![]() The normal fetus is constantly swallowing amniotic fluid and urinating to create more fluid. Oligohydramnios can also occur because the patient's amniotic membrane has ruptured and amniotic fluid is leaking out of the uterus. ![]() Therefore, decreased amniotic fluid volume due to decreased urine production by the fetal kidney is a reflection of chronic hypoperfusion of the fetus. When the fetus receives adequate nutrients and oxygen from the placenta, blood is shunted away from the fetal kidney, glomerular filtration rate decreases, and urinary output decreases. It is the same mechanism that causes oliguria in critically ill adults. Decreased urine production by the fetal kidney typically reflects inadequate blood flow to the fetal kidney, caused by shunting of fetal blood flow away from the kidney to the heart and brain. Urinary tract obstruction can occur anywhere along the fetal urinary tract and can be catastrophic for the fetus. Decreased fetal urine output can have a number of causes, which fall into two general categories: fetal urinary tract obstruction and decreased urine production by the fetal kidney.
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