or medications that might be causing the oligohydramnios. Premature prelabor rupture of membranes or prelabor rupture of membranes is ruled out with a nitrizine test, evidence of ferning, or evidence pooling of liquid in the cervix. Sonographic evaluation of the fetus is done to identify fetal anomalies, aneuploidy, fetal growth restriction, or placental abnormalities. The National Institute of Health recommends detailed documentation of certain fetal organs that are most likely to be involved such as the kidneys, bladder, and the umbilical cord. If the lack of amniotic fluid prevents accurate visualization on ultraosund, MRI imaging can be considered. Genetic testing can be useful if fetal anomalies are documented on imaging. An elevated maternal serum alpha fetal protein (MSAFP) can indicate leaking amniotic fluid due to damage to fetal membranes or the placenta. This is associated with a poor prognosis. A maternal blood test or amniotic fluid test can be performed if suspicion of a TORCH infection is high. Increasing amniotic fluid There is no way to permanently increase the volume of amniotic fluid, but it can be temporarily increased to allow for a complete anatomy scan of the fetus on ultrasound. One way to achieve this is through an amnioinfusion, which is the insertion of 200mL of saline into the amniotic sac. One study showed an improvement in fetal structure visibility by 26% (51% to 77% before and after the infusion respectively). There is also some low quality data that may indicate a potential benefit of amnioinfusion is to facilitate external cephalic version. Amnioinfusion can be used during labor to prevent umbilical cord compression. There is uncertainty about the procedure's safety and efficacy, and it is recommended that it should only be performed in centers specializing in invasive fetal medicine and in the context of a multidisciplinary team. One to two liters of oral hydration can temporarily increase amniotic fluid in dehydrated patients with isolated oligohydramnios. Other investigational therapies may also be useful such as desmopressin, tissue sealants, or sildenafil citrate. These methods are less commonly used and are experimental. In case of congenital lower urinary tract obstruction, fetal surgery seems to improve survival, according to a randomized yet small study. Prenatal care Patients who are preterm are managed in the outpatient setting with weekly or biweekly testing to monitor for accurate fetal growth and decrease chances of unexpected fetal death. This includes a weekly non-stress test (NST) and single