Symptoms of Low Amniotic Fluid That May Indicate Medical Negligence

Pregnancy should be a time of careful monitoring, clear communication, and trusted medical guidance. When something feels off and concerns are overlooked, the consequences can be devastating. Our knowledgeable New York birth injury lawyers understand how critical it is to recognize red flags early — and what can happen when they’re missed. In this article, we explore what families need to know to protect both mother and baby.

What Is Low Amniotic Fluid?

Low amniotic fluid, medically known as oligohydramnios, occurs when there is too little amniotic fluid surrounding the baby during pregnancy. This fluid plays a vital role in fetal development by cushioning the baby, supporting the growth of lungs and organs, and helping to regulate temperature in the womb.

How Is Oligohydramnios Diagnosed?

Oligohydramnios is typically diagnosed through an ultrasound exam, which allows healthcare providers to estimate the amount of amniotic fluid in the uterus, a key indicator for diagnosing oligohydramnios based on the amniotic fluid level. If fluid levels appear lower than expected for the baby’s gestational age, or if there are abnormal levels of amniotic fluid, further evaluation is done to confirm the condition. Two common methods are used:

• Amniotic fluid index (AFI): The uterus is divided into four quadrants, and the deepest pocket of fluid in each is measured. The total of these measurements gives the AFI. A reading below 5 cm is generally considered low.
• Maximum vertical pocket (MVP): This method measures the depth of the largest visible pocket of fluid. An MVP measurement of less than 2 cm suggests oligohydramnios.

Symptoms of Low Amniotic Fluid

Recognizing the symptoms of low amniotic fluid is critical to protecting both maternal and fetal health. While some signs may be subtle, they often point to underlying complications that require immediate medical evaluation and monitoring.

Smaller Belly Size

One of the first visible indicators of a low fluid pregnancy is a uterus that measures smaller than expected for gestational age. Insufficient weight gain during pregnancy may also be a sign of underlying issues such as oligohydramnios. This is typically assessed through fundal height measurements during prenatal visits. A significant lag in growth may suggest decreased amniotic fluid and impaired fetal development.

Decreased Fetal Movement

Another warning sign is reduced fetal movement, especially during the third trimester when movement patterns are more predictable. If a baby becomes less active, it may be a response to stress caused by insufficient cushioning or poor oxygen flow due to low amniotic fluid levels.

Leaking Fluid

Women with oligohydramnios may experience leaking or dripping of clear fluid, which could indicate a rupture or slow leak in the amniotic sac. While it can be mistaken for urine or discharge, persistent leaking should always be evaluated, as it may lead to infection or preterm labor.

Abnormal Ultrasound Findings

Often, low amniotic fluid is diagnosed during routine ultrasounds, especially when fluid levels appear visibly reduced. Abnormal ultrasound findings may also reveal fetal growth restriction, which is often associated with decreased amniotic fluid and can indicate potential fetal complications. Medical professionals use measurements like the Amniotic Fluid Index (AFI) or Deepest Vertical Pocket (DVP) to quantify fluid volume. An AFI below 5 cm or a DVP less than 2 cm typically confirms the diagnosis of oligohydramnios.

Other Possible Symptoms

• Tight or compressed feeling in the abdomen
• Premature labor symptoms, such as cramping or contractions
• Fetal heart rate abnormalities, sometimes detected during a non-stress test (NST)

Understanding these symptoms and reporting them early can make a significant difference in preventing complications such as intrauterine growth restriction (IUGR), birth injury, or even stillbirth. If you suspect something is wrong, especially in the presence of multiple signs, prompt medical attention is essential.

Causes of Low Amniotic Fluid

Knowing what causes low amniotic fluid can help pregnant women and medical professionals take timely action. A low fluid pregnancy can occur for various reasons, many of which are linked to maternal health, fetal conditions, or issues with the placenta. Common causes include:

• Leaking or ruptured membranes: A slow, undetected leak or premature rupture can result in significant fluid loss.
• Placental insufficiency: When the placenta doesn’t deliver enough nutrients and oxygen, the baby may produce less urine, reducing fluid levels.
• Fetal abnormalities: Problems with the baby’s kidneys or urinary tract can interfere with normal urine production, which makes up much of the amniotic fluid.
• Maternal health conditions: High blood pressure, dehydration, diabetes, and certain autoimmune disorders can increase the risk of low fluid.
• Post-term pregnancy: Amniotic fluid naturally decreases after 40 weeks, and levels may drop dangerously low beyond 42 weeks.
• Multiple gestation pregnancies: In twin or triplet pregnancies, amniotic fluid levels may be imbalanced, especially in conditions like twin-to-twin transfusion syndrome (TTTS).

