High amniotic fluid during pregnancy - Polyhydramnios

Polyhydramnios or commonly referred to as "polyhydramnios" is a relatively rare condition that occurs in about 1% of pregnancies.

What is polyhydramnios?

Polyhydramnios occurs when excess amniotic fluid accumulates in the uterus during pregnancy. Excess amniotic fluid is the opposite of oligohydramnios, which means not enough amniotic fluid. In most cases, polyhydramnios is harmless, but it can lead to serious complications during pregnancy.

Symptoms

A mild case of polyhydramnios may not cause any symptoms. It's okay, because mild polyhydramnios usually does not cause pregnancy complications.

Moderate or severe polyhydramnios can cause the following symptoms:

Difficulty breathing
Swelling in the lower extremities
Swelling of the vulva
Decreased urine production
Constipation
Heartburn
Feeling huge or tightness in the belly

The above symptoms occur because an overly enlarged uterus puts pressure on other organs.

Your doctor can identify symptoms of polyhydramnios that you cannot. If your uterus is excessively large (measured two or more weeks before delivery) or if your doctor cannot feel the baby or determine its heartbeat, you may have polyhydramnios.

Polyhydramnios can occur as early as the 16th week of pregnancy, but in most cases it only occurs later in pregnancy. Early onset of polyhydramnios indicates a higher likelihood of pregnancy complications.

Causes

In many cases, the cause is unknown. Mild polyhydramnios is probably simply caused by the gradual accumulation of amniotic fluid during pregnancy.

The following conditions can cause moderate or severe polyhydramnios:

Birth defect or congenital disability. Sometimes polyhydramnios is a side effect of a birth defect that impairs a child's ability to swallow. Inside the uterus, babies will swallow the amniotic fluid and then urinate, keeping the amount of amniotic fluid at a constant level. If a child cannot swallow due to a genetic defect, amniotic fluid builds up.
Maternal diabetes. High blood glucose levels can lead to excessive accumulation of amniotic fluid. This complication can occur if the mother had diabetes before pregnancy or developed diabetes during pregnancy (gestational diabetes).
Twin-to-twin transfusion syndrome. If you are carrying identical twins, you may have a complication in which one twin receives too much blood and the other too little.
Mismatched blood groups. When a mother has an Rh negative blood type and her baby has an Rh positive blood type, there is a risk that the baby will develop an Rh factor or Rh disease, a type of anemia. This disease can cause, among other complications, polyhydramnios.
Problems with the baby's heartbeat. This includes anything from fetal arrhythmias to palpitations due to high amounts of amniotic fluid or congenital heart disease.

Complications

As mentioned earlier, mild polyhydramnios usually does not cause complications. But in severe cases, there are some risks, including:

Pre-term Labor
Premature Birth
Excess fetal growth
Placental abruption (the placenta detaching from the wall of the uterus before you give birth)
Postpartum hemorrhage
Umbilicalcord prolapse (the cord falling out of the vagina before the baby)
Fetal malposition
Stillbirth

Polyhydramnios test

If your doctor suspects you have polyhydramnios based on your symptoms or the appearance of your ultrasound, they will perform a more detailed ultrasound to assess the amount of amniotic fluid in your uterus. If you are above the threshold, your doctor may also perform the following tests:

Glucose tolerance test (for gestational diabetes)
Amniocentesis (sampling of amniotic fluid to test the baby for genetic abnormalities)
Non-StressTest (to check for abnormalities in the baby’s heart rate)
Doppler ultrasound (a stronger ultrasound that can see the baby’s circulatory system)

Treatment

Treatment depends on the severity of the disease and its cause. Mild cases of polyhydramnios usually do not require treatment. Your doctor will likely want you to have additional tests to make sure the condition isn't worsening. But you should be able to give birth to a healthy baby without complications and without labor induction.

In severe cases, the treatment plan may focus on the underlying condition. If, for example, your doctor determines that your polyhydramnios is the result of your child's heart rate, he or she may give you medication to correct the heart rate, thereby correcting the polyhydramnios.

Polyhydramnios is treated by regularly draining amniotic fluid from the uterus using a large needle. This procedure comes with a risk of complications, so your doctor will only recommend it if the risk of continuing your pregnancy with untreated polyhydramnios outweighs the risk of fluid drainage.

Polyhydramnios can also be treated with medications that reduce the amount of urine the fetus produces. This medicine carries a risk of damaging the baby's heart, so you will need to have regular checkups to monitor your baby's heartbeat.

In some severe cases, your doctor may decide that it is best to induce labor earlier, at 37 weeks or even earlier.

Cases of mild polyhydramnios found later in pregnancy can be treated with bed rest. Laying horizontal and rest are recommended to delay preterm labor as much as possible. Many women find it difficult to move or move and describe it as feeling like they are about to "pop". This may be true to some extent when it comes to the fact that your waters may be breaking early due to pressure.

It is important that you follow your doctor's instructions to help you and your baby have the best possible delivery.