Whether you are travelling by car, plane, bus, or train, sitting for long periods of time in cramped spaces can make a pregnant person very uncomfortable.  Here are some things you can do to make your trip more enjoyable:

●     Drink water.  Dehydration can cause fatigue, headaches, and lightheadedness, so it is important to stay hydrated.

●     Bring healthy snacks.  The motion involved with travel can make first trimester nausea worse, but you can help by eating small healthy snacks frequently and avoiding getting either too hungry or too full.

●     Bring a pillow (assuming you are not the driver.): you will be more comfortable if you need a little nap.

●     Wear loose-fitting comfortable clothes and slippers or shoes.  It is also a good idea to dress in layers, so you can adjust to indoor air conditioning/heat and the outdoor elements.

●     Wear support hose: both pregnancy and prolonged immobility increase your risk for blood clots.  Support stockings put mild pressure on the blood vessels of the lower extremities to improve blood flow and help counteract this risk.  They can also decrease swelling.

●     Take breaks regularly: every 90 minutes or so try to get out, walk around, stretch your legs, and use the restroom.  You can also do some seated leg exercises to keep the blood flowing.

If you are driving or riding in a car, always wear your seatbelt.  If you get in a car accident, the risk for injury to you and the baby is far greater if you fly out of the car than any seatbelt injury you or the baby may acquire.  However, it is recommended that pregnant women wear their seatbelts low across their abdomens below their bellies.  The reason for this is that if it is worn higher, a sudden jolt could tear the placenta away from the uterus (although this is not common.)

Assuming you are having a normal healthy pregnancy, airplane travel is generally unrestricted during the first and second trimesters.  If you have diabetes, high blood pressure, bleeding, placenta problems, preterm labor, a history of clots, or other complications it is a good idea to consult your doctor before booking your flight.  Different airlines have different restrictions regarding flying during the third trimester, not because it is necessarily unsafe for you or the baby, but because they do not want you to go into labor while in the air.  If you planning to fly in the third trimester, it is a good idea to contact the airline to make sure you are aware of their specific policies and to have a note from your doctor stating your due date and giving his/her permission for you to fly.  Most doctors discourage flying after 36 weeks, but if you do, ask your doctor for a referral to another provider in the area so that you have someone to contact if you do go into labor or have other pregnancy-related problems.  It is also a good idea to bring part of your chart containing things like number and outcome of previous pregnancies, lab and ultrasound results, a few recent blood pressure readings, any medical allergies, and current medications as well as a name and phone number for your doctor.

Airport screening is also considered safe in pregnancy.  Metal detectors are still the most common screening modality and emit low frequency electromagnetic waves which are considered safe for everyone.  However, there are also two newer technologies being used in some airports.  Both create an image of the surface of the body to detect objects that might be hidden under clothes.  The back-scatter machine emits low level xrays (about 1/1000 of the radiation of one chest xray or the equivalence of two minutes of a high-altitude flight.)  The other is mm-wave scanners.  These emit non-ionizing millimeter length radiation that does not have the strength to damage DNA.  The radiation for both of these is minimal and considered safe even in pregnancy, but because the technology is relatively new, the effects have not been thoroughly studied.  Typically these methods are used as a secondary screening, so you may be able to opt to go through the metal detector instead.  If not, you can always ask for the pat-down if you or your doctor are uncomfortable with these newer scanners.

Folic acid is a B-vitamin that is required for the production of DNA and essential for the rapid cell division needed to form fetal tissues and organs during pregnancy. If there is an inadequate amount of folic acid, the neural tube, which will later become the spinal cord, brain, and vertebral column, may not form correctly or close completely. When either of these things happen, a neural tube defect occurs. The neural tube (and thus neural tube defects) form very early in pregnancy, usually 4-6 weeks from the first day of the woman’s last menstrual period (or 2-4 weeks after conception); this is often before the woman even knows she is pregnant.

