Too Much Amniotic Fluid: 10 Symptoms of Polyhydramnios In Pregnancy

What is the main cause of polyhydramnios? Is polyhydramnios high-risk pregnancy? What are the dangers of having polyhydramnios? Can a baby survive with high amniotic fluid?

Polyhydramnios in pregnancy is a rare condition when excess amniotic fluid accumulates in the uterus.

Amniotic fluid is the fluid that surrounds your baby in your uterus (womb). During pregnancy, your baby needs amniotic fluid to grow. Your baby stays in this fluid throughout pregnancy. It helps to cushion and protect your baby and is also essential for your baby’s development.

During the first 14 weeks of your pregnancy, fluid passes from your circulatory system into the amniotic sac. Early in the second trimester, your baby starts to swallow the fluid and pass it out as urine (and the cycle continues). The waste is taken away through your placenta.

Pregnant women normally have about 500 to 1,000 ml of amniotic fluid. Too much or too little amniotic fluid can affect how your baby develops and/or cause pregnancy complications.

This can pose many risks to the mother and baby. Read along to learn more about it:

What Is Polyhydramnios

Polyhydramnios is a condition with extra fluid in the amniotic sac. The fluid builds up because of a defect in the placenta or uterus, which increases amniotic fluid. It can also be caused by an infection, such as toxoplasmosis, chorioamnionitis, or fungal infections.

If left untreated, polyhydramnios can cause complications for both mother and baby. For example, it can lead to premature birth and low birth weight for the baby. It's also associated with a higher risk of stillbirths and miscarriages.

Polyhydramnios occurs in about 1 to 2 per cent of pregnancies. It can occur as early as 16 weeks but is usually seen later in pregnancy.

Polyhydramnios is usually harmless, but in rare cases, it can lead to serious pregnancy complications, especially if it occurs early on in the pregnancy and depending on the amount of excess amniotic fluid.

Causes of Polyhydramnios in Pregnancy

What is the main cause of polyhydramnios?

In many cases, the exact cause of polyhydramnios cannot be determined.

Mild polyhydramnios can be caused by the gradual buildup of amniotic fluid throughout the pregnancy.

Moderate to severe polyhydramnios may be caused due to:

• A birth defect or congenital disability that affects the baby's gastrointestinal tract or central nervous system

The baby’s swallowing ability may be impaired due to a birth defect.

While inside the womb, babies swallow amniotic fluid and then urinate it. This keeps the amount of amniotic fluid at a steady level. Amniotic fluid will build up if the baby cannot swallow due to a genetic defect.

• Maternal diabetes

Elevated blood glucose levels can lead to an excessive buildup of amniotic fluid.

This can happen when the mother has diabetes before getting pregnant or becomes diabetic during pregnancy (gestational diabetes).

• Being pregnant with twins or other multiples

Polyhydramnios is especially likely in the case of twin-to-twin transfusion syndrome, in which one twin has too little amniotic fluid while the other has too much.

• Mismatched blood types between mother and baby

When a mother has an Rh-negative blood type, and her baby has an Rh-positive blood type, there is a risk of the baby developing, Rh-factor or Rh disease, a type of anaemia. This can cause, among other complications, polyhydramnios.

• A problem with the baby’s heart rate

This includes anything from foetal arrhythmia, a faint heartbeat due to a large amount of amniotic fluid or a congenital heart defect.

• Infection during pregnancy

The exact mechanism is not entirely understood, but it is believed that certain infections can disrupt the balance of amniotic fluid production and absorption. F

or instance, infections like TORCH (Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes Simplex) can cause fetal anomalies that interfere with normal fetal swallowing, leading to an increase in amniotic fluid levels.

• A lack of red blood cells in the baby (foetal anaemia)

When the fetus is anaemic, it may experience a decrease in red blood cells, leading to reduced oxygen-carrying capacity. In response, the fetal body tries to compensate for the lack of oxygen by increasing blood flow to the placenta.

This increased blood flow can result in higher levels of urine production by the fetal kidneys, leading to an accumulation of excess amniotic fluid in the womb.

Is Polyhydrammios Considered a High-Risk Pregnancy

Polyhydramnios is considered a high-risk pregnancy due to its association with increased maternal and neonatal morbidity and mortality. This condition involves an excessive accumulation of amniotic fluid during pregnancy, which can lead to various complications.

It is estimated that up to one in five neonates affected by polyhydramnios are born with a congenital anomaly. Prompt diagnosis through ultrasound and investigating the underlying cause are crucial for directing appropriate care.

