Polyhydramnios

The excessive accumulation of amniotic fluid which surrounds the baby in the uterus during pregnancy is called polyhydramnios and this occurs in about 1 percent of pregnancies. Mostly this is just a mild case and occurs in the second half of pregnancy but severe polyhydramnios can cause preterm labor or shortness of breath.

To prevent complications, your doctor will monitor your pregnancy if you are diagnosed with polyhydramnios and the treatment depends on the severity of your condition such as draining the excess amniotic fluid.

Pressure being exerted within the uterus and on nearby organs is the result of the symptoms of polyhydramnios.

Severe polyhydramnios can cause:

• swelling in the lower extremities,
• abdominal wall and vulva,
• shortness of breath,
• decreased urine production.

Some of the known causes of polyhydramnios are:

• maternal diabetes,
• a birth defect that affect the baby’s gastrointestinal tract or central nervous system,
• twin-twin transfusion (identical twin pregnancies in which one twin receives too much blood and the other is too little),
• blood incompatibilities between the baby and the mother,
• lack of red blood cells in the baby (fetal anemia).

Consult your doctor if you have any symptoms of polyhydramnios to receive a diagnosis. 

Write down the symptoms including your major stresses and recent changes in your life. Write down the medications, supplements and vitamins that you are taking.

Ask a family member or a close friend to accompany you.

Some of the questions that you can ask your doctor include:

• What kind of tests do I need?
• What treatments are available?
• Do I have any restrictions?
• How could this condition affect my baby?
• If I get pregnant, will this happen to me again?

Your doctor will also ask you questions such as:

• When did you first begin experiencing symptoms?
• Are your symptoms occasional or continuous?
• Do you have shortness of breath?
• Do you feel dizzy?
• Have you noticed any swelling?

Your doctor will first conduct a physical exam and will do a fetal ultrasound that uses high frequency sound waves to produce images of your baby to rule out birth defects and other complications. He will estimate how much the amniotic fluid is by measuring the deepest pocket in your four specific of your uterus. The sum of these is the amniotic fluid index (AFI). If the AFI is 25 centimeters or more it means you have polyhydramnios.

Some of the additional tests are:

• Amniocentesis – a sample of the amniotic fluid will be removed for testing;
• Glucose challenge test – if you have a gestational diabetes, you will drink a syrupy glucose solution then your blood sugar will be checked every hour for a period of 3 hours;
• Karyotype – to check the baby’s chromosomes for abnormalities, small piece of tissue will be removed from the placenta during a test called chorionic villus sampling.  

Your doctor will do regular tests such as:

• Nonstress test – to check your baby’s heart rate, you may be asked to eat or drink to make the baby active and to encourage movement;
• Biophysical profile – ultrasound with nonstress test to check your baby’s breathing, movement and tone even the volume of amniotic fluid in your uterus;
• Doppler ultrasound – to check your baby’s circulation.

Mild cases of polyhydramnios do not require treatment.

Some of the treatments include:

• Drainage of excess amniotic fluid: your doctor will drain excess amniotic fluid from your uterus which is called amniocentesis or amnioreduction but these may have complications such as placental abruption, preterm labor and premature rupture of the membranes,
• Medications: oral medication indometahcin (Indocin) for reducing fetal urine production and amniotic fluid but is not recommended if you are more than 31 weeks pregnant and side effects may include vomiting, nausea, acid reflux and gastritis, your baby’s heart will be monitored with a Doppler ultrasound and fetal echocardiogram.

You will probably delivering by the 39th to 40th week if you only have a mild to moderate polyhydramnios but if you have a severe polyhydramnios, you may be induced to 37 weeks to avoid complications.

Polyhydramnios cannot be prevented because half of the cases, the cause is completely unknown. Sometimes it can be genetic, meaning it is unavoidable. The best that you can do to prevent this is to avoid diabetes.

One of the homeopathic remedy for polyhydramnios is Natrum Muriaticum. This alternative remedy is to be used with professional advice.

Lifestyle modifications are necessary in order to cope with polyhydramnios.

Having polyhydramnios may be difficult and scary. Follow some of these self-care measures so you will never be at risk of complications:

• have a complete bed rest,
• avoid any jerky movements,
• avoid eating large meals,
• use pillow to support the baby in bed,
• avoid lying down immediately after eating,
• avoid spicy foods and other foods that may lead to heart burn.

There are several risks and complications associated with polyhydramnios.

Polyhydramnios is related to:

• premature birth,
• premature rupture of membranes wherein the water breaks easily,
• placental abruption wherein the placenta peels away from the inner wall of the uterus before delivery,
• excess fetal growth,
• umbilical cord prolapsed wherein the umbilical cord drops into the vagina ahead of the baby,
• stillbirth,
• C-section delivery,
• heavy bleeding due to lack of uterine muscle tone.

You will be at higher risk of complications if you have an earlier polyhydramnios and if there is great amount of excess amniotic fluid.