The two most common types of neural tube defects are spina bifida and anencephaly. Anencephaly is a condition where the upper part of the neural tube fails to close, causing the brain to either not develop completely or be completely absent. Pregnancies affected by anencephaly often result in miscarriage or the baby will die soon after birth. Spina bifida occurs when the lower portion of the neural tube does not close, which leads to improper develop of the spinal cord and vertebrae. There will often be a sac of fluid that protrudes through an opening in the back with a portion of the spinal cord also contained in it. There is a wide range of severities, but paralysis of the legs, lack of bowel or bladder control, hydrocephalus, and learning disabilities are all possible results of spina bifida.

Any woman could have a baby with a neural tube defect. However, there are some known risk factors. If you have had a previous pregnancy that was affected by a neural tube defect, your risk increases about 20 times. Women with insulin-dependent diabetes, women who take seizure medication, women who are obese, women who are exposed to high temperatures early in pregnancy (high fevers or hot tub/sauna use), and white or hispanic women (more often than black women) of lower socio-economic status appear to be at higher risk. Regardless of your risk status, all women should take at least 400 micrograms of folic acid daily to reduce your risk. Because the neural tube begins to form before you are aware of your pregnancy, it is a good idea to take folic acid before you are pregnant. If you are at particularly high risk, ask your doctor about taking a much larger dose of folic acid while you are trying to conceive and for the first three months of your pregnancy.

Not all of neural tube defects can be prevented, but 50-70% of them can just by getting adequate amounts of daily folic acid starting BEFORE you are pregnant. You can easily do this by taking a daily multivitamin containing at least 400 micrograms of synthetic folic acid and eating foods fortified with folic acid like cereals and breads. Naturally occurring folate founds in foods like leafy greens is slightly harder for the body to utilize, but still serves as a source for folic acid. It is recommended that ALL women CAPABLE of becoming pregnant consume adequate daily folic acid and not just those planning a pregnancy. If this would occur, the incidence of neural tube defects would be significantly reduced.

1. Frequent Urination:

During pregnancy, more blood flow is directed to the kidneys, allowing them to eliminate waste more efficiently and sending you to the bathroom more often.  The expanding uterus also puts pressure on the bladder causing more frequent urination.  It can be frustrating to finally fall asleep, only to awaken a short time later because you need to urinate, but it is not uncommon.  You may be able to minimize this symptom by drinking as much fluid as you can during the day, but limiting your intake in the hour or two preceding bedtime.  You should also limit caffeine because it is a diuretic and can make the problem worse.  In addition, it is important to make sure that you are completely emptying your bladder.  This will both help prevent infections and make you need to urinate less often.

2. Nausea and Heartburn:

Both are common first trimester symptoms and sleep disturbance culprits.  Try elevating the head of your bed by propping yourself up on pillows and eating small snacks throughout the day so that you never get too hungry or too full since both states tend to aggravate nausea and heartburn.  There are also medications available that are considered safe in pregnancy and used to treat severe nausea and heartburn.  If you consider your symptoms severe and/or your sleep has been significantly disturbed, ask your doctor if a medication may be right for you.

3. Nasal Congestion and Snoring:

Higher amounts of estrogen can cause swelling of the nasal mucosa leading to congestion and potentially snoring and sleep disturbance.  Using a saline nasal spray or a humidifier at bedtime may help

4. Leg Cramps:

There is nothing worse than being jolted awake in the middle of the night by a horrible cramp in your calf, and it does appear that pregnant women are more susceptible to such awakenings.  This may be because the growing uterus is placing more pressure on the blood vessels of the legs, but there may be other factors involved.  Avoiding sitting with your legs crossed, stretching your calf muscles regularly (and especially before bed), drinking plenty of water, exercising daily, and sleeping on your left side may help prevent these painful cramps and improve sleep.  If you do get a cramp, try stretching it gently by pulling your toes backwards.

