Question

After my 20-week ultrasound my doctor said that my amniotic fluid levels are low. What does this mean for my baby and me, and what can I do to help?

Answer

You have asked a very complex question. Low amniotic fluid levels during the second trimester might signal a problem in a pregnancy, but also might get better at the next testing, so it is important to follow through with future testing during this pregnancy. Testing for amniotic fluid levels is done through a test called the biophysical profile. This test examines five different things: fetal breathing movement, amniotic fluid levels, fetal body movements, fetal heart rates in response to fetal movements, and fetal muscle tone through bending motion of limbs. The part of the test your physician is concerned about is called the AFI (amniotic fluid index). The first thing you should know is that you didn't cause this condition, and there is little you can do to change the situation except to follow your doctor's advice. Low amniotic fluid levels can be caused by the fluid leaking from your vagina (called "ruptured membranes"), or by a problem with the baby's development, or by the placenta not functioning properly, or sometimes by a condition of the mother such as high blood pressure or diabetes. If your doctor says that your amniotic fluid is low, then you should be sure to continue with all your checkups, and follow his/her directions. Your doctor might want to have you tested every few weeks to see if the fluid has increased, and if the baby is growing properly. If the baby is growing too slowly (called "intrauterine growth restriction"), then the doctor might want to deliver the baby early, for even though a premature birth is not what we usually want, it might be healthier for a baby who is not doing well in the uterus to be born and taken care of in a neonatal intensive care unit (NICU). The biophysical profiles the doctors do throughout your pregnancy will not only test for amniotic fluid levels, but for all the other things listed above, so the doctors will know if the baby is moving well, has a strong heartbeat, and has good muscle tone. All of these things matter to how healthy the baby is. Good luck, and try not to worry too much. Remember that the vast majority of pregnancies result in healthy babies!