High Amniotic Fluid (Polyhydramnios): Causes, Symptoms And Treatment

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The amniotic fluid acts as a cushion to the baby in your womb. It also helps in the development of the baby’s lungs, digestive tract, and muscles.  Too high or too little fluid volume may sometimes cause complications in pregnancy.

In this MomJunction post, we will help explain the signficance of amniotic fluid.

What Is Polyhydramnios?

Excess build-up of amniotic fluid around the growing baby is termed as polyhydramnios or hydramnios (1). According to the Fetal Medicine Foundation, UK, this condition occurs in one out of 100 cases (2).

Ideally, the doctor checks the amniotic fluid levels through an ultrasound. The normal volume of amniotic fluid should be between 500 and 1000ml. If it goes beyond this, there could be certain problems in the pregnancy.

What Are The Causes Of Polyhydramnios?

In most cases, it not clear why the amniotic fluid levels increase. However, some possible causes are:

  1. Diabetes: According to the University of Rochester Medical Center, women who had diabetes before pregnancy or have gestational diabetes could be at risk of hydramnios (1).
  1. Twin-to-twin syndrome: In this rare condition, the twins share a placenta. The baby that sends blood to its twin will have less amniotic fluid around, and the baby that receives will have a high volume of amniotic fluid or polyhydramnios (3).
  1. Birth defects: Congenital anomalies such as duodenal atresia or conditions relating to the heart or lungs (hydrops fetalis) may also lead to building up of the fluid, causing polyhydramnios (4).
  1. Others: Some other conditions, such as viral infections, fetal anemia, and kidney or heart problem, can also be responsible for increased amniotic fluid levels in the uterus (5) (4).
  1. Most commonly, however, there is no cause for higher amniotic fluid, termed, “idiopathic”.

[ Read: Leaking Amniotic Fluid ]

Symptoms Of Polyhydramnios

Excess amniotic fluid can put pressure on the uterus and nearby organs. This could cause (2) (6).

  • Discomfort in the stomach
  • Shortness of breath
  • Contractions
  • Swelling in the abdominal wall and lower extremities
  • Change of fetal position
  • A uterus enlarged more than normal for that time in pregnancy.

Risks Related To Excess Amniotic Fluid

Polyhydramnios could be mild, moderate, or severe. Severe polyhydramnios is associated with the following complications (2) (6).

  • Too much fluid can expand your uterus and result in preterm labor
  • Early rupture of the amniotic sac
  • When amniotic fluid leaks, there could be placental abruption (detachment of the placenta from the uterus)
  • Umbilical cord prolapse (when the umbilical cord drops into the vagina)
  • Heavy bleeding after birth
  • Stillbirth

Timely diagnosis could help prevent these risks.

Diagnosis Of Polyhydramnios

Based on the checkup and the symptoms displayed, the doctor will recommend a fetal ultrasound. If the results hint at excess amniotic fluid, a detailed ultrasound is done (6).

There are two ways to measure the volume of the amniotic fluid.

  • The latest method and most accurate is measuring the deepest vertical pocket of amniotic fluid, call the “DVP”. Normal range is greater than 2cm but less than 8cm.
  • The second method is AFI or amniotic fluid index, which is the sum of the largest pockets of different parts in the uterus. If this measurement is greater than 25cm, it suggests excess amniotic fluid volume.

[ Read: Low Amniotic Fluid (Oligohydramnios ) ]

How Can Polyhydramnios Be Treated?

Polyhydramnios rarely requires any treatment. However, scheduled ultrasounds are done to closely monitor the amniotic fluid index and the baby’s health.

Rarely occuring but in severe cases of polyhydramnios, a few treatments may be recommended to reduce the amniotic fluid level become symptomatic with shortness of breath or signs and symptoms of preterm contractions. Treatment options may differ depending on certain factors such as the severity of the condition, its cause, symptoms, and gestational age (8).

  1. Medications: Based on the cause of excess amniotic fluid in the uterus, doctors prescribe medicine to reduce the fluid. For instance, if hydramnios is due to fetal condition, then medicine to treat that condition is prescribed. This, in turn, adjusts the fluid level.
  1. Amnioreduction: In this procedure, the doctor inserts a  needle inside the uterus to drain out the excess amniotic fluid. This procedure may cause a little discomfort in the abdomen.
  1. Delivery: In case of complications that seem risky for the mother’s or baby’s health, early delivery is scheduled.

Besides the treatment, following a few self-care measures can help.

Can Polyhydramnios Cause Birth Defects?

Polyhydramnios or too much of amniotic fluid may rarely indicates that there could be a congenital anomaly or a birth defect in the baby, but it dose not cause them.

If the doctor finds that there is too much amniotic fluid, an ultrasound or other tests could be done to analyze the risks.The treatment options are recommended based on the results.

[ Read: Water Break During Pregnancy ]

Is Polyhydramnios Dangerous For The Baby?

A severe case of polyhydramnios could increase the risks of preterm labor, placental abruption, infections, and stillbirth. But proper diagnosis and treatments in time can help in cutting down these risks.

Regular checkups during pregnancy are essential for every expectant mother. These help in figuring out problems early on, giving enough time to manage the issue. As polyhydramnios is not a common condition, there is no need to get too concerned anxious about it. Even if the doctor suspects or diagnoses you with the condition, timely treatment and care can help minimize the risks.

Do you have any experiences to share? Do let us know in the comment section.

References:

1. Hydramnios; University of Rochester Medical Center
2. Polyhydramnios; The Fetal Medicine Foundation
3. Twin-to-twin transfusion syndrome; C. S. Mott Children’s Hospital Michigan Medicine
4. Polyhydramnios treatment at Midwest Fetal Care Center; Children’s Minnesota
5. Polyhydramnios; Darthmouth-Hitchcock
6. Polyhydramnios; NCH Healthcare System
7. Polyhydramnios; Spectrum Health The Medical Group
8. A. Hamza, D. Herr, E. F. Solomayer, and G. Meyberg-Solomayer; Polyhydramnios: Causes, Diagnosis and Therapy; Geburtshilfe und Fraueneilkunde (2013)

 

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