5. Restless Leg Syndrome:

Restless leg syndrome (RLS) is a crawling, tingling, burning sensation (usually) in the legs that is relieved by movement.  However, it is very difficult to fall asleep if you need to keep moving.  The cause of RLS is unknown, but it does seem to be more common and more severe during pregnancy possibly due to the increased estrogen or circulatory changes that take place.  Caffeine and diphenhydramine seem to make it worse in some people, so avoid or limit those.  You should also avoid laying in bed (watching tv or reading) for long periods of time before you are ready to sleep.  The longer you lay still, the more likely it is that your symptoms will kick-in making sleep difficult.

6. Anxiety:

It is common and normal to feel a certain amount of anxiety about the baby’s health and safety, future characteristics and life, your parenting capabilities, etc. However, if this anxiety is interfering with your sleep, it can become a problem.  Try to implement some relaxation techniques to help you clear your mind and prepare for sleep.  Try a warm bath, a massage, writing in a journal, or talking to a friend or your significant other.  If none of these things provide any relief, discuss it with your doctor.

General Recommendations for healthy sleep:

●     Maintain a regular sleep schedule.  If you go to bed and wake up at approximately the same times each day, your body will learn to sleep and wake at those times.

●     Do not watch tv or use the computer or other electronic devices in the hour or so preceding bedtime.  Studies have shown that the lights from these devices can cause insomnia.

●     Get regular daily exercise but not in the hour or two before bed.

●     Sleep on your left side.  This position maximizes the blood flow to the placenta and baby.  You can make this position more comfortable by putting a pillow between your legs.

Antihistamines like diphenhydramine have a side effect of drowsiness, so they are sometimes used as a sleep aid.  They are considered to be safe in pregnancy, but it is always a good idea to discuss any new medication with your doctor.

●     Estrogen: cycles up and down throughout the menstrual cycle, but will begin being produced in abundance by the placenta once it is formed.  It improves the blood supply to the uterus to allow the baby to grow.  It’s production will continue until the end of pregnancy when you will have 1000 times more estrogen than your non-pregnant self!

●     Progesterone: is manufactured by your body and has anti-inflammatory properties, which aids in preventing your body from rejecting the baby.

●     Human Chorionic Gonadotropin (hCG): helps regulate the amount of progesterone being produced to ensure that it is enough to sustain the pregnancy until the placenta is completely formed and functional.  It’s concentration doubles every 48 hours during the first trimester.  It has been hypothesized that this hormone plays a role in causing morning sickness.

The progesterone and hCG hormones are increasing so rapidly that your body doesn’t have time to adjust before they increase again; this may leave you feeling irritable one minute and happy the next.  You may find yourself tearing up over silly commercials without understanding why.  And then you take the test.  And it’s a big fat positive.  And you are thrilled.  But also a little shocked (even if you were trying and had been dreaming of this moment), and a little scared, and very excited, and a little anxious, and a little worried, and still wondering if it’s real and thinking it might be a good idea to take a few more tests to be absolutely sure……

Pregnancy is a time of great change, and it is normal to worry and feel stressed and overwhelmed about all the things that are changing or will change.  Even if you are stoked about being pregnant, you might find yourself wondering if you will be a good parent, how the new baby will affect your relationship with your significant other and/or other children, what the new baby might mean for your job or career, how you will handle the financial burden of having a child.  In addition to the changes that a baby will surely evoke on your life, pregnancy causes many physical changes.  Most women experience symptoms beginning in the first trimester, which may include nausea, fatigue, tender breasts, heartburn, and increased urination (potentially resulting in less sleep.)

So between the raging hormones, worries and insecurities about inevitable changes, and the physical symptoms and exhaustion, it is no surprise that pregnant women are prone to fluctuating emotions and moodiness.

What can you do?

●     Talk to someone (your significant other, a friend, a counselor) about your worries.

●     Take deep breaths.

