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tinkerbelle

Low amniotic fluid levels (yong toi sui)

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im a little troubled wif the comment given by my ob/gyn today as he mentioned that my amniotic level is quite low (@ 4.4). fyi, my EDD is on 10/06/09, which is 2 days from today.

question :

1) wat is the optimum level of amniotic fluid ?

2) the consultant ob/gyn said i shd go back for antr check up on friday (if i hvn't popped by then), so immediately i went to seek 2nd opinion in GH and the docs there insisted that im to be admitted tonite, citing that im a first time mother and it's quite risky to wait/delay until friday. so.. to admit (according to GH) or to wait (till friday, as adviced by the consultant) ?

cheers.

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1. tinkerbelle, u shd ask yr gynae or GH about optimum level of amniotic fluid. unless nckeat is around to answer, i dont think we're qualified to help u since this is a serious matter.

2. if u're admitted to GH now, is it just for observation or are they goin to induce u? if its just for observation, maybe best to follow their advise since now & friday is at least 4 days difference. a lot of things can happen. if u're still not sure, get a 3rd opinion.

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I would suggest you to just admit to the hospital and monitor the condition. Whether induce or not, I bet the doc will decide upon your condition. Anyway, I will be going for c-sec on 10/6.. Maybe our BB will share the same birthdate.

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Babycenter has a pretty good article on this - link here. What the doc did for me when I went for the ultrasound in Week 28 was scan four sections of the uterus and added them together to see the rate (she didn't mention the rate - just that it's optimum level so I guess it's above 5).

According to the same article (link above), it says

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 measure for the third trimester is between 5 and 25 centimeters (cm). A total of less than 5 cm is considered low.

I had a friend who went through her first pregnancy with low amniotic fluid. Basically she had to go to the docs to monitor her condition every week. Her first baby was a premature one (34 weeks, I think, but am not too sure if induced, C-sec or natural) - but I can tell you that you wouldn't know he was a premie if you look at his pics now (strong, healthy, very kuai kuai and smart).

When she got pregnant the second time, her doc was concerned about amniotic fluid levels because of her previous history so beginning from the 3rd trimester, she again went for regular monitoring and check-ups - at least once a week or once every two weeks. But this time, her baby was full-term - at 38 weeks and via natural delivery.

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tinkerbelle,

hope everything is ok for you.

i dont know what's the optimum level of amniotic fluid but i was told the same by my obgyn during week 38 & i was induced 2 days later. my obgyn didnt seem very "kan cheong" about it BUT he told me not to delay too long, so i chose 2 days after the visit (cos the next day was a public holiday).

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im a little troubled wif the comment given by my ob/gyn today as he mentioned that my amniotic level is quite low (@ 4.4). fyi, my EDD is on 10/06/09, which is 2 days from today.

question :

1) wat is the optimum level of amniotic fluid ?

2) the consultant ob/gyn said i shd go back for antr check up on friday (if i hvn't popped by then), so immediately i went to seek 2nd opinion in GH and the docs there insisted that im to be admitted tonite, citing that im a first time mother and it's quite risky to wait/delay until friday. so.. to admit (according to GH) or to wait (till friday, as adviced by the consultant) ?

cheers.

tinkerbelle- My amniotic level is low too, at the borderline of 7-8 (doc says it's still acceptable, but am afraid it'll drop any further & will cause fetal distress during labour). My Doc discovered this on my Week 36 & has put me on various tests to check on the condition of the baby, eg. Doppler test once, CTG scan twice weekly (i.e. is it growing to size, is the fetal heartbeat normal, is the baby getting enough nutrients/blood from my umbilical cord/placenta). On that day, he also advised me that I may need to be induced, or even the possibility of C-section. On Week37, the amniotic level has increased to 14 and all else is fine, even the result from my Doppler test. So Doc says we shall wait another week & let the baby grow inside me. Same positive results on Week38. Until Week39, Doc said my amniotic level has dropped to 8 again & baby size didn't grow that much anymore, so he asked me to check in for an induced labour on the same night! I gave birth to my baby girl 23hrs later. :)

If ur amniotic level is 4, i would think it'll warrant higher precaution? If u're going in for an induced labour, my advise is go for Epidural! I've had it & even with it, I was quite traumatise with the pain of contraction till the end, maybe coz my labour was sooooooo long & I practically konked out after the final push!