Symptoms of Polyhydramnios in Pregnancy

There may not be any symptoms in the case of mild polyhydramnios.

Moderate to severe Polyhydramnios may cause the following symptoms due to the enlarged uterus exerting pressure on the other organs:

• Difficulty breathing
• Swelling in the lower extremities and abdominal wall
• Uterine discomfort or contractions
• Swelling of the vulva
• Decreased urine production
• Swollen feet
• Constipation
• Heartburn
• Feeling huge or tightness in the belly
• Foetal malposition, such as breech presentation

Complications from Polyhydramnios

What are the dangers of having polyhydramnios?

Mild polyhydramnios usually does not cause complications during pregnancy. But in severe cases, there are certain risks, including:

1. Preterm birth – Birth before 37 weeks of pregnancy
2. Premature rupture of the membranes (PROM) – When the amniotic sac breaks after 37 weeks of pregnancy but before labour starts
3. Placental abruption – When the placenta partially or completely peels away from the wall of the uterus before birth
4. Stillbirth – When a baby dies in the womb after 20 weeks of pregnancy
5. Postpartum haemorrhage – Heavy bleeding after having a baby
6. Fetal malposition – When a baby is not in a head-down position and may need to be born via Cesarean section (also called Cesarean birth or C-section)
7. Severe breathing problems during pregnancy
8. Uterine atony – When the uterus becomes stretched out and can’t contract normally
9. Bleeding after delivery
10. Prolapsed umbilical cord – When the umbilical cord comes out of the vagina before the baby
11. Macrosomia – When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth
12. Shoulder dystocia – A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labour
13. Birth defects, including problems with the baby’s bones and genetic conditions

If an individual has polyhydramnios, close monitoring by their healthcare provider is essential throughout pregnancy to prevent and manage potential complications. They may undergo tests like nonstress tests to check the baby's heart rate response to movements

Testing For Polyhydramnios in Pregnancy

Suppose your doctor suspects that you have polyhydramnios. In that case, he or she will perform a more detailed ultrasound to estimate how much amniotic fluid is inside your uterus and to look for any foetal abnormalities.

Your doctor may also perform the following tests:

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

Treatment For Polyhydramnios

How can you treat polyhydramnios?

If you have polyhydramnios, you will usually have ultrasounds weekly or more often to check amniotic fluid levels. You may also have tests to check your baby’s health.

Treatment for polyhydramnios depends on the condition's cause and how severe it is. Mild cases of polyhydramnios usually do not require any treatment and may go away on their own.

Severe polyhydramnios may require closer monitoring, especially from week 32 of pregnancy.

• Bed Rest

Cases of moderate polyhydramnios found later in pregnancy can be treated with bed rest. Laying horizontal and resting is recommended to delay any preterm labour as long as possible.

• Amnioreduction

In more severe cases, polyhydramnios can be treated by regularly draining amniotic fluid from the uterus using a large needle.

This procedure is called amnioreduction and carries a risk of complications. Your doctor will only recommend it if the danger of continuing the pregnancy with untreated polyhydramnios is greater than the risk of draining the fluid.

• Medications

If your doctor determines that your polyhydramnios results from your baby’s heart rate, he or she might give you medication to correct the heart rate.

Polyhydramnios can also be treated with a medication that reduces the amount of urine the foetus produces.

• Induce Early Labour

In some cases of severe polyhydramnios, your doctor may decide that the best course of action is to induce labour early, at 37 weeks, or even sooner.

Doctors may also consider a caesarean delivery if they feel the baby is too large or a breech or vaginal birth is too risky.

If you have polyhydramnios in pregnancy, it is important to follow your doctor’s advice to help you have a safe delivery.

How to Reduce Polyhydramnios Naturally

Polyhydramnios in pregnancy can cause complications for both mother and child, so it's important to know how to reduce polyhydramnios naturally.

Here are some steps you can take:

• Drink plenty of water. Water helps to flush out excess fluids from your system and will help reduce the amount of liquid surrounding your baby.
• Eat foods high in fibre, such as fruits and vegetables. These foods will also help you feel full longer, so you aren't tempted to overindulge in empty calories.
• Exercise regularly to keep your body fit and healthy so it can handle any changes that may occur during pregnancy or labour more easily than someone who isn't as active regularly.
• Take prenatal vitamins daily - this ensures your body has all the nutrients it needs while expecting (which is hard enough!).

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