●     Try to maintain balance in your life: eat well, get plenty of rest, exercise, do things you find enjoyable

Talk to your doctor if you feel that your moodiness is severe or if you are depressed.

●     Baby 5-10 pounds

●     Blood volume increase 4 pounds

●     Breast tissue 2-3 pounds

●     Placenta 2-3 pounds

●     Amniotic fluid 2 pounds

●     Uterine mass 2-5 pounds

This adds up to 18-27 pounds.  Losing the weight associated with these components will be effortless (unless you count pushing the baby out as effort).  Delivering your baby will result in an immediate weight loss of 10-15 pounds (baby, amniotic fluid, and placenta).  After the baby is born, you will likely notice an increase in sweating and urination.  Your body is working hard to lose the blood volume and fluid that was necessary during pregnancy.  Over the next six weeks, your uterus will also shrink back to its original size.

However, you will also gain some fat stores during your pregnancy, though the amount varies among women.  It is necessary to gain a small amount of fat during pregnancy to support the developing baby and prepare your body for lactation.  However, the more fat stores you gain, the more difficult it will be to lose after the baby is born.  But remember, it took you nine months to gain the weight, so you should expect it to take at least as long to lose it.  Be patient.

If you are nursing, you will need to be careful about losing weight too quickly, restricting your diet too much, or exercising too vigorously because it may affect your supply.  However, most women are able to resume light exercise 6-8 weeks after delivery.  It’s a good idea to consult your doctor first, especially if you had a c-section.

So what should you do?

●     Give yourself a break.  Spend the first 6 weeks postpartum getting to know your baby, figuring out nursing (if you choose to do so), and trying to get some sleep.  Try to make healthy food choices, but don’t worry about counting calories or going on a diet quite yet.  Don’t worry too much about exercise either.  If you feel up to it, try some kegel exercises, gentle stretching/yoga, or easy walking.  Your body needs time to recover from the pregnancy and delivery and adjust to your new life-style.

●     Attend your postpartum appointment and ask about diet and/or exercises.  Ask if there are any restrictions and if your provider has any suggestions.

●     Start moving!  Exercise is an important part of any weight loss program because it encourages your body to lose fat rather than muscle, but start slow.  If you exercised before and during your pregnancy, you will be able to gradually work back up to your previous duration and intensity of exercise, but start slowly.  Plan to do less than you think you can handle on your first time out.  If you were not an exerciser before pregnancy, now is a great time to start!  Try something simple like walking around the block with the stroller, and gradually increase the distance.  There are also a variety of exercise DVDs available that you could do while the baby is napping.  If you are fortunate enough to have someone else to watch the baby while you work-out, you could try classes at the gym, biking, swimming, etc.  Find something you enjoy, and stick with it.

●     Start thinking about what you are eating.  Try to make healthy choices.  Eat fruits, veggies, lean protein and dairy.  Avoid processed foods and too much sugar.  If you want to count calories, you can, but it is important to not be too restrictive (especially if you are nursing.)  Women need 1200-2200 calories per day and at least 1800 if they are nursing, more if they are also exercising regularly.  If you do decide to count calories, start by figuring out about how many calories you typically consume, and then try to decrease that by 200-500 calories per day.  If this results in more than a pound per week of weight loss, you may need to increase your intake slightly.

Be patient.

Assuming your timing is good and there are sperm available, one of them will sneak through the outer membrane and fertilize the egg. (It is actually thought that hundreds of sperm are required to release enzymes that eat away at and penetrate the outer membrane for the one lucky winner to sneak through.) After fertilization, the outer membrane’s proteins change to make it impossible for another sperm to get in. The fertilized egg immediately begins to divide, while the follicle that produced the egg begins to make progesterone, and will continue to do so until the placenta is formed and can take over. Progesterone thickens the uterine lining preparing it for implantation and prevents the body from rejecting the baby.

