Low Amniotic Fluid?

Sometimes late in a pregnancy a woman's amniotic fluid is measured to be low and interventions are suggested based on the possibility of issues related. Lets look at the measurement of low fluid, indications and approaches.

Here is a blog post from Gloria Lemay's blog.
Ms. Lemay is on the advisory board of ICAN.
http://www.glorialemay.com/blog/?p=60
Here is an article she wrote for Midwifery Today with a lot of the same information included-
Suspect Diagnoses Come with Biophysical Profiling

Often induction is recommended or version for breech is denied according to an ultrasound measurement of fluid.
Here is an article from the Journal of Perinatology that disputes induction is necessary. Low Levels of Amniotic Fluid No Risk To Normal Birth (2004) The full article is posted below Gloria Lemay's blog post.

It is certainly worth discussing in depth with your care provider any treatment based on ultrasound measurement of fluid. Ideally there would be other indications of an issue present. Does the intervention create more risk then the possible issue does?

Childbirth Connection has a great paper on ultrasound.
Imaging Ultrasound in Pregnancy

"An unusual number of diagnoses seem to be made that "there is not enough amniotic fluid." This seems to be the factor in this outline that is most often used as an excuse for induction. It is important for parents to know that this is likely an inaccurate assessment.
What the ultrasound technician is doing could be compared with viewing an adult in a see-through plexiglass bathtub from below the tub. In such a scenario, it would be difficult to assess how much water is in the tub above the body that is resting on the bottom of the tub. You might be able to get an idea of the water volume by measuring how much water was showing below the elbows and around the knees, but if the elbows were down at the bottom of the tub too, you might think there was very little water.
This is what the technician is trying to do in late pregnancy—find pockets of amniotic fluid in little spaces around the relatively large body of an eight-pound baby who is stuffed tightly into an organ that is about the size of a watermelon (the uterus). If most of the amniotic fluid is near the side of the uterus closest to the woman's spine, it cannot be seen or measured. This diagnosis of low amniotic fluid frightens the parents into acquiescing to an induction of labor. Even though the official BPP guidelines do not require immediate induction for a finding of low amniotic fluid, in practice the parents are pressured to induce. Stories abound of mothers who are induced for this indication and then report having abundant fluid when the membranes released in the birth process. The risks of induction, which can be catastrophic, and the resulting increase in the need for pain relief medication and cesarean section are usually not discussed with the parents before embarking on induction."
http://www.midwiferytoday.com/enews/enews0620.asp

There are also other treatments possible with a low fluid diagnosis-
"Oligohydramnios: Too Little Amniotic Fluid -
Recent studies suggest that women with otherwise normal pregnancies who develop oligohydramnios probably need no treatment. Their babies are likely to be born healthy. Even so, your provider may want to watch you closely. When treatment is needed, the amniotic fluid may need to be replaced with an artificial substitute once the woman is in labor. "
http://search.marchofdimes.com/cgi-bin/MsmGo.exe?grab_id=6&page_id=11272448&query=low+amniotic+fluid&hiword=FLUIDS+amniotic+fluid+low+

Low fluid diagnosis alone is not an emergency. Talk to your care provider and do your own research!