The amniotic fluid index is the norm for weeks. Amniotic Fluid Index

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Water is the first thing a child is introduced to. Even in the womb, he swims in a fluid called amniotic. What amniotic fluid looks like and what is the norm by week (table) of pregnancy you will learn from the article.

Why amniotic fluid is needed

Amniotic fluid is necessary for the normal development of the child in the womb, they are needed for

• protecting the child from loud sounds, shocks (water - absorbs noise and is a shock absorber during shocks);
• maintaining a comfortable temperature (amniotic fluid has a temperature of 37 degrees);
• protection from external threats (the bladder with amniotic fluid is sealed, which allows you to protect the child from external influences);
• feeding the baby (water does not allow the bladder to shrink, preventing clamping of the umbilical cord);
• freedom of movement of the baby (in the 1-2 trimester, the baby can move freely, swim in the amniotic fluid).

At birth, leaving the native environment, the child experiences stress, which water helps to relieve. When the birth ligament is washed off a newborn baby, he relaxes. This is very important to prepare for a new stage of his life.

The composition and rate of amniotic fluid

The membranes of the fetus begin to form after the fertilized egg attaches to the wall of the uterus. Then a complex process starts. From the fetal membranes (amnion and chorion), a protective bubble is formed with a sterile liquid inside. As the fetus grows, the bubble increases.

Amniotic fluid is formed due to the "leakage" of maternal blood plasma. In the later stages, the child himself, his lungs, and kidneys are already involved in the production and renewal of the amniotic fluid.

Amniotic fluid consists of water (97%) with proteins dissolved in it, mineral salts (calcium, sodium, chlorine). It can also detect skin cells, hair, aromatic substances.

There is an opinion that the smell of amniotic fluid is similar to the smell of mother's milk, so a newborn baby can easily find his mother's breast, because he drank a liquid similar to milk in the womb.

Norm and pathology

The normal amount of amniotic fluid by the end of pregnancy is 600-1500 ml. For a number of reasons, these figures may deviate from the norm up or down. Then doctors talk about polyhydramnios or oligohydramnios.

Oligohydramnios is diagnosed when the expectant mother has less than 500 ml of amniotic fluid. The reason for the decrease in the amount of water lies in the insufficient development of the endometrium (water membrane) or a decrease in its secretory ability. Other causes of pathology include

1. anomalies in the development of the genitourinary system of the child;
2. maternal hypertension;
3. inflammatory diseases of a woman;
4. metabolic disorders, obesity;
5. fetoplacental insufficiency.

Oligohydramnios in one fetus during the bearing of twins is explained by the uneven distribution of blood in the placenta.

With oligohydramnios, there are severe pains in the abdomen, painful movements of the child, the uterus is reduced, the size of its bottom does not correspond to the gestational age.

With polyhydramnios, the secretory function of the aqueous membrane is increased. Polyhydramnios can lead to:

1. diabetes mellitus, infectious and viral diseases of the mother;
2. diseases of the heart, kidneys;
3. incompatibility of the Rh factor in the blood of mother and child;
4. multiple pregnancy (polyhydramnios in one fetus, oligohydramnios in another);
5. placental disease.

Signs of polyhydramnios are heaviness in the abdomen, swelling of the legs, breathing and blood circulation become difficult, the child's movements become too active.

Oligohydramnios and polyhydramnios are dangerous pathologies. To eliminate them, the help of a specialist is required. At the slightest suspicion, you should consult a doctor.

Deviations in the color of amniotic fluid

Normal amniotic fluid is colorless and clear. The consistency is similar to water, odorless. Most often, expectant mothers are concerned about the change in the color of amniotic fluid.

You can judge the color of amniotic fluid during their outflow, which occurs during childbirth. In most cases, if the pregnancy is full-term, the water is clear or hazy yellow. This is their normal color, it does not pose a danger. The task of a woman after the outpouring of water is to get to the maternity hospital within 2-3 hours.

Amniotic fluid may be of a different color.

1. In red dots. A slight admixture of blood in a fluid of a normal (light or hazy yellow) color is considered normal, as it indicates the opening of the cervix.
2. Green color. The original feces of the child stain the greenish or marsh color of the water. The child experiences oxygen starvation, swallowing such water is dangerous for the development of pneumonia in the baby.
3. Red. Dangerous color, indicates internal bleeding in the mother or fetus. The most correct decision is to take a horizontal position, urgently call an ambulance.
4. Dark brown. This color indicates the death of the fetus, you should immediately consult a doctor.

If the color of the amniotic fluid changes, the mother and child may be in danger. Therefore, it is better not to get to the maternity hospital on your own, it is worth calling an ambulance, reporting the color of the waters.

Water research methods

To date, there are several ways to obtain information about the state of the amniotic fluid before the onset of the birth process. All methods are divided into invasive (requiring direct material sampling) and non-invasive (not requiring penetration into the uterine cavity).

