Too Much Amniotic Fluid in Pregnancy - Causes and Complications of Polyhydramnios
Pregnancy holds various risks to both mother and the baby. Most prospective parents should be concern about some of the things that might go wrong during the pregnancy, resulting in serious complications. Polyhydramnios is one such condition that needs to be timely addressed.
Polyhydramnios is a condition in which a pregnant woman has too much of amniotic fluid. This fluid-filled sac in the uterus allows the baby swims and completes his/her term of gestational life. This fluid level should be in the normal range. If it’s too low, it leads to oligohydramnios, while too much or excess accumulation of amniotic fluid can be a case of polyhydramnios.
How much amniotic fluid is too much?
The range of the amniotic fluid level depends on how far the pregnancy has progressed. Generally, the amniotic fluid level will increase till the third trimester and then decreases. The fluid level is normally assessed through Amniotic Fluid Index which should be 8-24 cm. The second method is by determining the deepest pocket of fluid or fluid volume. If it measures over 8 cm, then it suggests polyhydramnios.
How common is Polyhydramnios?
It is estimated that Polyhydramnios occurs in less 1 percent of pregnancies. Most cases of polyhydramnios or high amniotic fluid are mild and can result from gradual accumulation of the fluid during the second half of the pregnancy.
However, in severe cases, there could be complications such as shortness of breath and preterm labor.
While mild cases will resolve on their own, severe polyhydramnios might require close monitoring.
What causes Polyhydramnios?
Some of the causes related to Polyhydramnios are:
- Maternal gestational diabetes
- Abnormality or birth defects in the fetus
- Lack of red blood cells in the fetus (anemia)
- Infection during pregnancy
- Blood mismatches between the mother and the baby
Symptoms of Polyhydramnios
The symptoms of polyhydramnios can arise from the pressure created within the uterus and nearby organs. These include:
- Shortness of breath or difficulty in breathing
- Discomfort or contractions in the uterus
- Swelling in the abdominal wall
- Faulty position of the fetus
- Problem in moving or pain in hips
Known complications for Polyhydramnios
High amniotic fluid can cause a range of complications. While mild ones cause few or no symptoms, in serious cases the symptoms might be:
- Premature rupture of membranes (water breaking early)
- Preterm delivery
- Umbilical cord coming out of the uterus and dropping into the vagina before the baby during the delivery (uterine cord prolapse)
- Heavy bleeding complications after birth
- Placenta detaching from the uterine wall prematurely (Placental abruption)
- Cesarean delivery
How to diagnose Polyhydramnios?
If the doctor suspects of polyhydramnios, he will probably go for an ultrasound test. The calculations will be based on deepest pocket of fluid and amniotic fluid index mentioned above. The doctor will also rule out any birth defects using detailed ultrasound.
Based on the severity of the case, the doctor may also recommend additional such as:
- Blood test - For checking any infectious disease
- Amniocentesis - To check any abnormalities in the fetus
If you are diagnosed with polyhydramnios, the doctor will further monitor your condition through following procedures:
- Nonstress test - In this test you have to wear special device or band around your abdomen. The test determines the baby heart rate when he/she moves. You might be asked to eat or drink something to check the activity of the baby. The doctor might also use a buzzer-like device which wakes up the baby and encourage his/her movement.
- Biophysical profile - This test analyzes breathing, movement and amniotic fluid volume using an ultrasound. The biophysical profile might be combined with non-stress test.
How to treat Polyhydramnios?
Mild polyhydramnios cases hardly require any treatment and may resolve on their own. Even the symptom of discomfort can also be managed without much intervention. If there is some underlying condition such as gestational diabetes, managing it might resolve polyhydramnios. In serious cases such as abdomen pain and chances of preterm labor, the doctor may recommend:
- Medication - To reduce fetal urine production or amniotic fluid level. The medication might not be recommended after 31 weeks of pregnancy. Your baby’s heart needs to be monitored to avoid any heart problems. You might face some side effects such as vomiting, nausea and acid reflux.
- Draining excess of amniotic fluid - The procedure is done through amniocentesis. But it carries a little bit of risk of developing complications such as placental abruption, premature rupturing of the membranes and preterm labor.
Even after getting the treatment, you will require frequent monitoring of the amniotic fluid level every couple of weeks. Polyhydramnios can be a troubling thing for a pregnant woman. Talking with the gynecologist and timely check-ups would ensure proper care and prevent the case from worsening.