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Q. The 25th week pregnancy scan showed oligohydramnios and IUGR. What to do?

Answered by
Dr. R Balakrishnan Menon
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 26, 2017 and last reviewed on: Oct 09, 2018

Hi doctor,

I am 31 weeks and two days pregnant. I had an ultrasound at 20 weeks, and everything was normal. However, with time, I noticed there was little or no movement, and the baby's movement was more like a ball rolling in a difficult position. So, my doctor sent me for an ultrasound at the thirtieth week. The scan showed severe oligohydramnios and intrauterine growth restriction. My due date was brought forward by a month. On the twenty-fifth week, the baby's weight was 603 g. I have tried rehydration and bed rest. Can you offer more help?

#

Hi,

Welcome to icliniq.com.

Let me put forth few facts about pregnancy and baby growth.

The growth of the baby is progressive, but if it stops at some stage, that amount of growth cannot be regained. Some reason has been missed by the doctor during the pregnancy monitoring.

There could be many causes like uncontrolled diabetes, severe thyrotoxicosis, inadequate food intake or severe vomiting, or a condition called APLA (antiphospholipid antibodies) syndrome (here the baby is rejected by mother's body gradually, as it is a foreign body). So blood flow gradually reduces, as the blood flow to baby's kidney reduces, baby's urine output reduces and thus oligohydramnios becomes severe.

  • As the baby's growth reduces over time due to lack of nutrition, IUGR (intrauterine growth retardation) becomes severe over time.
  • All that can be done is to treat any of the causes if present. To give the mother high-protein diet, lots of water, liquids, sweets (if not diabetic), etc. Keep noticing the baby's movement. No one can decide the date of the delivery if the baby has IUGR the date will get preponed.
  • It is like a person is stuck in a room with insufficient food and air, so if we leave the person in the room for more time without checking more frequently, the person will die of starvation.

In the same way, the baby has to be monitored with scans every week or more often depending on the scan report, fluid level, and doppler scan changes. We cannot take the baby out very early because it will die of immaturity.

We can give the mother Steroid prophylaxis at around 28 weeks, to improve baby's lung maturity and to prevent hemorrhage in the baby. Once any of the findings are abnormal, the baby has to be immediately delivered.

All we can do is wait and monitor. At least in the next pregnancy, such problems should be anticipated.

For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


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