The only non-invasive method is ultrasound. This study can provide information about the amount of amniotic fluid, allows you to diagnose oligohydramnios or polyhydramnios.

The remaining methods of research (invasive) are associated with high risks, therefore, they are carried out according to serious indications.

1. Amnioscopy. Inspection of amniotic fluid with an amnioscope. This device is a tube with a light fixture at the end. Examination of the expectant mother is carried out on a gynecological chair by inserting the device into the cervix. The doctor pays attention to the color, consistency of the water. Examination is possible after 37 weeks if fetal hypoxia is suspected, Rhesus conflict.
2. Amniocentesis. Unlike amnioscopy, amniocentesis is performed after 16 weeks of pregnancy, when the fluid volume reaches 150 ml. a needle is inserted into the amniotic cavity under ultrasound control, a small amount of fluid is taken. Amniocentesis requires serious indications: suspicion of genetic diseases or intrauterine infections, Rh conflict, insufficient oxygen supply, chronic diseases of the mother.

Invasive diagnostic methods are associated with the risks of abortion, premature rupture of amniotic fluid, miscarriage, placental abruption. Only a doctor can prescribe the procedure.

Amniotic fluid rates by week of pregnancy

With increasing gestational age, the amount of amniotic fluid increases. Approximate calculations look like this:

• 30 ml at 10-11 weeks;
• 100 ml for 13-14;
• 400 ml for 17-20;
• 1200ml for 36-38;
• 600-800 a few days before delivery.

The amount of amniotic fluid is individual for each expectant mother, the above calculations are approximate, so doctors do not measure the amount of amniotic fluid in milliliters, using the definition of "amniotic fluid index". It is measured using an ultrasound machine starting at 16 weeks. The rules look like this:

• 73-201 mm (average 121) at 16 weeks;
• 77-211 (127) at 17;
• 80-220 (133) at 18;
• 83-230 (137) at 19;
• 86-230 (143) at 20;
• 88-233 (143) at 21;
• 89-235 (145) at 22;
• 90-237 (146) at 23;
• 90-238 (147) at 24;
• 89-240 (147) at 25;
• 89-242 (147) at 26;
• 85-245 (156) at 27;
• 86-249 (146) at 28;
• 84-254 (145) at 29;
• 82-258 (145) at 30;
• 79-263 (144) at 31;
• 77-269 (144) at 32;
• 74-274 (143) at 33;
• 72-278 (142) at 34;
• 70-279 (140) at 35;
• 68-279 (138) at 36;
• 66-275 (135) at 37;
• 65-269 (132) at 38;
• 64-255 (127) at 39;
• 63-240 (123) at 40;
• 63-216 (116) at 41;
• 63-192 (110) at 42.

These figures can be seen in the medical card, in parentheses are the average figures for each stage of pregnancy. Only a doctor can correctly decipher the data, since the norms of the amniotic fluid index depend on the individual characteristics of the body.

Leakage of amniotic fluid

You can determine the leakage of amniotic fluid at home. There is a special test pad for this. The method is quite popular, but such a gasket is quite expensive (400-600 rubles), and the result is not always reliable. So a positive result can show not only leaking water, but also inflammatory diseases.

An accurate result can be obtained in the hospital after examining the discharge.

The most informative way to determine the leakage of water is amniocentesis. A safe dye is injected into the fetal bladder with a needle, and a swab is placed in the pregnant woman's vagina. Staining the swab will show leakage of amniotic fluid. This method is used in special cases when the child's life is at risk.

Violation of the formation and absorption of amniotic fluid threatens with oligohydramnios. Let's consider this concept in more detail.

What is low water?

An insufficient amount of amniotic fluid in obstetrics and gynecology is called oligohydramnios.

Amniotic fluid (or amniotic fluid)- the liquid environment in which the fetus is located during pregnancy.

This biological fluid performs several important functions. These include:

• protective function- the water shell protects the child from the penetration of infections (due to the tightness of the shells and the immunoglobulins that make up the water), from mechanical influences from the outside (for example, from shocks and shocks), loud sounds (water muffles them), external fluctuations in pressure and temperature (maintaining optimal pressure and a constant temperature of 37 ºС, of course, if the mother is healthy and her body temperature does not exceed 37.8 ºС);
• exchange function- the child absorbs the amniotic fluid, enriched with nutrients, and releases it back.
  To all this, the fetal waters provide free movement of the crumbs inside the womb. Therefore, with a normal amount of amniotic fluid, the baby is cozy and comfortable, he is protected and provided with everything necessary.

What is in the amniotic fluid?

With increasing gestational age, the composition of the amniotic fluid changes, and becomes more diverse and saturated, which makes the waters slightly cloudy in appearance. The amniotic fluid is secreted by cells of the aquatic membrane.

At the beginning of pregnancy, amniotic fluid is almost the same in composition as blood plasma. They contain nutrients (proteins and fats), vitamins and minerals, hormones, enzymes, and more.