Good luck!!!

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hi ya everyone,

just got back from GH after spending 4hrs there. spoke to the nurses, doctors & specialist.

my concern is that - i DON'T WANNA BE INDUCED (i wont go into length why i dont wanna be induced, am sure everyone knows how to use google). i wanted a natural birth. since my amniotic fluid is low, the procedure in GH is to hv me induced. so i asked for c-sect and after discussing wif the doc/specialist, they said okay, they will honour the maternal request.

then i registered and got admitted into the ward. an hour later, the doc did the ultrasound and confirmed my amniotic level is very low (@ 4.0 today - she said optimum level is 7.0). however, the doc told me, the c-sect is only scheduled for friday. a bit too long to stay in GH while waiting for the c-sect on friday (mind u, it's not a holiday resort), so i asked to be discharged so that i can arrange for a c-sect in private hosp. b4 they can discharge me, i hv to do a CTC to check the fetal's heartbeat. thank god, i passed the scan.

while waiting for the discharge letter from GH, i went to the toilet and found out that i hv a big patch of brownish discharge. looks like it, i'll be able to go for natural birth afterall.

so now .. im home (thankful & praying hard) and just waiting to pop.

cheers.

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tinkerbelle,

Please be extra alert and careful, ok? Make sure your HB is within reach so that he can send to the hospital as soon as contraction starts.

I wonder whether our BB will share the same birthday or not since I am going for c-sec tomorrow.

Anyhow, I wish you all the best!!

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im a little troubled wif the comment given by my ob/gyn today as he mentioned that my amniotic level is quite low (@ 4.4). fyi, my EDD is on 10/06/09, which is 2 days from today.

question :

1) wat is the optimum level of amniotic fluid ?

2) the consultant ob/gyn said i shd go back for antr check up on friday (if i hvn't popped by then), so immediately i went to seek 2nd opinion in GH and the docs there insisted that im to be admitted tonite, citing that im a first time mother and it's quite risky to wait/delay until friday. so.. to admit (according to GH) or to wait (till friday, as adviced by the consultant) ?

cheers.

If your amniotic fluid index is low (<5) and your baby already term (>37 completed week), than the reasonable management should be offered induction for delivery immediately as low amniotic fluid is a sign for placenta insufficiency. Thus your gov doctor is correct. If you want to wait, you must have some kind of monitoring like doppler, CTG twice per day etc. Usually no benefit of waiting as we don't know what will happen next.

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i agree with nckeat. although you might read a lot of horror stories about inducement (i was induced too & to be honest, i am not looking forward to repeat the experience) BUT the main thing is the safety of your baby & you. if your doc feels an inducement is warranted, i feel it's best you follow his advice.

good luck & hope to hear good news from you soon.

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Hi all,

I have read through all the posts on this thread and seems like most of the mummies have this low amniotic fluid level in your third trimester and even approaching your due date. However, my case is bit different. I am in my week 19 and during the routine check up yesterday, my gynae mentioned that my amniotic fluid level was at borderline and the distribution of the fluid was not even. It was only found concentrated at the area around baby's head which was measured @ 4 and the rest of the areas were very less. My gynae didn't say much after that, he said could be the kidney of the baby is not fully functioning yet. His answer certainly freaked me out. Mummies with the similar experience, could you please share with me is this something to concern about as I really worry this may cause harm to my baby. When's the kidneys of the baby are going to function fully? Can the fluid intake influece the level of the amniotic fluid? I am taking average of 1.5L plain fluid a day and that is excluding soup/milk.