Identifying these risk factors early is crucial for managing a healthy pregnancy and preventing complications associated with oligohydramnios.

How Is Oligohydramnios Treated?

Treatment for oligohydramnios focuses on supporting a healthy pregnancy while closely monitoring the baby’s well-being. The approach depends on several factors, including the stage of pregnancy, the severity of amniotic fluid loss, and any underlying conditions that may affect the mother or baby. In many cases, the goal is to prolong the pregnancy safely until the baby is fully developed and ready for delivery.

Standard treatment options may include:

• Increased prenatal monitoring to closely track fluid levels and fetal growth.
• Frequent ultrasounds and non-stress tests to assess fetal health and amniotic fluid status.
• Hydration therapy, including oral fluids or IV fluids, may help raise fluid levels in mild cases.
• Amnioinfusion, a procedure where a sterile saline solution is introduced into the uterus during labor to cushion the baby and relieve umbilical cord pressure.

In more severe cases or if the pregnancy is near term, early delivery may be recommended to reduce the risk of complications.

Complications of Oligohydramnios

When amniotic fluid levels fall below normal, oligohydramnios can lead to serious complications for both the baby and the pregnancy. The severity of these risks often depends on how early in the pregnancy the condition develops and how it is managed.

Potential complications include:

• Impaired fetal development: Low fluid can restrict movement, leading to musculoskeletal abnormalities such as clubfoot or joint stiffness.
• Underdeveloped lungs (pulmonary hypoplasia): Especially dangerous if oligohydramnios occurs in the second trimester, when lungs are still forming.
• Umbilical cord compression: Less cushioning increases the risk of the cord becoming pinched, which can reduce oxygen and nutrient flow to the baby.
• Intrauterine growth restriction (IUGR): Babies may not grow at a normal rate due to placental insufficiency or cord issues.
• Complicated labor and delivery: Low fluid levels may lead to induced labor or an emergency C-section.
• Stillbirth: In untreated or severe cases, prolonged oligohydramnios can result in fetal death.

Early diagnosis and proactive management are crucial in reducing these risks and safeguarding the baby's health.

Real Client Stories: Missed Signs of Low Amniotic Fluid and Fetal Growth Issues

At 31 weeks, our client raised concerns about a low fluid pregnancy and lack of fetal growth. Her midwife failed to measure fundal height, a basic check for fetal development. Despite the mother’s insistence, a delayed ultrasound was ordered but improperly performed and interpreted.

Medical staff failed to assess amniotic fluid levels using standard methods like AFI or DPV and overlooked a drastic decline in fetal growth — abdominal circumference dropped by 76% and estimated fetal weight by 65%. These were warning signs of placental insufficiency, a condition that compromises blood and nutrient flow to the baby.

No follow-up tests were ordered — no Doppler, BPP, or NST — which would have confirmed fetal distress. At 34 weeks, the baby was stillborn. Medical negligence during a child's birth can have devastating, lifelong consequences. When children suffer due to preventable birth injuries, families may face long-term challenges. With proper monitoring and early delivery, this tragic outcome could have been prevented.

Your Legal Options After a Preventable Birth Injury

When low amniotic fluid is not properly identified or managed, and a baby is harmed as a result, families may have the right to pursue a medical malpractice claim. Healthcare providers are expected to recognize and respond to the warning signs of oligohydramnios in accordance with accepted medical standards. Failing to do so may be considered medical negligence. If your child suffered a preventable birth injury, here are your potential legal options:

• File a medical malpractice lawsuit against the negligent doctor, midwife, or hospital.
• Seek compensation for medical bills, long-term care, therapy, and future lost earnings.
• Request damages for emotional distress and the pain and suffering caused by the birth injury.
• Consult our birth injury attorney to review medical records and determine if the standard of care was breached.
• Pursue justice on behalf of your child to prevent similar harm to others.