From the second trimester, the composition of this biologically active fluid is supplemented by dead skin cells (as a result of the natural process of changing the old skin layer to a new one), the fluff (hairs) of the fetus, the original cheese-like lubricant of the fetal body and its waste products (sterile urine).

Fertile waters are updated every 3 hours.
Drinking water does not affect the amount of amniotic fluid. From excessive fluid intake in a pregnant woman, only edema will appear.

The norm of the amount of amniotic fluid

When the amount of amniotic fluid deviates from the norm, doctors diagnose oligohydramnios or polyhydramnios. The doctor-diagnostician determines the amount of fluid during an ultrasound scan, starting from the second trimester of pregnancy.

The volume of amniotic fluid in medicine is commonly referred to as the amniotic fluid index (AFI).

Table - The norm of the amniotic fluid index by week

The norms may differ slightly from those given above, depending on the type of ultrasound machine. And also the value can be written not in millimeters, but in centimeters (1 cm = 10 mm).

Also, the amount of fetal water characterizes another indicator - the vertical size of the largest (free) water pocket (VC). This size should normally be in the range from 2 to 8 cm (or from 20 to 80 mm), with a borderline amount of water - from 2 to 1 cm (from 20 to 10 mm), and with oligohydramnios - less than 1 cm (or 10 mm).

What are the causes of oligohydramnios?

Depending on the severity of the pathology, moderate and severe oligohydramnios are distinguished.

Often you can find in the ultrasound protocol the inscription - "tendency to moderate oligohydramnios." This means that it is possible that the expectant mother has health problems and needs more careful monitoring.

Moderate oligohydramnios- this is a slight deviation in the amount of fetal water from the norm. This type of deviation may be caused by the individual characteristics of the body of a pregnant woman or, in the worst case, may be a prerequisite for the occurrence of a more severe form of this pathology. In any case, doctors recommend prophylaxis of fetoplacental insufficiency (FPI).

Moderate oligohydramnios is not a critical situation, because the amount of water is a variable number, and can change several times a day. Perhaps there was an error in establishing the diagnosis and the doctor was to blame for this, who made a not very accurate calculation during the ultrasound, because the determination of the amniotic fluid index is a subjective and approximate matter. Therefore, you should not panic, in 8 out of 10 cases, pregnancy ends with a successful birth of a healthy baby.

Severe oligohydramnios poses a danger to the health of the fetus, so you must follow all the instructions of the doctor observing the pregnancy.

The causes of oligohydramnios, regardless of the degree of its severity:

• fetoplacental insufficiency;
• problems with the cardiovascular system in a pregnant woman (hypertension and others);
• diseases of the urinary system of the fetus (kidneys, for example);
• leakage of amniotic fluid (in violation of the integrity of the membranes);
• pathology in the development of fetal membranes;
• transferred bacterial infections during pregnancy or shortly before its onset;
• diabetes;
• late gestosis.

Most often, oligohydramnios occurs due to a metabolic disorder in a pregnant woman, as well as after viral diseases (ARI, SARS, and others) and with fetoplacental insufficiency.

Personal practice shows that ultrasound doctors often exaggerate the magnitude of the problem, and a slight deviation from the norm is already a disaster for them. Such pseudo-low water causes unnecessary stress for the expectant mother, but in fact, babies are born relatively healthy.

The only thing is that childbirth with oligohydramnios (even slight ones) can take place with some complications (poor opening of the cervix, painful contractions and prolonged labor due to breech or breech presentation of the fetus, which arose due to oligohydramnios). Although complicated childbirth can occur in any woman in labor, regardless of the amount of water.

obstetrician-gynecologist A. Berezhnaya

The occurrence of oligohydramnios during a post-term pregnancy is considered a common occurrence, since the placenta has grown old and can no longer fully perform its functions, therefore it exfoliates. Then doctors prescribe labor induction or conduct a planned caesarean section.

Why is oligohydramnios dangerous for the fetus?

Oligohydramnios (or oligohydramnios) is a complication of pregnancy, sometimes even dangerous for the fetus, because it is at risk of infection, as a result of which even its death can occur.

For example, with the loss of the integrity of the membranes - this is when there is leakage of amniotic fluid - the child becomes vulnerable to infections entering the membranes.

The genital tract of a woman is not sterile, pathogenic microorganisms constantly live in the vagina, “plus” immunity is weakened due to pregnancy. All this can lead to the multiplication of harmful bacteria that can penetrate the uterine cavity and infect the fetal membranes, causing their inflammation, called chorioamnionitis in gynecology. Without timely treatment, infection of the fetus itself occurs.

This is with regard to oligohydramnios, caused by a violation of the integrity of the membranes.

With severe oligohydramnios, regardless of the causes of its occurrence, the baby suffers from hypoxia (lack of oxygen), because of this, it lags behind in fetal development. In addition to all this, the baby is uncomfortable to be in such a “nest”, his neck is often twisted, and the bones of the face and head are susceptible to deformation due to squeezing them by the walls of the uterus.

