most likely not going to do any harm and will benefit your body in more ways than one

 

[yellowdart]

So, three weeks later (32 weeks 3 days) and today my AFI was 7.2, which is lowish again. The high risk OB they brought in to consult today told me that "if everything looks ok" they will "let me go to 39 weeks then deliver me", otherwise they might induce earlier.

Baby looks great and is huge (78th percentile for size, measuring a week and a half ahead), NST was perfect, cord and placenta have no problems, movement is good. From what I know now about borderline low fluid, I don't think I would let them induce me for this. We'll talk about it though - I trust my midwives more than I trust these high-risk OBs, who seem to be extra alarmist about everything.

The OB did emphasize that I should do kick counts every day, and call if movement seems decreased, or even just if I have even a funny intuition, and I appreciate that.

I'm going to have weekly AFI checks and NSTs for a while now. I want to know if there's really a problem, so I'm doing these rechecks, and I know if it hits the fan I will have amazing OBs nearby ready to jump in and save the baby, but also I really want to be as smart as I can about avoiding a cascade of interventions in labor due to this one possibly dubious measurement, especially when all the other indicators are just fine. I wouldn't even be having these AFI checks if I weren't measuring large (probably due to being overweight and having pre-existing belly fat), which is why the midwives sent me for a growth scan in the first place.

Anyway, for now I just keep drinking water. That's my low fluid update for today.

 

[yellowdart]

Quote:

Originally Posted by corrabelle

My friend had this problem and she was told to drink more water, more frequently etc. Her fluid level didn't go up much, but it never went down to a danger point-it rather maintained itself and everything was fine. They continued to monitor the baby on a by-weekly basis for the duration of the pregnancy, and she had a healthy, normal, natural birth.

She was later told by her ob (after she worried for 4 months!) that the ultrasound isn't always very accurate at measuring (just like the weight of the baby).

Keep us posted, i'm interested to know what comes of this.

Reading this again - this is pretty much what I expect will happen to me. I think the OB who threatened me with induction was just being kinda dumb and insensitive. It's good to have a general idea of how things might play out if IUGR or poor NSTs develop or something, but this "we'll let you go to 39 weeks" nonsense was pretty much unnecessary.

 

[Amy May]

Yellowdart- good for you for being proactive in taking care of yourself, and continuing to drink a ton of water. I'd definitely recommend salting to taste too- your organs are working super hard to filter everything, and you need salt!

Good for you also for asking questions and talking to your midwives and not just taking what the doctor says as gospel. This is my own personal annoyance, but I really don't like those threats, especially the "if I LET YOU" do something. It is YOUR body and YOUR baby, and YOUR decision! You can do whats best when you have the info you need to make an informed decision, not when you're bullied into doing something or are made to feel like you don't have permission in your own body.

Anyway, keep up with the water, and keep us posted- we are sending you good vibes!

 

[Vermillion]

DDCC to subscribe and follow your story!

I was told my fluid looked a little low after an u/s at 16 weeks. At my 18 week anatomy scan, I was told it was on the low side of normal, and then again at a follow up for the fluid the other day at 21 weeks. Like you, my baby looks great and is growing on target, & the placenta and cord looked good, no leaks... so for now I'm looking at growth scans every few weeks to monitor. I don't know my exact AFI number (though I read that wasn't even a great/accurate way of measuring) but instead am going by the largest pocket of fluid, which is "adequate"... just at the lower end of normal right now.

Honestly it's freaking me the heck out, especially since I had a 17 week loss a few years ago! I feel like my baby is fine, and nobody else seems super concerned right now, just keeping an eye on things, which I am very thankful for! ...so I'm just trying hard to focus on the "normal" part of "low normal"... Right now I'm just supposed to be taking it really easy and drinking lots of water! & of course keeping my fingers crossed that it all turns out well in the end and the little guy stays healthy!

Anyway, thinking lots of good thoughts for you and your little one!!! This kind of stuff can be so stressful!

 

[alpenglow]

Quote:

Originally Posted by yellowdart

Reading this again - this is pretty much what I expect will happen to me. I think the OB who threatened me with induction was just being kinda dumb and insensitive. It's good to have a general idea of how things might play out if IUGR or poor NSTs develop or something, but this "we'll let you go to 39 weeks" nonsense was pretty much unnecessary.

Totally agree. How patriarchal/condescending to suggest they would "let you go".

I had low amniotic fluid with my first (can't remember the actual number but it was 2nd or 3rd percentile or something like that). I was followed by a team of family physicians at a family obstetrics clinic....and they were fine with letting it go...but they did say that in a larger hospital they would want to induce at 38 weeks or so. HOWEVER, I also developed quite high blood pressure and underwent daily NST's until baby born. Baby was totally fine, active, etc. I managed to delay induction until 40 + 3....and had them make sure my cervix was ripe (Bishop score good). Induction (with pitocen drip) and birth went fine (except for the hemorrhage afterwards...no surprise with high BP and induced labour), baby did great.

Before dd1 born, I researched oligohydramnios (low fluid)....and basically ultrasounds are not that accurate when compared to actual fluid measurement. There may even be something on the Cochrane database of systematic research reviews.

So if low fluid late in pregnancy is the only issue (and remember baby is producing a new batch of fluid every 3 hours) then I think I recall that that alone is not shown by evidence to be a valid reason for labour induction before full term. Outcomes (baby's health, etc.) are thought to not be affected by low fluid alone (unless it's earlier in pregnancy - can cause club foot, etc). It's when it is combined with other factors that it is an issue.