When the zygote reaches the uterus, it has already divided several times. It attaches itself the uterine wall of the endometrium; this process is called implantation and can occur anywhere between 6 and 10 days after ovulation. Some women will have a small amount of harmless spotting when implantation occurs but most women do not have any idea that it is happening.

Once the embryo is firmly implanted, it will divide into two parts. One part will become the placenta, and the other will become the baby. Your estrogen, progesterone, and hCG levels are all continuing to rise in order to support the pregnancy. You can reliably take a pregnancy test 5-7 days after implantation (which is about the time you are expecting your next period. The increasing hormone levels may also cause some other early pregnancy symptoms including bloating, mild cramping, mood swings, skin break-outs, constipation, heartburn, and sore, tender, or tingly breasts. (Most women do not experience nausea until they are around 6 weeks gestation.) If you are having any of these symptoms, you could be pregnant! However, these symptoms are all non-specific and can be quite similar to symptoms that occur right before you get your period or could be related to other conditions. Therefore, it is impossible to tell for sure until you miss a period and get a positive pregnancy test.

Sushi:
The perceived concerns with sushi are the potentially high levels of mercury and the possibility that raw fish may contain bacteria or parasites that are unsafe for pregnant women. Consuming very high levels of mercury is a real concern for the baby’s developing nervous system; however, there are many sushi options made with low-mercury fish that are considered safe in pregnancy like salmon, crab, and trout. You should, however, continue to avoid sushi made with high-mercury fish like swordfish and mackerel. The other concern is that the raw fish may carry bacteria. The risk of contracting food poisoning from raw fish is the same regardless of whether you are pregnant or not. However, severe food poisoning could cause dehydration or a miscarriage. Some sushi is actually prepared with cooked fish, so if you are concerned, try one of those options. However, the raw fish is typically flash frozen, which kills potentially harmful bacteria and parasites making it safe. If you love sushi, there is no reason why you shouldn’t be able to enjoy it (in moderation) throughout your pregnancy.

Caffeine:
Caffeine has acquired a reputation for causing miscarriage and preterm birth, but studies have been inconclusive. In 2008, two studies were conducted on this topic. One (published in American Journal of Obstetrics and Gynecology) found that women who consumed more than 200 mg caffeine daily were twice as likely to suffer a miscarriage than women who did not drink any caffeine. The other study (published in Epidemiology) found that there was no increased risk of miscarriage in women who drank 200-350 mg of caffeine daily. The conflicting results of these studies do encourage further research in this area; however, most experts agree that caffeine is safe in moderation. Moderate amounts of caffeine (150 mg – 300 mg) have not been shown to cause any adverse effects on pregnancy. One 12 oz cup of coffee has about 200 mg of caffeine. So feel free to enjoy your morning cup of coffee (just don’t have five).

Artificial Sweeteners:
Artificial sweeteners are found in many sugar-free foods, low calorie foods, and diet soda. Some people believe that artificial sweeteners can cause problems for the baby or the pregnancy, but there is no evidence for this. Research is limited in this area; however, experts agree that artificial sweeteners like aspartame and splenda are safe for pregnant women to use in moderation. Sweet n’ low has been shown to cross the placenta. The effects it has on the baby is not known, but it is better to stick with the other approved sweeteners.

Another common misconception regarding food in pregnancy is that you must eat for two. Pregnancy can be exhausting, and it does increase energy (calorie) expenditure. However, this additional energy requirement is actually quite minimal. Most women require about 300 additional calories (ex: an apple and a glass of milk) per day in the first and second trimesters and up to 500 additional calories in the third trimester. You certainly do not need to double the amount of food you eat, and if you do, you will be at increased risk for excessive weight gain which will be harder to lose after the baby is born.

As long as you practice moderation, it is safe to consume sushi and other fish, caffeine, and artificial sweeteners. Moderation is also an important principle to keep in mind when making daily food choices. Remember that you are not eating for two and really only require a few extra calories, and do your best to make those extra calories count by choosing vitamin-rich, nutritious foods from a variety of food groups.