Moderate oligohydramnios does not have such a critical effect on the health of the fetus: the baby is weak and lags behind in weight gain (so-called malnutrition is observed), his muscle tone is reduced (torticollis, clubfoot may develop), and mild fetal hypoxia occurs.

If the screening and urine / blood / smear tests are normal, the cardiotocogram (CTG) is in order and the fetus is developing well, and the pregnant woman has no complaints about her well-being, then the diagnosis of oligohydramnios is conditional. It’s just that obstetricians will prepare for labor induction, since there is a high probability of a post-term pregnancy, or for a caesarean section with a non-standard position of the fetus at the time of birth.

Diagnosis of oligohydramnios

With an ultrasound examination, the doctor makes some measurements and calculations to determine the amount of amniotic fluid, after which he makes a conclusion about oligohydramnios, a normal amount of water, or polyhydramnios.

A gynecologist can also suggest little or polyhydramnios at the next measurement of the circumference of the abdomen and the height of the fundus of the uterus, but a more accurate diagnosis can only be made with the help of ultrasound.

At home, you can only test for leakage of amniotic fluid. If watery discharge is often observed on the underwear, and the baby’s kicks began to be painfully perceived by the pregnant woman, although such discomfort was not felt before, or the size of the abdomen is small, although the gestational age has already exceeded 20 weeks, then it is advisable to conduct a special test. Perhaps the reason for everything is lack of water, caused by leakage of water due to a violation of the integrity of the membranes.

The test can be done at home by monitoring the discharge for some time, or by buying a special amniotic fluid leak test at the pharmacy and using it.

The “free” test is carried out as follows: empty your bladder, take a shower (without douching and possible water getting inside the vagina), dry yourself with a towel and lie down on a dry diaper. Lie still for 15 minutes, and then get up and see if a wet spot has appeared on the diaper. Ordinary secretions are not able to form and flow out so quickly, most likely, amniotic fluid is leaking. You can find out more precisely by contacting the LCD with a complaint about unusual discharge. There they will conduct a special test and say it is water or ordinary vaginal discharge.

The pharmacy test looks like a gasket, the surface of which will change color to blue or green if amniotic fluid leaks.

Staining also occurs with bacterial / viral discharge, so if spots of a blue-green hue are noticed on the surface of the pad, contact your gynecologist.

Any test for amniotic fluid leakage is recommended after 12 hours since the last intercourse, douching or use of vaginal suppositories.

Treatment of oligohydramnios

It is impossible to artificially increase the amount of amniotic fluid, so the treatment of oligohydramnios comes down to determining the causes of its occurrence. Further, the treatment of the root causes of oligohydramnios is carried out.

To determine the causes of oligohydramnios, a pregnant woman is referred for doppler ultrasound or cardiotocography (CTG), in order, first of all, to refute or confirm a violation of blood flow in the placenta.

If the fetoplacental circulation is still disturbed, then the patient is prescribed drugs to normalize it - Curantil, Actovegin.

Moreover, Curantyl is often prescribed as a preventive measure for placental insufficiency.

Often, the treatment complex includes medications that help normalize metabolic processes in the body of a pregnant woman (for example, Magne + B6) and support the normal functioning of important internal organs of a woman (for example, Hofitol).

It is also necessary to exclude the presence of infections in a pregnant woman. For this purpose, urogenital smears for STIs and from the throat + nose for cocci are re-taken, a blood test for TORCH infection is performed. If an infection is present, antibiotic therapy is prescribed.

Childbirth with oligohydramnios

With severe oligohydramnios, a planned caesarean section is prescribed. With a small volume of amniotic fluid, the fetal bladder takes on a flat appearance. Because of this, contractions will be irregular and weak, and labor can be long and difficult.

Moderate oligohydramnios is not a contraindication for natural childbirth. Even with a breech or breech presentation of the fetus caused by oligohydramnios, childbirth takes place safely for both the mother and her child.

Insufficient amount of amniotic fluid does not give the baby the opportunity to move freely inside the womb. Therefore, often the child takes a transverse or gluteal position and he can no longer roll over correctly.

There are various exercises that can help turn the baby into the right position, but their effectiveness has not been medically confirmed. Exercise can lead to cord entanglement, so you need to weigh the pros and cons before doing them.

Amniotic fluid (amniotic fluid) is the biologically active fluid that surrounds the fetus during pregnancy. It consists of water and contains a small amount of mineral salts, fetal cells, fragments of the sebaceous glands and epidermal flakes. The formation of amniotic fluid begins in the third week of pregnancy and reaches 1-1.5 liters by the time of delivery.

Amniotic fluid not only allows the baby to move freely in the womb, but also maintains a constant body temperature and protects against infection and mechanical influences from the external environment. By the end of pregnancy, the kidneys and lungs of the unborn child begin to take part in the production of amniotic fluid.

