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Expert Q&A

	By Traci Kurtzer Obstetrician and Gynecologist

I recently delivered a stillborn baby boy. I had not felt movement and discovered my baby had died. I was told there was no water around the baby and they kept asking if my waters had already broken which they had not. Do you know what this could mean or how it happened where the water would have gone? I will be getting the postmortem results soon, but it's driving me crazy.

There can be many reasons why the amniotic fluid level can be low. You did not mention how far along in the pregnancy you are which can determine the most likely cause for this condition of oligohydramnios (low amniotic fluid). In many cases, it is due to a small leak in the bag of water which causes a slow continuous decline in the fluid level over time. Some medications, like non-steroidals (i.e. Motrin) and some for high blood pressure, can cause the fetal kidneys to not work as well, and amniotic fluid is basically fetal urine. There are also some fetal congenital defects, especially those involving the kidneys that can cause low urine production. If the placenta is not working well, due to high blood pressure, diabetes or autoimmune problems, like lupus, or if there is a placental separation , it will not allow good blood flow to the fetus and that will make the kidneys not work well either in urine production. As you can see there are so many different causes and this is not a full list. I hope you will get more information from the postmortem exam, so that this tragedy can be avoided in the future.

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