Q: I am 26 weeks pregnant. Recently I underwent an ultrasound due to self interest. Everything was normal but the amniotic volume index (AVI) value was 18. I got some sugar tests done around 2 months back as I had an abcess in the back and was operated. But the results were normal. My parents were diabetic and are no more now. The doctor has advised for some sugar related tests. How serious is this? I already had three miscarriages in the first trimester and this is a precious one for me. How serious is this and what complications can it create? What medications and personal precautions should I take to reduce this value?

A:The normal amniotic fluid index also known as amniotic volume index (AVI) is 12-14 cm. The reading of 18 indicates a mild increase. The causes of this are several and include high blood sugar, fetal malformations and infections. The vast majority of patients with a high AVI do not have any specific cause. A careful ultrasound scan can exclude most (but not all) malformations. Blood tests on the mother are useful to exclude specific infections. Elevated blood sugars are a common cause. These can be assessed be simple blood tests. Once these sinister causes have been excluded the fluid needs to be monitored frequently and a premature rupture of the water bag needs to be prevented by restricting the activity of the patient and treating the underlying cause if discovered. By itself this is not a problem to be alarmed about.