Amniotic Fluid Analysis

Invasive diagnosis of amniotic fluid includes:

Amnioscopy. During amnioscopy, a tube with a flashlight (amnioscope) is inserted into the cervix. When illuminating the amniotic fluid, you can see their color and consistency, as well as the presence of blood or feces in them. Amnioscopy is performed after 37 completed weeks of pregnancy.

Amniocentesis. Amniocentesis is the removal of amniotic fluid by puncturing the amniotic membranes. The puncture is performed through the abdominal cavity, or through the wall of the vagina or cervix. With amniocentesis, it is possible to determine the composition of amniotic fluid and thereby identify pathology in the unborn child. It is carried out according to indications after 16 weeks. After taking amniotic fluid, bacteriological, histological, cytogenetic, biochemical analyzes are carried out.

Amniotic fluid index and its norm

The change in IAI has a certain pattern. From the beginning of pregnancy to the 27th week of gestational age, the amniotic index gradually increases and averages 156 mm, then it declines. The amniotic fluid index is not reduced compared to 27 weeks by about 10 mm.

The amniotic fluid index at 37 weeks, which is very close to childbirth, decreases by another 10 mm. Immediately before the baby is born (38-40 weeks of gestational age), there is a final decrease in the amniotic fluid index to an average of 125 mm.

Attention! The planned passage of ultrasound and the determination of IAI help to diagnose deviations in the amount of amniotic fluid in time and prescribe effective treatment to prevent various pathologies in the unborn child.

Objectively, the amniotic fluid index is determined by dividing the uterus into 4 squares, the vertical marking axis passes through the center of the abdomen, the horizontal one through the navel. In each quarter, the maximum pocket is determined - the space where amniotic fluid is located without a child. Further, these indicators are summarized and the amniotic index is displayed - the result of adding the obtained values.

Norms of the amniotic fluid index by week in the form of a table

oligohydramnios during pregnancy

• renal pathology of the fetus;
• somatic diseases in a pregnant woman (chronic heart failure, chronic obstructive pulmonary disease, etc.);
• urogenital infections;
• smoking and alcoholism;
• placental diseases;
• carrying twins;
• aging of the placenta during re-carrying.

When fetal oligohydramnios is severe, or there are deviations in CTG, symptomatic therapy is used:

1. Vitamins.
2. Drugs that improve the blood supply to the placenta (Kurantil, Actovegin).
3. Antibiotics.

Polyhydramnios during pregnancy

• somatic diseases of the expectant mother (diabetes mellitus);
• infection during pregnancy;
• Rhesus conflict;
• congenital anomalies;
• increase in the weight of the unborn child.

In the process of treatment, constant monitoring of the fetal condition with the help of CTG is necessary, since with this pathology there is a possibility that the unborn child will become entangled in the umbilical cord. In case of ineffectiveness of conservative therapy, amniocentesis is used - taking a small amount of amniotic fluid, or premature delivery.

The entire period of intrauterine development, the child spends in the fetal bladder filled with amniotic fluid or amniotic fluid.

Amniotic fluid, which has a complex chemical composition, is necessary for the normal life and development of the fetus, it protects the unborn child from infections and external influences, and ensures freedom of movement.

The composition and amount of amniotic fluid are constantly changing throughout pregnancy, the maximum volume of fluid inside the fetal bladder is reached by 32 weeks, then gradually decreases and by the end of pregnancy is about 1.5 liters.

To assess the amount of amniotic fluid, the amniotic fluid index is used, which is determined during an ultrasound examination by summing up the four values ​​of the amniotic space on the monitor, the vertical size of the amniotic fluid, measured in mm, is displayed in black. To obtain these data, during the examination, the uterus is conditionally divided into 4 squares, the largest space in each of them is measured, then the obtained indicators are summarized.

Below is a table of the norm of the amount of amniotic fluid for different periods of pregnancy. If the amniotic fluid index goes beyond the upper limit of these norms, then, in accordance with the gestational age, the doctor speaks of polyhydramnios. If this index slightly exceeds the norm, then it is customary to talk about moderate polyhydramnios during pregnancy .

Table of norms of amniotic fluid at different stages of pregnancy.

During 9 months of pregnancy, the unborn child develops in a special sac, which obstetricians call the amniotic sac. This transparent and tightly closed bag is filled with a special liquid that protects the baby throughout pregnancy. This fluid is called amniotic fluid.

When the time comes for childbirth, the bubble breaks, and all the fluid comes out. Obstetricians call this the outpouring of amniotic fluid, and often the rupture of the fetal bladder indicates the beginning of the birth process and provokes contractions.

Amniotic fluid performs a number of important functions.

Firstly, they protect the child from infections, as they contain antibacterial and antimicrobial substances.

Secondly, water is a kind of shock absorber, and protects the child from various possible injuries, shocks or shocks.

And, thirdly, they help the child to master digestion and breathing, since with their help the baby can train the lungs, and also learns to swallow.

