What is the amniotic fluid index at 23 weeks of pregnancy?

We all know that amniotic fluid provides nutrients for the fetus to grow in the belly. Once there is too much or too little amniotic fluid, it will have a certain impact on the growth and development of the fetus. The amniotic fluid index of each woman is different at different stages of pregnancy. Entering the mid-pregnancy at 23 weeks of pregnancy is also crucial for the growth and development of the baby. Therefore, many mothers will worry about whether there is any abnormality in the amniotic fluid that will have a certain impact on the baby. Let’s take a look at what the amniotic fluid index is at 23 weeks of pregnancy.

What is the amniotic fluid index at 23 weeks of pregnancy?

Amniotic fluid index: The uterus is divided into four quadrants: upper left, upper right, lower left and lower right. The sum of the maximum vertical depths of the dark areas of amniotic fluid in the four quadrants is AFL. If AFL is greater than 24cm, it is diagnosed as polyhydramnios. If AFL is between 18-24cm, it is suspected polyhydramnios or too much amniotic fluid.

During a normal pregnancy, the amount of amniotic fluid increases with the gestational weeks and begins to gradually decrease in the last 2 to 4 weeks. At full-term pregnancy, the amount of amniotic fluid is about 1000ml (800-1200ml). If the amount of amniotic fluid exceeds 2000ml at any time during pregnancy, it is called polyhydramnios. Up to 20000ml. For most pregnant women, the increase in amniotic fluid is slow and takes a long time, which is called chronic polyhydramnios. For a few pregnant women, the increase in amniotic fluid is rapid within a few days, which is called acute polyhydramnios.

The main manifestation of oligohydramnios is that the pregnant mother has obvious fetal movements and feels abdominal pain during fetal movements. The uterus is sensitive and often contracts due to mild stimulation during examination. The fetal heart rate accelerated, and examination revealed that the abdominal circumference and uterine height were smaller than those of pregnant women of the same period. Too little amniotic fluid often leads to prolonged labor and delivery, making the fetus prone to intrauterine asphyxia. If the membrane ruptures, a small amount of viscous amniotic fluid can be seen. Oligohydramnios is sometimes difficult to diagnose and is easily overlooked. B-ultrasound examination showed a significant decrease in amniotic fluid. Some people also suggest that the possibility of oligohydramnios should be considered in any case of overdue pregnancy, pregnancy-induced hypertension, or fetal changes before delivery for which no other cause can be found.

Ultrasound examination shows the vertical depth of the largest amniotic fluid pool. A depth of 3-8cm is considered normal. A value less than 3 cm indicates oligohydramnios, while a value greater than 8 cm indicates polyhydramnios. If there is too much amniotic fluid, the fetus can grow healthily; if there is too little amniotic fluid, it can cause meconium accumulation during the fetal delivery period, or even premature birth or suffocation.

What to do if there is too much amniotic fluid

If there is polyhydramnios and fetal malformations, the pregnancy needs to be terminated, usually by artificial rupture of membranes. If the fetus is normal, the following measures should be taken for treatment:

1. Amniocentesis decompression: For patients with severe compression symptoms, short gestational age, and immature fetal lungs, transabdominal amniocentesis can be considered to relieve symptoms and prolong gestational age.

2. Treatment with prostaglandin synthase inhibitors: Indomethacin 2.2-2.4 mg/(kg?d), orally taken in 3 divided doses. Indomethacin has an inhibitory diuretic effect and can inhibit fetal urination to reduce the amount of amniotic fluid. However, while taking the medication, the changes in amniotic fluid volume and fetal heart rate should be closely observed. If the amount of amniotic fluid decreases significantly or the ductus arteriosus is narrowed, the medication should be stopped immediately.

3. Etiological treatment: If the polyhydramnios is caused by pregnancy complicated with diabetes, blood sugar needs to be suppressed; if the polyhydramnios is caused by maternal and fetal blood insolubility, the fetus is not yet mature and has edema, or the umbilical cord blood shows Hb<60g/L, fetal intrauterine blood transfusion should be considered.

4. Management during delivery: After natural labor, artificial rupture of membranes should be performed as soon as possible. If uterine contractions are still weak after rupture of membranes, low-concentration oxytocin can be given intravenously to enhance uterine contractions, and the progress of labor should be closely observed. Uterine contractions should be used promptly after the fetus is delivered to prevent postpartum hemorrhage.

The above is an introduction to the amniotic fluid index at 23 weeks of pregnancy. I hope it will be helpful to many expectant mothers after understanding it. You must observe your baby's fetal movements more often. Once the fetal movements become frequent or slow, you must consult a doctor in time. In addition, you must maintain a happy mood throughout the pregnancy, pay attention to the balance of nutrition in your diet, and do regular prenatal examinations.