As a women’s health nurse practitioner in a prenatal clinic, I have seen several patients with oligohydramnios. Why does low amniotic fluid occur so late in pregnancy despite regular prenatal visits and good prenatal care? — Vishnu Maya, WHCNP, Mesquite, Tex.

There is a normal decline in amniotic fluid from about 800 mL at 28 weeks’ gestation to 400 mL at 42 weeks’ gestation (J Perinatol. 2005;25:341-348). Amniotic fluid index (AFI) levels are available for each gestational week between 28 and 42 (Int J Gynaecol Obstet. 2005;91:132-136). Remember, the AFI is only one parameter to use when making a judgment about maternal or fetal well-being. — Julee B. Waldrop, DNP (184-2)

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These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical question, submit it here.