The consistency of amniotic fluid is not like the water we are used to. They are transparent, but thick, sometimes yellowish or pinkish. While the baby is developing in the womb, he tastes them, and if the mother ate something sweet, the child feels it, since sugar enters the mother's body. Also, the child exercises the lungs by inhaling the amniotic fluid and exhaling it back.

From the very beginning of pregnancy, the amount of amniotic fluid gradually increases, and by the end of the third trimester, it gradually decreases to give the growing baby more space in the uterus. Sometimes they can be too small throughout pregnancy, and then the doctor makes a diagnosis - oligohydramnios. Sometimes too much, and then we can talk about polyhydramnios.

IAI norm

The composition and quantity of the contents of the fetal bladder plays a big role in the formation of the future baby and his well-being. If their volume corresponds to the norm, then the doctor concludes that the child feels well and develops normally. Too little amniotic fluid and, conversely, too high an indicator, indicate that something is wrong in the body of the expectant mother, which means that the health of the fetus may be in danger.

To find out if everything is in order, you need to do an ultrasound. With the help of ultrasound, the doctor will be able to determine the approximate amount of water in the bladder. Your baby is constantly swallowing amniotic fluid and also urinating, so the difference in the amount of water can be noticeable throughout the day.

It must be remembered that this fluid changes in composition every 3-4 hours a day, and is completely renewed every 24 hours, which means that its composition and quantity also change constantly. Therefore, do not be afraid if the IAI, according to the study, differs from the one that results in our table. In any case, check it with our calculator and check with the values.

2 comments: Amniotic fluid index - table and calculator

• Mamalysha86

Amniotic fluid and its index

Amniotic fluid is the water that is in the amniotic sac and ensures the favorable development of the child. Amniotic fluid promotes breathing and nutrition of the baby, protects it from external damage, softening the force of physical impact, and allows the baby to move freely in the tummy.

The amniotic index is a number indicating the amount of water in the amniotic sac. The quantity and quality of amniotic fluid depends on many factors, for example, infections, pathologies, viruses in the mother's body; violation of the functions of the child's body; pathology of pregnancy, for example, amniotic cord. Some diseases lead to changes in the amniotic fluid index, and a change in this number may accompany the development of other pathologies of pregnancy or the fetus, for example, malnutrition or premature termination of pregnancy.

Amniotic fluid index normal

In order to find out if the amniotic fluid index is normal, the table fits perfectly. The table contains information at what period of pregnancy, what is the norm of the amniotic fluid index should be. But at the same time, small deviations of approximately 70-100 cm are possible, which will be considered minor and will not require hospitalization.

If you have a slight deviation from the norm of the amniotic index, do not worry, because each organism is unique. But still, we are all human and serious deviations should be known to the doctor in order to take timely action.

Amniotic fluid index, table

low water

Low water is a situation in which the amniotic index during pregnancy is below normal. If these deviations are small, then it is recommended to check the body for the presence of infectious diseases, since the risk of their penetration to the baby increases. If the lack of water is significant, then hospitalization and constant monitoring by an obstetrician-gynecologist are necessary. Significant lack of water may indicate or cause a violation of the nutritional and respiratory processes of the baby.

polyhydramnios

Polyhydramnios is a situation in which the amniotic fluid index is higher than the norm provided for this period of pregnancy. Polyhydramnios can be formed as a result of pathologies of the nervous system or digestive system of the baby, as well as various diseases of the mother, for example, syphilis, mycoplasmosis. In most cases, pregnancy with polyhydramnios ends in a successful, natural birth. In severe cases, premature birth or forced termination of pregnancy is possible.

Amniotic cord during pregnancy

Amniotic cord is one of the most terrible consequences of both low water and high water. The amniotic cord during pregnancy, or as it is also called the amniotic constriction, in most cases have a thin structure and tear over time without harming the child. But there are times when the amniotic septum during pregnancy, accompanied by a large or small amount of amniotic fluid, becomes elastic and can interfere with the normal development of the fetus and even lead to its death.

Diagnosis of deviations from the norms of the amniotic fluid index

The amount of amniotic fluid in the amniotic sac is measured several times during pregnancy using ultrasound. During the passage of ultrasound, the amount of liquid measured in cubic centimeters is displayed on the monitor of the device. The specialist, comparing the data from the monitor with the amniotic index in the table, determines whether the amount of water is normal or there are deviations.

Also, with the help of ultrasound, a change in the position of the uterus can be recorded, that is, the bottom of the uterus is above or below the position that it should occupy during this period of pregnancy. In addition, an ultrasound examination will show whether there are pathologies in the development of the child and whether he captures water with his mouth.

Unfortunately, ultrasound is unable to fix some disorders in the child's body, for example, abnormalities in the functioning of the nervous system or kidneys, which can cause a change in the amount of amniotic fluid. To identify such pathologies, an analysis of amniotic fluid is performed.

