Is your baby's water level low? Let's talk about amnioinfusion treatment

You may be in the last weeks of your pregnancy. Or you may be in the labor room giving birth. Suddenly, the doctor comes in and says, "The baby's heartbeat is slowing down a bit, and the amount of water around the baby seems to be low." At times like these, we are going to talk about a special treatment that doctors use to protect you and your baby. Don't be alarmed when you hear this, this is a very successful treatment in most cases.

Simply put, what is Amnioinfusion?

Amnioinfusion is a procedure where a special fluid is injected into your uterus, where your baby is. It's like refilling a small tank that's been sitting for a while. This is done when your baby's heartbeat becomes irregular or slow during labor. The main reason for this is because the amount of water around your baby is decreasing.

Now you may be wondering what these fluids are. These are not harmful to you or your baby. Doctors use a solution called saline solution or lactated Ringer's solution . These are clean, sterile fluids that are very similar to the fluids in our bodies.

When this fluid is injected into the uterus, it replaces the amniotic fluid that has been depleted. This stops the umbilical cord from pushing, restores the baby's oxygen supply, and stabilizes the baby's heartbeat.

So, what is this amniotic fluid?

Amniotic fluid is like a warm, protective liquid cushion that surrounds your baby inside your uterus. It provides significant protection for your baby.

• Protects the baby from germs coming from outside.
• Prevents umbilical cord compression.
• It protects the baby from other injuries as it moves around inside the uterus.
• Helps the baby's lungs and digestive system develop.
• It helps keep the baby's body temperature constant.

If enough of this important amniotic fluid is lost, the baby can develop health problems and complications during childbirth.

The importance of the umbilical cord

The umbilical cord is the lifeline of the baby inside the womb. It is what connects the baby to the placenta. The baby gets all the oxygen, blood, and essential nutrients it needs through this umbilical cord. So if this umbilical cord gets compressed, all these supplies to the baby can be cut off. That can be very dangerous for the baby.

In what cases is amnioinfusion treatment necessary?

This treatment is not for everyone. Doctors only recommend it in a few specific cases. It is mainly done in cases where there is a decrease in the amount of water around the baby, a condition called Oligohydramnios .

The table below can help you understand this more clearly.

Are there any cases when this treatment should not be done?

Yes, absolutely. There are some cases where amnioinfusion treatment is not done and other measures should be taken instead.

• If the baby is in serious distress: If the baby's heart rate is very low, every minute counts. In such cases, doctors may decide to deliver the baby quickly (for example, by emergency cesarean section) rather than waste time with this treatment.
• If you have an active infection, such as genital herpes: This treatment is not recommended if you have an infection involving the uterus.
• If there are problems with the placenta: This treatment is not performed if there is any suspicion of a condition such as placenta previa (placenta lying low in the uterus) or placental abruption (placenta separating from the uterine wall).
• If the baby is not positioned correctly: This treatment is not suitable if the baby is not head down, is breech, or is in another abnormal position.

How is this Amnioinfusion treatment done?

Don't be afraid to ask how this is done. It's usually not painful. Your doctor and nurses will sit next to you and take care of everything.

First, the doctor will make sure that the baby is in a head-down position. Also, your cervix should be at least 1-2 centimeters dilated.

Then, a very thin, flexible tube called an Intrauterine Pressure Catheter (IUPC) is carefully inserted into your uterus. This tube is connected on one end to a monitor that measures the baby's heartbeat and uterine contractions. On the other end, it is connected to a tube that injects saline solution.

Then, the doctor will slowly inject room-temperature saline into your uterus. This will usually take between 10 and 30 minutes. During this time, the doctor and staff will closely monitor you and your baby. They will also continue to check to make sure the amount of fluid in your uterus is adequate.

You may feel a little discomfort after the treatment, but that is normal.

What are the benefits of this treatment?

In addition to restoring the baby's heartbeat, this treatment has several other benefits.

• Reduced risk of cesarean section (c-section): Emergency cesarean sections are often performed due to a low baby's heart rate. If this treatment can prevent that condition, you will have a better chance of having a normal delivery.
• Reduced use of instruments: The need to use instruments like forceps or vacuum may be reduced.
• The baby receives a good blood and oxygen supply: Since the umbilical cord is free, the baby receives oxygen and nutrition without any obstruction.
• Helping to delay premature birth: As mentioned earlier, if the waters break early, this can help keep the baby inside the womb for a few more days.
• Improved Apgar scores : The Apgar score is a scoring system that assesses the health of a baby immediately after birth. This score is higher when the baby is born healthy due to this treatment.
• Reduced risk of infection in the mother: When amniotic fluid is lost, the mother can also develop infections. For example, postpartum endometritis . This treatment reduces that risk.

Are there any potential risks?

As with any medical procedure, there are very small risks. But these don't happen very often. Your doctor will take good care of all of these.

• Infection (Chorioamnionitis): There is a very small chance of infection of the placenta and amniotic fluid.
• Umbilical cord prolapse: Very rarely, the umbilical cord can descend into the vagina before the baby is born.
• Polyhydramnios: There is a risk of more fluid accumulating in the uterus than necessary.
• Damage to the uterus: Very rarely, the uterus can become overstretched (uterine overdistention) or the uterine wall can become perforated (perforated uterus).

How effective is this treatment?

Amnioinfusion treatments are often successful. Interestingly, the less water there is around the baby, the more likely the treatment is to be successful.

Doctors have a way to measure the amount of fluid around your baby. It's called the Amniotic Fluid Index (AFI) . Studies have found that:

• This treatment has been successful in 63% of cases in those whose AFI value was less than 4 centimeters when initially measured.
• The success rate for those with an AFI between 4 and 8 centimeters is 44% .

That means, for someone who is really dehydrated and needs help, the results of this treatment are very good.

Amnioinfusion, pregnancy, amniotic fluid, oligohydramnios, childbirth, umbilical cord, fetal distress, C-section, cesarean section, uterus