I am curious if OB's make more money from labour inductions???

 

[MamabearDeTrois]

Hello, OP,

I have been thoroughly searching the internet trying to find some semblance of reason, someone who is going through what I am so early. You are one of the earliest, as is another poster her. IUGR. I am 29 weeks.

I wanted to ask you about the AC measurement. AC = Abdominal circumference. From everything I have read and researched, this is the very first (and most accurate) method of detecting IUGR early on. This is because, as my previous Peri described, the baby stores fat in its abdomen. Unfortunately, when it is suffering from IUGR, it depletes these fat stores to continue getting adequate nutrition. So, instead of growing with the rest of baby, growth here will slow or stop first, indicating baby's nutrition is not well (from amnio, placenta).

My son's AF has gone from being ~10 to being ~7.6.
His AC has gone down from being ~19 (being on target) to being ~21 (a 3 week lag).

This seems to indicate IUGR. We are only 29 weeks. IUGR seems to be more common later in pregnancy (35, 39 weeks, or the more rare 32 weeks), and it seems the disabilities and risks seem to be based on the CAUSE of the IUGR, not just the IUGR itself.
Do you know what the cause of your IUGR is?

Thanks!

Quote:

Originally Posted by yellowdart

So, three weeks later (32 weeks 3 days) and today my AFI was 7.2, which is lowish again. The high risk OB they brought in to consult today told me that "if everything looks ok" they will "let me go to 39 weeks then deliver me", otherwise they might induce earlier.

Baby looks great and is huge (78th percentile for size, measuring a week and a half ahead), NST was perfect, cord and placenta have no problems, movement is good. From what I know now about borderline low fluid, I don't think I would let them induce me for this. We'll talk about it though - I trust my midwives more than I trust these high-risk OBs, who seem to be extra alarmist about everything.

The OB did emphasize that I should do kick counts every day, and call if movement seems decreased, or even just if I have even a funny intuition, and I appreciate that.

I'm going to have weekly AFI checks and NSTs for a while now. I want to know if there's really a problem, so I'm doing these rechecks, and I know if it hits the fan I will have amazing OBs nearby ready to jump in and save the baby, but also I really want to be as smart as I can about avoiding a cascade of interventions in labor due to this one possibly dubious measurement, especially when all the other indicators are just fine. I wouldn't even be having these AFI checks if I weren't measuring large (probably due to being overweight and having pre-existing belly fat), which is why the midwives sent me for a growth scan in the first place.

Anyway, for now I just keep drinking water. That's my low fluid update for today.

 

[tutucrazy]

Two posts by Gloria Lemay on the subject...

Low Amniotic Fluid....I Don't Think So:
http://www.glorialemay.com/blog/?p=60

Low Amniotic Fluid Scam:
http://www.glorialemay.com/blog/?p=306

 

[yellowdart]

Quote:

Originally Posted by MamabearDeTrois

Hello, OP,

I have been thoroughly searching the internet trying to find some semblance of reason, someone who is going through what I am so early. You are one of the earliest, as is another poster her. IUGR. I am 29 weeks.

I wanted to ask you about the AC measurement. AC = Abdominal circumference. From everything I have read and researched, this is the very first (and most accurate) method of detecting IUGR early on. This is because, as my previous Peri described, the baby stores fat in its abdomen. Unfortunately, when it is suffering from IUGR, it depletes these fat stores to continue getting adequate nutrition. So, instead of growing with the rest of baby, growth here will slow or stop first, indicating baby's nutrition is not well (from amnio, placenta).

My son's AF has gone from being ~10 to being ~7.6.
His AC has gone down from being ~19 (being on target) to being ~21 (a 3 week lag).

This seems to indicate IUGR. We are only 29 weeks. IUGR seems to be more common later in pregnancy (35, 39 weeks, or the more rare 32 weeks), and it seems the disabilities and risks seem to be based on the CAUSE of the IUGR, not just the IUGR itself.
Do you know what the cause of your IUGR is?

Thanks!

Hello! What I've got is just low fluid - they looked for IUGR and didn't find any sign of it. I don't remember what my baby's AC was, but they didn't think there was any growth restriction problem. Just low fluid for no apparent reason and with no apparently ill effects. They also checked the placenta healthy and cord blood flow for any signs of problems. I think those would be connected to IUGR. In my case, however, everything looked perfect except for the unexplained low fluid.

Sorry I couldn't help more. I hope your babe's numbers come up and he's healthy.

Thanks for the articles, Amy May! They definitely support my thinking on the issue. As long as there are absolutely no signs of any real problems, I would be extremely hesitant consent to an induction for this.

As it happens, I had another AFI scan today which showed the fluid up a bit, enough to be just over the percentile threshold for normal (5th percentile today vs 2.5th percentile last week). So, now they're completely happy - I got no talking-to from a high risk guy, and they canceled all the NSTs and AFI scans I had scheduled going forward. Ha! I have a growth scan in three weeks, and my AFI could easily dip again, and then they will panic again I suppose and rush me off for another perfect NST.

I definitely appreciate having access to advanced high-tech medical care, and if they suspect a problem I want to be sincere in having it investigated, but I am a little unimpressed with how this has been handled, especially by that MFM guy who last week was mumbling about how my baby would probably survive ok if we induced now and if I'm a good girl maybe he'll let me go to 39 weeks, and this week didn't think he had to see me at all, all because my AFI went up by one point.