Amniotic index broken, actions

Amniotic fluid, the norm of the composition or amount of which is violated, can cause the development of pathologies in the fetus, and consequently, pregnancy with such deviations should be accompanied by the supervision of a specialist. After a thorough examination, in the form of ultrasound and examination of amniotic fluid, the cause of the deviation is established. If serious pathologies in the development of the fetus have become the cause of the violation of the amniotic fluid index during pregnancy, or amniotic constrictions have been found that are not comparable with the life of the child, then termination of pregnancy is recommended. In cases of detection of abnormalities in the development of the fetus comparable to normal life or other less serious causes, treatment is directed to the favorable condition of the baby and getting rid of the cause of the deviation from the norm of the amniotic index during pregnancy.

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amniotic fluid, or amniotic fluid, is the environment in which the child lives before birth, warming, protecting from external influences and infections, providing freedom of movement. Throughout pregnancy, amniotic fluid is constantly updated, maintained in the amount required for a given period. To assess the amount of water in ultrasound, an indicator such as amniotic index.

By the end of pregnancy, there is 1-1.5 liters of water in the amniotic bladder; deviation from this norm in one direction or another may indicate any pathology. Therefore, among other features of the development of pregnancy, which you need to pay attention to during examinations, is the amount of amniotic fluid. But visually assessing the volume of amniotic fluid is quite difficult. To calculate the amniotic index, the uterine cavity is conditionally divided into four equal parts and the largest vertical pocket in each of them is measured. Vertical pocket- this is a free area between the fetus and the wall of the uterus, which on ultrasound appears as an echo-negative (black) space. The sum of the four measurements is the amniotic index. There is an opinion that such an assessment is not accurate, since the location and volume of such pockets directly depends on the position of the fetus and changes with its movements. Therefore, it is more correct to take measurements several times.

The volume of amniotic fluid increases weekly by 40-50 ml, reaching a maximum by the 32nd week of pregnancy, then decreases slightly. Table of amniotic index norms:

Amniotic fluid index table

Well, I’m restless, I climbed into the Internet, to see how many waters there should be, that they give me polyhydramnios =) And how much polyhydramnios is to me))

And so, in yesterday's ultrasound, the doctor wrote the anatomical index 239

according to the table, of course, I'm in the upper redistribution of the permissible, but still not too much)))

For those who are interested, there are also tables of the main indicators of the fetus at different weeks http://www.budumamoi.ru/uzi_beremennost.html. Yes, dry tables and numbers, so if someone has “not according to the table”, close and forget))) We are all individual)))

in the table the norm is written in MM. For 24 weeks - the norm is 90-238 mm, i.e. the maximum rate of norms is 23.8 cm

I'm MAMA I was online 37 minutes agoRussia, Moscow

Oles help. I also can’t figure something out, I have a 28 week index of 22 cm, they put polyhydramnios, how much is it in mm to look at the table?

22 cm is 220 mm. The norm for 28 weeks is 146, but possible fluctuations are 86-249. You are in the upper limit, if nothing bothers you, then there is nothing to worry about

I look at my period 37-38 weeks (more precisely 37 + 5)

on the doppler today they said IAI 276 mm - polyhydramnios. The doctor prescribed a bunch of drugs without finding out the cause ....

and at the same time, I already have a planned hospitalization at exactly 38 weeks due to pelvic ....

Sofigrom I was online 22 hours agoRussia, Novosibirsk

now I’m sitting and thinking - do I need them at all - or do I still have to wait for what they say in the maternity hospital? maybe at least there they will find out the reason ... well, or at worst, they will prkesaryat earlier .... even I don’t want to swallow packs of medicine again ... I just got rid of everything ...

In theory, they should take tests for all infections before prescribing an antibiotic. I had severe polyhydramnios, but the cause was not infections, so there was no point in taking antibiotics.

If you go to the hospital, then of course it is better to wait for the conclusion of the doctor who will observe. If there is any infection, but it does not threaten to infect the child, then there is no point in taking pills. Mostly those who give birth themselves are treated, because. during the passage of the child through the birth canal, the risk of infection is high ... Your case should be discussed with the doctor