While mild nausea and vomiting can be unpleasant, uncomfortable, and exhausting, it does not pose any risks to the baby. However, if you experience severe vomiting that makes it impossible for you to keep any food or liquids down, if you are losing weight, or if you have decreased urination or other signs of dehydration, it is a good idea to be evaluated by your physician. Otherwise, it is safe to manage your nausea at home.

Change the way you eat:
Eat smaller more frequent meals. Many women find that the nausea is worse if they are really hungry or really full, so try to avoid both extremes. Eat a small snack at the first sign of hunger and avoid large or fatty meals. Avoid foods that make your nausea worse.

Fluids:
It is important to stay hydrated especially if you are vomiting. Try consuming clear, sour, carbonated beverages like 7UP, Sprite, ginger ale, or lemonade. Take small sips often rather than guzzling a can all at once.

Avoid strong odors:
Many women are especially sensitive to odors during pregnancy. Perfumes, chemicals, cleaning supplies, coffee, food, smoke, and toddler diapers are all odors that could worsen your nausea. It may be impossible to avoid them completely, but it is a good idea to try. Perhaps you could ask your husband to change diapers when he is home. You could eat lunch outside rather than in the cafeteria to avoid strong food smells. Avoid bars and other places where smoking is allowed.

Avoid other things that trigger nausea:
Although nausea triggers are different for every woman, some common ones include heat and humidity, motion, excessive exercise, being tired, and brushing teeth. Try to stay indoors during the hottest parts of the day. Ask to ride in the front seats of cars or buses and look straight ahead. Change positions slowly (laying to sitting, sitting to standing). Keep your exercise routine moderate. Get plenty of sleep. Try using children’s toothpaste since the flavor is not as strong.

Medications:
If the above lifestyle changes do not help with your nausea, there are medications available that are effective and safe in pregnancy.

Vitamin B6 is thought to reduce mild to moderate nausea but not vomiting. B6 may be included in your prenatal vitamin but it is probably safe to take more. Ask your physician.

Doxylamine is an antihistamine that is found in some over-the-counter sleep aids and is effective in decreasing vomiting. Many women take B6 and doxylamine together.

Diphenhydramine and meclizine are other antihistamines that can be used to help with nausea. They are safe in pregnancy but may cause drowsiness.

Phenergan, Reglan, And Zofran are prescription medications that are safe in pregnancy and can be effective for treating nausea and vomiting of pregnancy.

Do your best to eat a variety of healthy foods in small meals dispersed throughout the day, consume plenty of liquids in small amounts, and avoid triggers. If you continue to experience nausea, talk to your doctor about trying an over-the-counter or prescription medication.

Early pregnancy symptoms include:

Tender or enlarged breasts: after conception, the progesterone level begins to increase immediately. This can lead to tender and swollen breasts and is often one of the first things a woman might notice.

Nausea with or without vomiting: around 75% of women will experience some nausea in the first trimester. Most women won’t notice it until after their pregnancy test becomes positive, but some do. You may be more likely to notice it earlier if you are having multiples because your hormone levels will increase faster.

Increased urination: this is again due to hormonal changes

Food aversions or cravings: many women experience aversions to certain foods throughout pregnancy especially if they are already feeling nauseated. Cravings may also occur throughout pregnancy.

Fatigue: ranks up with nausea as one of the most commonly reported symptoms of early pregnancy. It occurs because of the increased progesterone as well as the additional work your body is doing to grow a human.

Dizziness: early in pregnancy blood vessels dilate causing your blood pressure to drop. This may leave you feeling lightheaded or dizzy. Low blood sugar may also cause lightheadedness or dizziness in early pregnancy.

Constipation: the increased progesterone causes GI motility to slow, resulting in constipation. The iron in prenatal vitamins may exacerbate the condition.

Headaches: the sudden rise in hormones during early pregnancy can lead to headaches.

