Posts Tagged ‘amniotic fluid’

What is twin-to-twin transfusion syndrome?

Friday, December 15th, 2017

Twin-to-twin transfusion syndrome (TTTS) is a serious condition that occurs in about 10-15% of identical twin pregnancies where the babies share a placenta (monochorionic).

In TTTS, the blood vessels in the placenta form abnormal connections and blood does not flow evenly between the babies. One twin becomes a “donor” and the other becomes a “recipient.” The donor twin pumps blood to the recipient twin. This means that the recipient twin is bigger, has more blood, and makes more urine. This results in too much amniotic fluid (polyhydramnios) and an enlarged bladder. The extra fluid can also strain the recipient twin’s heart. However, the donor twin is smaller, has less blood, little to no amniotic fluid (oligohydramnios), and a smaller bladder.

How do you know if your twins have TTTS?

TTTS is usually found during an ultrasound in the second trimester. Once TTTS is identified, your health care providers will evaluate how serious the TTTS is. They will look at how much amniotic fluid is in each sac, how the donor twin’s bladder is working, and they will look at blood flow in both babies. They may also do an amniocentesis and echocardiogram (an ultrasound of the baby’s heart) if needed.

What treatment is available for TTTS during pregnancy?

The treatment plan will depend on how severe the condition is. Options for treatment include:

  • Monitoring with regular ultrasounds: Monitoring allows your providers to regularly check on your twins and look for any signs that TTTS is getting worse.
  • Removing amniotic fluid from the recipient twin: Extra amniotic fluid is removed from the larger (recipient) twin. This is only a temporary option and may need to be repeated.
  • Laser surgery (known as selective fetoscopic laser photocoagulation or SFLP): This procedure uses a laser to stop the transfer of blood between the babies. It is often the

Without treatment TTTS can cause serious problems for both babies. So it is important that you go to all of your prenatal checkups—even when you’re feeling fine. Twins with mild to moderate TTTS may be at increased risk for premature birth.

When your baby is overdue

Monday, September 30th, 2013

bellyThe average healthy pregnancy is around 40 weeks. Some babies come earlier and others run later. A pregnancy that lasts longer than 42 weeks is called a post-term pregnancy.

Dr. Siobhan Dolan discusses overdue pregnancies in the book Healthy Mom Healthy Baby. Here is an excerpt from the book.

“Although many post-term babies are healthy, some risks do start to increase after 41 to 42 weeks. An overdue pregnancy takes a toll on the placenta, amniotic fluid, and umbilical cord. As the baby grows larger, the chances of stillbirth and delivery injuries go up, and there is a greater likelihood that the baby will experience meconium aspiration (inhaling stool from the amniotic fluid into the lungs) or a condition called dysmaturity syndrome (in which the baby is no longer getting enough nourishment because the placenta is aging and becoming calcified).

“When a baby is overdue, the provider may do some tests to check on the baby’s health. They include:
– Ultrasound exam
– Kick count, which is a count of how many times your baby moves or kicks you during a certain period of time
– Nonstress test, in which a fetal monitor measures your baby’s heart rate for a certain amount of time
– Biophysical profile, which uses a fetal monitor and an ultrasound to score a baby on each of five factors (nonstress test, body movements, breathing movements, muscle tone, and the amount of amniotic fluid)
– Contraction stress test, which compares your baby’s heart rate at rest with the heart rate during contractions induced by a shot of oxytocin or nipple stimulation

“If these tests suggest that your baby is in good condition, you can continue to wait for labor to begin naturally. If they raise concerns, your provider may wish to induce labor or perform a c-section. Providers rarely allow a pregnancy to go beyond 42 weeks.”

Amniotic fluid surrounding your baby

Friday, July 26th, 2013

insideWhat is this made of and how much is enough, too much? What’s normal, what’s not?

The amniotic sac that contains your baby begins to form about 12 days after conception. Amniotic fluid begins to form at that time, too. In the early weeks of pregnancy, amniotic fluid is mainly made up of water supplied by the mother. After about 12 weeks, your baby’s urine makes up most of the fluid. The amount of amniotic fluid increases until about 36 weeks of pregnancy. At that time you have about 1 quart of fluid. After that time, the level begins to decrease.

Sometimes you can have too little or too much amniotic fluid. Too little fluid is called oligohydramnios. Too much fluid is called polyhydramnios. Either one can cause problems for a pregnant woman and her baby. Even with these conditions, though, most babies are born healthy.

The amniotic fluid that surrounds your baby plays an important role in her growth and development. This clear-colored liquid protects the baby and provides her with fluids. Your baby actually breathes this fluid into her lungs and swallows it. This helps her lungs and digestive system grow strong. Your amniotic fluid also allows your baby to move around, which helps her to develop her muscles and bones.

Normal amniotic fluid is clear or tinted yellow. Fluid that looks green or brown usually means that the baby has passed his first bowel movement (meconium) while in the womb. (Most babies have their first bowel movement after birth.)

If the baby passes meconium in the womb, it can get into his lungs through the amniotic fluid. This can cause serious breathing problems, called meconium aspiration syndrome, especially if the fluid is thick. Some babies with meconium in the amniotic fluid may need treatment right away after birth to prevent breathing problems. Babies who appear healthy at birth may not need treatment, even if the amniotic fluid has meconium.