Natasha I was on the site 2 hours ago Russia, Azov girls, as you see on this table, they wrote me an amniotic fluid index of 27 cm on an ultrasound. What does this mean, please tell me! Olesya I was on the site on May 14, 18:24 Russia, St. Petersburg the cause of polyhydramnios… it is usually an infection that needs to be treated with antibiotics, which does not require hospitalization. If by ultrasound the condition of the placenta and the baby is normal, then do not worry much. The only threat in this case is the outpouring of waters due to their severity, i.e. the beginning of childbirth. But at your time it’s not scary anymore) Natasha I was on the site 2 hours agoRussia, AzovThanks for the Doppler they said that the child’s blood vessels work well! Yes, and not much water much than it should be, right? Russia, St. Petersburg, the indicators are all too subjective and approximate, if the doctor didn’t say anything, then everything is fine, come calmly Natasha I was on the site 2 hours ago Russia, Azov, then nothing didn’t say she gave a referral for hospitalization and that’s it! but I don't know what to think? Olya I was online September 23, 2013, 21:26Russia, Armavirthank you! otherwise they also gave me polyhydramnios, although according to the tables it’s normal ... 22.3 cm at 32 weeks, almost 33 ... Olya I was on the site on September 23, 2013, 21:26 Russia, Armavir did they say this by ultrasound? this is how we determine it on ultrasound .... I also think not! reinsured! they didn’t do an ultrasound, they somehow determine by measurements and by touch Zoya I was on the site 1 hour ago Russia, Moscow I had polyhydramnios for unknown reasons. There were no infections. Was in storage. The belly was huge. The doctor suggested that polyhydramnios is due to a conflict in the blood group. I have 1+, and my son has 2+. The doctor said that this happens if the mother has 1+, and the child has 2 or 3 groups. Olesya I was on the site on May 14, 18:24 Russia, St. Petersburg which is really huge) A couple of cm differs in volume from what should be on my term) I will hope that the amount of water will not increase to critical levelsOlga I was on the site on May 15, 11:29 Russia, St. Petersburg

Oles, they put polyhydramnios on my ultrasound, my gynecologist said that everything is garbage, there is nothing (like she sees everything, without ultrasound). I went to another doctor, they also diagnosed polyhydramnios, they said that I needed to retake tests for infections, viruses, etc. The list was huge. Checked it out, found nothing.

Then I went to my parents and they went to the doctor at the maternity hospital, she did an ultrasound, said that it was along the upper border of the water. She asked if I accidentally got sick during B. And I was sick, a cold with a cough lasted for almost three weeks. In childbirth, the waters went green ((

Well, “greenness” here and many things are not interconnected)) Greenness is due to the fact that the child begins to secrete myconium into the water ahead of time ...

I'm not particularly worried, because the indicators are not critical and there was no increase in the water level for two weeks

Saint Petersburg, Russia

greenness is an indicator of infection

When my water broke, the midwife told me so, and then the doctor came up and asked if I had any infection. I said that there was nothing but a cold. To which he replied that why is it not an infection? Infection - causes polyhydramnios ... everything is logical ... It is not for nothing that when polyhydramnios is sent to take everything that is possible.

Amniotic fluid index - table

A very important role in the normal course of pregnancy is played by the composition of the waters around the fetus and their sufficient amount. There are several ways to determine these parameters. The most reliable is the establishment of the amniotic fluid index in cm.

In order for the ultrasound doctor to be able to provide the most accurate information regarding the study of amniotic fluid, modern ultrasound machines are equipped with special programs that contain tables of amniotic fluid norms and automatically calculate the desired index. The results of such an analysis show such pathologies of pregnancy as polyhydramnios or oligohydramnios during pregnancy.

Determining the rate of amniotic fluid

1. The uterus is scanned in all sections and the ultrasound machine automatically calculates the indicator.
2. Ultrasound is also used, but during the study, the readings of the maximum upper quadrants of the uterus are summarized, which will equal the amniotic fluid index.

Amniotic fluid index table

The numbers obtained as a result of ultrasound examination are compared with the table of amniotic fluid. It is worth noting that each device is equipped with its own version of the table, the components of which can differ significantly, however, there is a more or less average version. Index indicators become the reason for establishing such diagnoses as polyhydramnios or oligohydramnios. However, they are not a guide to decisive action, since the doctor will determine many more concomitant factors.

Amniotic fluid index by week

Over the entire period of gestation, amniotic fluid is constantly changing its quantitative and qualitative composition in direct proportion to the duration of pregnancy and the growth of the baby. Every week, the volume of fluid steadily increases by an average of 40-50 ml and can reach 1-1.5 liters before delivery itself and may decrease slightly. However, a one-time assessment of the amount of water cannot be reliable, since the fetus is constantly changing position.

An approximate table of amniotic fluid contains data on the normal volume of amniotic fluid for each week of gestation and the maximum allowable deviations from generally accepted indicators.

In order to talk about a really occurring polyhydramnios or a deficiency of amniotic fluid, it is necessary to determine the exact deviation from generally accepted norms that do not fit into the limits of the maximum permissible indicators. So, for example, if an amniotic fluid index of 11 cm occurs at the 32nd week of gestation, then there is no reason for concern. But the presence of such a volume of water on the 22nd or 26th week already indicates their excess.

Knowing the indicators of the amniotic fluid table, depending on the gestation period, will help the expectant mother independently understand the results of the study if no objective explanations have been received from her gynecologist. Neglecting the results of an ultrasound study is fraught with complications in the process of getting rid of the burden, namely:

• premature discharge of amniotic fluid;
• sluggish delivery process;
• oxygen starvation of the fetus and its insufficient development;
• increased pressure on the umbilical cord;
• postpartum hemorrhage, rupture of the placental organ, and so on.

It must be understood that the amount of amniotic fluid does not depend on the lifestyle and diet of the pregnant woman, since it is a primordially natural indicator that is rarely subject to medical adjustments.