Problems with amniotic fluid: what you should know

Amniotic fluid is the medium in which the baby develops and is therefore of decisive importance. Sometimes there are problems with that fluid, which may resolve on their own or with treatment.

Last update: 15 October, 2022

Problems with amniotic fluid can be of 3 types:

  1. Too much quantity.
  2. Very little liquid.
  3. Infection of the amniotic fluid.

In some cases, the problems affect the mother, other times the fetus or both. They can present at different times of pregnancy and are usually detected by clinical evaluation or through ultrasound.

1. Too much amniotic fluid

Excess amniotic fluid is known as hydramnios either polyhydramnios. It is estimated that it is present in 1 in 100 pregnancies. In most cases, this problem is mild and appears in the second half of the feat.

More than half of the cases fail to establish the cause. In others, the reason could be one or more of the following:

  • Multiple pregnancy.
  • Gestational diabetes.
  • Anemia in the fetus.
  • congenital anomalies
  • Infections in the fetus.


In some cases, increased fetal fluid does not cause any symptoms. If the excess is significant, it could generate the following signs:

  • Rapid growth of the uterus.
  • anticipated contracts.
  • Upset stomach in the mother.
  • Shortness of breath or trouble breathing in the mother.


Though most cases of excess amniotic fluid can be treated without problemssometimes complications with different levels of severity occur:

  • Premature labor.
  • Premature rupture of the membranes.
  • Severe respiratory problems in the mother.
  • Heavy vaginal bleeding after childbirth.
  • Uterine atony: The uterus is stretched and cannot return to its original shape.
  • Placental abruption – occurs only after premature rupture of the membranes.
  • Prolapsed umbilical cord: occurs when the umbilical cord comes out of the vagina before the baby.
The excess of amniotic fluid can favor the malposition of the placenta, its detachment and the previous exit of the umbilical cord in childbirth.

2. Too little amniotic fluid

The shortage of amniotic fluid is known as oligohydramnios. It is estimated that this anomaly affects less than 10% of pregnant women, but only 5% of total cases are diagnosed.

This disorder is more common in the third trimester, although it can also appear at any time. If it occurs in the early stages of pregnancy, it usually leads to more serious consequences.

It is not always possible to establish the cause of the shortage of amniotic fluid. However, it is usually related to one of the following factors:

  • Death of the fetus.
  • Multiple pregnancy.
  • Alterations in the placenta: such as premature rupture of membranes.
  • Maternal diseases: gestational diabetes, preeclampsia, dehydration, lupus.
  • Fetal anomalies: congenital malformations, restricted intrauterine growth, infections.
  • Post-term pregnancy: when the pregnancy is prolonged beyond the estimated date of delivery.


A shortage of amniotic fluid rarely causes noticeable symptoms. In any case, the size of the uterus is usually smaller than expected for the time of gestation. Likewise, it is possible that the mother feels a decrease in fetal movements.


A shortage of amniotic fluid can lead to problems such as the following:

  • Caesarean section: in some cases, the fetus cannot tolerate vaginal delivery.
  • Stagnation in growth: with the possibility of fetal death.
  • Compression of the fetus: causes limb deformities, chin recession and flattened nose.
  • Potter syndrome: It occurs when there are malformations and the fetus’s lungs do not mature as they should.

3. Intra-amniotic infection

Another possible problem with the amniotic fluid is chorioamnionitis or intra-amniotic infection. This can occur in the fluid alone or in combination with a similar condition in the placenta.

The main cause of intra-amniotic infection is the presence of pathogens in the mother’s genital tract. These microorganisms can ascend to the uterus. The usual thing is that the body avoids this type of infection, but there are some conditions that favor them:

  • Multiple vaginal exams during labor.
  • Premature rupture of the membranes.
  • Meconium amniotic fluid.
  • Prolonged labor.


There are no characteristic symptoms of intraamniotic infection. Nevertheless, fever, abdominal pain, and purulent discharge from the vagina are common. Likewise, that the heart rate of the mother and the fetus are very accelerated.


This amniotic fluid problem can lead to complications, such as the following:

  • Fetal death.
  • shock septic.
  • Uterine atony.
  • Premature labor.
  • Seizures in the fetus.
  • Bacteremia in the mother.
  • Cerebral palsy in the baby.
  • Placental abruption.
  • Acute respiratory distress syndrome in the mother.
Any situation of fever in pregnancy should lead to immediate consultation with a health team. It could be an infection in the amniotic fluid.


Problems with the amniotic fluid often do not cause symptoms.. Sometimes the only sign is that the uterus is too large or too small. In the case of intra-amniotic infection, that there is fever.

It is very common for these problems to be discovered incidentally during an ultrasound. The test allows you to determine the amount of amniotic fluid present.

Usually, other tests are done later to determine the specific cause. The most requested are blood tests and amniocentesis.

Treatment of problems with amniotic fluid

Treatment of problems with amniotic fluid It is based on performing periodic ultrasound scans to monitor the evolution. Likewise, regular monitoring of the fetal heart rate is done.

If there is too much amniotic fluid, you tend to just control it, unless the excess is extreme. If so, the fluid is withdrawn with a needle through the mother’s abdomen. When there is little fluid, delivery may be scheduled for 36 or 37 weeks.

If there is an infection, it is usual to have a course of antibiotics.

It is important to pay attention to signs, such as the size of the belly, the mother’s breathing difficulties and the frequency of the baby’s movements. Similarly, it is essential to comply with all control appointments during pregnancy, as well as with the ultrasounds ordered by the doctor.

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