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22 May, 2020

What Is Polyhydramnios And How To Deal With It

Your baby swims in the amniotic fluid for the 9 months that she’s in your womb. This fluid plays an important role in the baby’s health. She needs just the right amount of fluid to protect and help her grow. Normal amniotic fluid levels in later stages of pregnancy are between 5 and 25 cm, or about 800-1000 ml. If the measurement is over 25, it is called polyhydramnios.

So what exactly is polyhydramnios and does it pose any risks for mom and Baby? Read on to know more.

What is Polyhydramnios?

Polyhydramnios is the excessive accumulation of amniotic fluid – the fluid that surrounds the baby in the uterus during pregnancy. This condition occurs in about 1 to 2 percent of pregnancies. Most cases of polyhydramnios are mild and result from a gradual buildup of amniotic fluid, during the second half of pregnancy. Severe polyhydramnios may cause shortness of breath, preterm labor, or other signs and symptoms.

When a pregnant woman is diagnosed with polyhydramnios, the doctor will carefully monitor your pregnancy to help prevent complications. Treatment depends on the severity of the condition. Mild polyhydramnios may go away on its own. Severe polyhydramnios may require closer monitoring. These are rare and are sometimes seen with babies who have blockage along gastrointestinal tract.

Symptoms of Polyhydramnios

Polyhydramnios symptoms result from pressure being exerted within the uterus and on nearby organs. Mild cases show little or no signs or symptoms. However, severe polyhydramnios may cause the following:

  • Shortness of breath or the inability to breathe
  • Swelling in the lower extremities and abdominal wall
  • Uterine discomfort or contractions
  • Foetal malposition, such as breech presentation

Your doctor may also suspect polyhydramnios if your uterus is excessively enlarged and he or she has any trouble feeling the baby.

Causes of Polyhydramnios

About 50-65% of the time, nobody knows what causes a woman to develop polyhydramnios. However, the rest of the time, doctors can pinpoint it to certain conditions. These are some of the factors that may lead to an increased risk of polyhydramnios:

  • Diabetes – Certain moms with diabetes might have increased levels of amniotic fluid.
  • Birth defects – Certain birth defects involving baby’s ability to swallow or kidney function can also cause increased amniotic fluid. It is your baby’s ability to swallow and process fluid through the kidneys that regulates this fluid level in the uterus.
  • Rh Incompatibility – A mismatch between mom’s blood and baby’s blood group.
  • Twin-to-twin transfusion syndrome (TTTS) – When one identical twin gets too much blood flow than the others, it may lead to more amniotic fluid.
  • Problems with baby’s heart rate – These usually show up on ultrasound or monitoring.
  • An infection in the baby.

Complications of Polyhydramnios

These are some of the complications that can occur with polyhydramnios.

  • Too much amniotic fluid is associated with an increased risk of stillbirth.
  • Polyhydramnios increases the risk of premature rupture of membranes and/or preterm labor.
  • Some babies with high amniotic fluid levels can wiggle their way into a weird birthing position, instead of the normal late-pregnancy, head down, ready-to-be-born position.
  • Polyhydramnios increases risks for breech or transverse positions, which increases chances for C-section.
  • During labor, the umbilical cord could get pinched or pushed out before the baby, which can be very dangerous.
  • Amniotic fluid could lead to placental abruption, which means the placenta could separate before the baby is born, and increased risk for postpartum haemorrhage.

Although this situation sounds scary, polyhydramnios and its complications are fairly rare. As long as your baby is close to term, your amniotic fluid is still near normal range, and you’re being taken care of by an excellent team such as the one at KIMS Cuddles, high amniotic fluid levels may not pose a big problem.

Diagnosis and Treatment

If your doctor suspects polyhydramnios, they will do a fetal ultrasound. This test uses high-frequency sound waves to produce images of your baby on a monitor. If the initial ultrasound shows evidence of polyhydramnios, your doctor may ask to do a more detailed ultrasound. They will estimate the amniotic fluid volume (AFV) by measuring the single largest, deepest pocket of fluid around your baby. An AFV value of 8 cms or more suggests polyhydramnios. Your doctor may even ask to do additional testing if you have a diagnosis of polyhydramnios.

Mild cases of polyhydramnios generally don’t require any special treatment and may go away on their own. Even cases that cause discomfort can usually be managed without intervention. In other cases, treatment for an underlying condition – such as diabetes – may help resolve polyhydramnios. If you experience preterm labor, shortness of breath or abdominal pain, you may need treatment in the hospital. This includes:

  • Drainage of excess amniotic fluid: Your doctor may use amniocentesis to drain excess amniotic fluid from your uterus. This procedure contains a small risk of complications such as preterm labor, placental abruption and premature rupture of the membranes. Your doctor will inform you about the same.
  • Medication: Your doctor may prescribe an oral medication to help reduce foetal urine production and amniotic fluid volume. Due to the risk of foetal heart problems, your baby’s heart may also need to be monitored with a foetal echocardiogram and Doppler ultrasound. Some side effects may include nausea, vomiting, acid reflux and inflammation of the lining of the stomach.

Even after treatment, your doctor will want to monitor your amniotic fluid level once every one to three weeks. Most women with mild to moderate polyhydramnios will be able to carry their baby to term, delivering at 39 to 40 weeks. Those who have severe polyhydramnios will be advised by their doctor about the appropriate timing of delivery to avoid complications for you and your baby. Polyhydramnios can be a worrisome condition during pregnancy. Work with your gynaecologist to ensure that you and your baby receive the best care possible. Our doctors at KIMS Cuddles can help you experience a healthy, comfortable pregnancy.

*Information shared here is for general purpose Please take doctors’ advice before taking any decision.

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