During pregnancy, amniotic fluid surrounds and protects the developing baby in the uterus. The amount of amniotic fluid is carefully regulated, and changes in fluid levels can sometimes indicate problems. While amniotic fluid levels are best evaluated by your healthcare provider, there are a few ways you can get a general sense of whether your amniotic fluid levels are normal at home.
What is amniotic fluid?
Amniotic fluid is the fluid that fills the amniotic sac during pregnancy. It has several important functions:
- It cushions the baby from bumps and injury.
- It regulates the baby’s temperature.
- It allows the baby to move freely and develop muscles and joints.
- It facilitates lung development.
- It protects the umbilical cord from compression.
- It helps maintain constant pressure in the uterus.
The amount of amniotic fluid increases steadily during the first half of pregnancy, peaking around weeks 34-36. Towards the end of pregnancy, the amount decreases as the baby takes up more room in the uterus. The amniotic sac contains around 1 cup of fluid at full term.
What are normal amniotic fluid levels?
The amniotic fluid index (AFI) is a measurement used to estimate the volume of amniotic fluid during pregnancy. It is calculated by adding together 4 measurements from different quadrants of the uterus.
Normal AFI levels are:
- 24-25 cm from weeks 20-24
- 22-24 cm from weeks 24-28
- 20-24 cm from weeks 28-32
- 18-24 cm from weeks 32-36
- 10-18 cm from weeks 36-40
An AFI of 8-18 cm is considered borderline, while less than 8 cm is considered oligohydramnios (low fluid) and more than 24 cm is considered polyhydramnios (high fluid).
It’s important to note that a single AFI measurement may not accurately reflect amniotic fluid levels. Fluid levels can fluctuate hourly based on the baby’s urine output and maternal hydration. That’s why providers prefer to follow trends in AFI over time rather than relying on a single measurement.
What causes abnormal amniotic fluid levels?
Causes of low amniotic fluid (oligohydramnios) include:
- Fetal abnormalities affecting urine output or swallowing
- Intrauterine growth restriction
- Placental dysfunction
- Preterm premature rupture of membranes
- Maternal dehydration
- Maternal hypertension
- Post-term pregnancy
Causes of high amniotic fluid (polyhydramnios) include:
- Maternal diabetes
- Multiple pregnancies
- Placental dysfunction
- Fetal GI tract blockage
- Birth defects
- Rhesus isoimmunization
- Fetal anemia
Sometimes no cause is found, especially in cases of mild abnormalities. Fluid levels often return to normal without intervention.
Is it possible to measure amniotic fluid at home?
There is no precise way to measure amniotic fluid levels at home like the ultrasound-based AFI. However, there are a few general assessments you can do:
Fundal height measurement
Measuring from your pubic bone to the top of your uterus (the fundus) can give a rough estimate of fetal size and amniotic fluid volume. To check your fundal height:
- Lie flat on your back with your knees bent.
- Place one end of the tape measure at the top of your pubic bone and stretch it upward alongside your belly/the midline of your abdomen.
- At the same time, use your fingers to palpate the top of your uterus (the fundus).
- Note the measurement in centimeters.
Between weeks 20-36, your fundal height should roughly match the number of weeks pregnant you are. Measurements significantly larger or smaller could indicate issues like excess or low fluid.
Fetal movement counting
Decreased fetal movement can be a sign of low amniotic fluid. Try counting your baby’s kicks, jabs, rolls, and swishes:
- Pick a time when your baby is usually active (often after meals).
- Sit or lie down in a quiet space without distractions.
- Count each distinct movement you feel.
- Aim to feel at least 10 movements within 2 hours.
- Notify your provider right away if you notice decreased activity.
You can also use kick counting apps to track patterns over time. Report any significant changes or concerns.
Visualization and palpation
As your belly grows, you may be able to see and feel how baby is floating and moving around:
- Visualization: During the second half of pregnancy, you may be able to see large, sweeping body parts movements through your belly. Clear impressions indicate good fluid volume. Subtle movements may suggest less room and fluid.
- Palpation: Being able to easily ballot or push your baby from side to side likely indicates adequate fluid. A baby that feels “stuck” in one position may signal low levels.
Note overall changes from what’s normal for your pregnancy. Sudden differences warrant a call to your provider.
When to see a doctor
Contact your healthcare provider right away if you notice any of the following:
- Significant changes in fundal height measurement
- Decreased frequency of fetal movement
- Changes in fetal activity patterns
- Difficulty seeing/palpating fetal movements
- Signs of early labor
- Vaginal leaking or gushing fluid
- Swelling, weight gain, or puffiness in the face and hands
- Visual disturbances or headaches
- Rapid weight gain
Your provider can do an ultrasound to evaluate fluid levels and check on baby. Further testing like a biophysical profile, non-stress test, or amniotic fluid index may be recommended depending on your symptoms.
How are abnormal fluid levels treated?
The approach depends on your specific situation:
Oligohydramnios treatment may involve:
- Increasing fluid intake to stay hydrated
- Resting in left lateral position to improve blood flow
- Monitoring with NSTs and BPPs
- Steroids if preterm birth is likely
- Early delivery if necessary for the baby’s wellbeing
Polyhydramnios treatment may involve:
- Monitoring maternal hydration and diabetes management if applicable
- Medications to reduce fetal urine output
- Serial ultrasounds to monitor fluid levels
- Early delivery if indicated
- Amnioreduction (removing excess fluid through amniocentesis)
Most cases of abnormal fluids resolve spontaneously without intervention. Your doctor will advise on the best steps based on your individual circumstances.
When to worry
Mild oligohydramnios or polyhydramnios often does not affect pregnancy outcomes. However, significant or worsening abnormalities can sometimes lead to complications:
Risks of untreated oligohydramnios include:
- Lack of cushioning, leading to deformation or limb contractures
- Umbilical cord compression
- Intrauterine growth restriction
- Non-reassuring fetal testing
- Stillbirth
Risks of untreated polyhydramnios include:
- Preterm labor and birth
- Placental abruption
- Cord prolapse
- Malpresentation
- Postpartum hemorrhage
- Perinatal mortality
That’s why following your provider’s recommendations is important if abnormal fluid levels are suspected. Most cases are mild and resolve without intervention. But monitoring and prompt treatment when indicated can help minimize risks.
Tips for monitoring fluid at home
Here are some tips for keeping an eye on your amniotic fluid from home:
- Measure fundal height weekly using a tape measure – record measurements to identify trends.
- Count fetal kicks daily during your baby’s active times – aim for at least 10 movements in 2 hours.
- Stay well hydrated by drinking plenty of water and electrolyte drinks.
- Avoid overheating and prolonged standing which can reduce fluid.
- Note general patterns in fetal activity you see and feel from outside your belly.
- Monitor for labor signs like contractions, bleeding, fluid leakage.
- Weigh yourself weekly and watch for sudden gains which may indicate excess fluid.
- Contact your provider right away for significant changes or concerns.
While home assessments are not definitive, being familiar with what’s normal for your pregnancy helps identify potential red flags. Open communication with your healthcare team is key.
Conclusion
Checking amniotic fluid levels at home can give you a general sense of whether volumes seem within normal limits. However, only your provider can accurately diagnose and monitor abnormalities through ultrasound and fetal testing. Contact your provider promptly for evaluation of any major changes or concerning symptoms. With close follow-up care, most cases of low or high fluid resolve safely under expert guidance. Monitoring your amniotic fluid is an important way you can proactively promote your baby’s health and wellbeing throughout pregnancy.
