WOMENS-HEALTH Messages for April, 2001: Re: extremely low amniotic fluid

Re: extremely low amniotic fluid

From: William F. von Almen, II, MD, FACOG (anonymous@obgyn.net)
Sat, 7 Apr 2001 08:05:27 -0500 (CDT)

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In reply to: anonymous@obgyn.net: "extremely low amniotic fluid"

At Fri, 6 Apr 2001, anonymous@obgyn.net wrote: >
>I am 43 at 36 weeks with child number six. I have gestational diabetes
>and recently developed PIH.
>
>I have had a severe cough for five months which has not responded to
>medication. A couple of weeks ago I suspected I may be leaking amniotic
>fluid. The fluid coming from my body was extremely hot and had a
>distinct smell. However, I thought I was being silly that I was just
>incontinent from the coughing fits. When my doctor did an AFI, she said
>that my fluid was low (7.3) and recommended bedrest. I continued to
>work but rested at home and the level went to 7.7. She said that it was
>unlikely I was leaking amniotic fluid, because it would gush. Then the
>leaking stopped, even when coughing.
>
>Now I have an increase in my coughing and a dramatic increase in the
>leakage. I have had several potentially embarrassing moments. An AFI
>showed my fluid level to be 3.4. The doctor wants to induce labor
>anyway because of my PIH although she hasn't tried controlling it with
>medication. Now she says that it is imperative that I go on complete
>bedrest and induce labor at 37 weeks, if not before.
>
>My baby is healthy as far as one can tell through ultrasounds, growth
>measurements, etc. All my numerous lab tests are normal although my
>doctor seems anxious to find me preeclamptic.
>
>What should I do? I don't entirely trust my doctor, but want to do what
>is best for the baby! The stress is killing me! Can I hold out for a
>natural childbirth when I go into labor on my own--even if I am leaking?
>Does increasing my fluid intake help the baby any? Does bedrest really
>help?

Anon

Yes, bedrest and increased fluid will help(bothlow afi and pih). It sounds to me like you have 3 strikes against you, gdm, pih and now low afi. Getting this baby out seems prudent to me. The only kicker is your diabetic control. If it has been good on diet alone, I think that delivery is a good choice. Hope this helps.

PS Meds (in general)do not help pih, nor do you have to have abnormal labs, only elevated bp, increased weight gain, significant edema and proteinuria.

--
William F. von Almen, II, MD, FACOG
Editorial Advisor-Pregnancy and Birth
Private Practice
New Orleans, La.

*Please understand I can not respond to private emails.

*These comments are for educational purposes only.  They are
not meant to take the place of an examination by a qualified
health care provider.  They are not intended to be the start
of a physician-patient relationship.

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