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
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.
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
A lack of red blood cells in the baby (foetal anaemia)
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
- Feeling huge or tightness in the belly
- Foetal malposition, such as breech presentation
Complications from Polyhydramnios
Mild polyhydramnios usually does not cause complications during pregnancy. But in severe cases, there are certain risks, including:
- Premature rupture of membranes — when your water breaks early
- Premature Birth
- Excess foetal growth
- Placental abruption (premature separation of the placenta from the wall of the uterus)
- Postpartum haemorrhage - Heavy bleeding due to lack of uterine muscle tone after delivery
- Umbilical cord prolapse (the cord falling out of the vagina before the baby)
- Foetal malposition such as breech presentation
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
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.
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.
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.
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.
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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Does Polyhydramnios Result in Birth Defects
Polyhydramnios in pregnancy can cause complications during pregnancy and birth but do not necessarily result in birth defects.
Most babies born with polyhydramnios do not have any problems at all. Babies with problems are typically born prematurely or have some other complication that causes them to be born early.
When polyhydramnios does lead to birth defects, it is usually due to a genetic disorder that affects the fetus’ organs or tissues. If this is the case, then there will be other signs of the genetic disorder present during pregnancy and birth.
Can You Have a Healthy Baby With Polyhydramnios
Polyhydramnios in pregnancy can cause complications during pregnancy, especially if you're carrying more than one baby. The good news is that it doesn't necessarily mean something is wrong with your baby or your pregnancy, and there are ways to treat this condition so you can have a healthy baby and a safe pregnancy.
Updated by Pheona Ilagan
AmericanPregnancy, MayoClinic, Stanford Children’s Health, NHS
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