Emotional Lability: the flood of hormones in early pregnancy may make you especially emotional. You may find yourself crying when you normally wouldn’t or experience sudden changes in mood: happy as a lark one moment and irritated or angry the next.

A feeling: many women report feeling pregnant without really being able to explain why.

Implantation bleeding: a small amount of vaginal bleeding that occurs when the fertilized egg attaches to the lining of the uterus. It is usually earlier, lighter in color and flow, and shorter than a regular period. It is sometimes accompanied by abdominal cramping. Most women do not experience this, but if you do, it could be a good indication that you are pregnant.

An increase in basal body temperature: you would only recognize this if you are taking your temperature daily as a method to detect ovulation. Progesterone causes the basal body temperature to rise after ovulation. It will stay elevated if you are pregnant. If you are not pregnant, it will drop around the time of your next period.

Unfortunately, all of these signs and symptoms can have alternative causes, so even if you have one or more of them, you might not be pregnant. It’s also possible that you would have none of them and actually be pregnant. However, if you do have several of these symptoms and have missed a period, it is a good idea to take a home pregnancy test. If the test is positive make an appointment with your doctor to begin prenatal care.

The amniotic fluid index (AFI) can be measured via ultrasound, and if it is less than 5, a diagnosis of oligohydramnios is made. This can occur at any time during the pregnancy, but it is more common in the last trimester.

There are a variety of causes for oligohydramnios. They include:

A tear in the amniotic sac will cause fluid to gush or leak out, resulting in decreased fluid levels.

Birth defects of the kidneys or urinary tract could cause defects in fetal urine production, which could lead to low amniotic fluid.

A problem with the placenta could lead to inadequate blood and nutrients to the baby, resulting in decreased urinary output and low amniotic fluid levels.

After 40 weeks gestation, the placenta becomes aged and less efficient at providing nutrients to the baby, which causes a decrease in urine output and amniotic fluid. Pregnancies that last longer than 40 weeks are therefore more likely to have oligohydramnios as a complication.

Maternal factors such as dehydration, hypertension, pre-eclampsia, hypoxia, and diabetes can also play a role in causing oligohydramnios.

The risks associated with oligohydramnios vary depending on the stage of the pregnancy. If it is detected in the first trimester, the risks are greater than if it is not detected until later. Low amniotic fluid in the first trimester can cause compression of fetal organs and birth defects as well as an increased risk for miscarriage and still-birth. If it is detected in the second half of pregnancy, it may cause intrauterine growth restriction, preterm birth, and cord compression during delivery.

The treatments available depend on the cause of the low fluid level as well as the gestational age of the pregnancy at diagnosis. If the pregnancy is at or near-term, the doctor may decide to deliver. If not, the doctor will probably watch you closely with ultrasounds (to monitor the fluid and make sure it doesn’t get dangerously low as well as the baby’s movements and practice breathing) and non-stress tests to monitor the baby’s activity levels and heart rate response to them. As long as the baby is continuing to thrive, your doctor will likely continue to monitor without necessarily doing anything. If at any point the baby appears to be in danger, the doctor may deliver early. If the oligohydramnios is secondary to diabetes or hypertension, every effort should be made to keep blood sugars and blood pressures under control as this may reduce the problem. Studies have also shown that large volumes of fluids (4-5 liters) either orally or through an IV leads to a statistically significant increase in the AFI at least temporarily. Lastly, there is a procedure called amnio-infusion where fluid is infused via intra-uterine catheter during delivery. This helps cushion the umbilical cord to prevent complications from it becoming compressed. It may reduce the need for cesarean delivery as well.

Oligohydramnios can be a scary diagnosis, but most women who have this diagnosis go on to have healthy babies. The extra fetal monitoring often provides reassurance that the baby is doing well and no further interventions need to occur. If it does become necessary to deliver early, try to remember that advances in the care of babies born early are favorable.