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Hi all,

I have read through all the posts on this thread and seems like most of the mummies have this low amniotic fluid level in your third trimester and even approaching your due date. However, my case is bit different. I am in my week 19 and during the routine check up yesterday, my gynae mentioned that my amniotic fluid level was at borderline and the distribution of the fluid was not even. It was only found concentrated at the area around baby's head which was measured @ 4 and the rest of the areas were very less. My gynae didn't say much after that, he said could be the kidney of the baby is not fully functioning yet. His answer certainly freaked me out. Mummies with the similar experience, could you please share with me is this something to concern about as I really worry this may cause harm to my baby. When's the kidneys of the baby are going to function fully? Can the fluid intake influece the level of the amniotic fluid? I am taking average of 1.5L plain fluid a day and that is excluding soup/milk.

At 19th week, normally AF is not measured as AFI because the uterus is difficult to be measured in 4 quadrants. It is usually assessed subjectively as adequate or not based on the experience of the doctor.

AF is produced due to the secretion of the lung and urine production throught the kidney. It is also reflective of the placenta function. The kidney MUST be functioning because AF is seen on ultrasound. If kidney not functioning, the AF will be none or very very little (not like AF accumulated in some pocket). BUT at the same time, the baby growth will also be retarded (especially the Abdomical circumference and thorax). Is the baby growth / parameters measurement corresponded to the date? If yes, the baby is most likely normal and healthy. Is the baby bladder visible on the scan? If yes, most likely the kidneys function is normal because the bladder is filled with urine. The other way to assess is to do a uterine artery or umbilical cord artery doppler, if both show normal pattern, most likely the baby is normal.

Fluid intake don't influence the amniotic fluid. AF is produce through the placenta, baby lung and baby kidney. The more advance the baby's age, the more the AF is produced by the kidney.

In simple words: If some amount of amniotic fluid is seen, that's fine ESPECIALLY if all the parameters of the baby is corresponded to the baby's gestational age and the bladder can be seen filled with urine.

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Dear nckeat, the baby's gestational age is in correspond to my pregnancy week. However, I was not sure about the baby's bladder as prior to this, I didn't know the bladder is visible via the scan. FYI, I was scanned via 2D ultrasound, is that good enough to see the baby's bladder? As for the tests suggested by you which are uterine artery or umbilical cord artery doppler, where can I do it and is there any risk to the baby?

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Dear nckeat, the baby's gestational age is in correspond to my pregnancy week. However, I was not sure about the baby's bladder as prior to this, I didn't know the bladder is visible via the scan. FYI, I was scanned via 2D ultrasound, is that good enough to see the baby's bladder? As for the tests suggested by you which are uterine artery or umbilical cord artery doppler, where can I do it and is there any risk to the baby?

For gerenal obstetricians, 2D is all they need for antenatal magement. 2D can see almost all the structures in the baby. 3D/4D mainly for entertainment of the patient to see their babies. As for doppler, most obstetricians machine are the mid range one which include the doppler. Though I never see you, from your description, if your baby's gestational age is corresponded to the scan measurements and some amount of AF seen, most likely the baby is normal. So in the next scan if the parameter measurements are growing according to date and liquor seems adequate (mean some pockets of liquor around the baby) most likely the baby is healthy. So ask about the bladder as well in next scan, if the bladder is visible (filled with urine), the kidneys are almost sure normal function.

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Dear nckeat, I am so much better now after your explanation. But, my next appointment is scheduled a month later from now. Do I need to ask for earlier appointment?

At 19th week, frankly nothing much can be done. So don't think earlier appointment can help unless you are so anxious that you need to calm your nerve by seeking 2nd opinion.

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Hi all,

i went for check up today, doc said i encounter low amniotic fluid level. sigh..Almost end of 2nd trimester, why do this happen? and he said its unexplainable.Is it due to heart defects or other abnormalities of the baby? Ask me not to worries but how can i'm not worried. Do i need to seek for another doc's opinion?

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