Polyhydramnios: Causes, Symptoms and Effects to Fetus

The amniotic fluid in your uterus is what protects the life of your baby. However, having too much amniotic fluid doesn’t bode well for both the mother and the baby. Why does polyhydramnios happen? What about the causes, the symptoms, treatment, or the effects to the baby?

What does having too much amniotic fluid mean, and why does it happen?

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Amniotic fluid is made from the alveolar fluid and urine that comes from the fetus’ kidneys and which is expelled by the fetus. The very same amniotic fluid becomes the fluid that the baby swallows as practice for real-life breathing. Through this ingestion and expelling of the amniotic fluid, the baby is able to maintain the amniotic fluid at a certain level. However, an upset in the balance could result in polyhydramnios – the buildup of excess amniotic fluid. There are a few possible reasons as to why polyhydramnios can happen.

Reasons why baby swallows and absorbs less amniotic fluid than what is normal (fetal factors):

  • Duodenal atresia or gut atresia: blockage in a part of the digestive system that results in the inability to absorb the normal amount of amniotic fluid

  • Brain and nervous system defects: microcephaly or anencephaly

  • Cardiovascular defects: problems with baby’s heart rate

An excess of amniotic fluid is produced due to one of the following causes (mother’s factors):

  • Having multiples (twins, triplets or more): This increases the amount of urine produced.

  • Gestational diabetes; problems with the heart, kidneys, and liver; infectious diseases

  • Placental tumor (chorioangioma)

Symptoms of high amniotic fluid

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From Week 25 onward, the signs of chronic polyhydramnios, which is more common, will start appearing. The symptoms of acute polyhydramnios can appear very quickly over the span of a few days, so be extremely vigilant if you think the symptoms you’re seeing are pointing at polyhydramnios.

Symptoms include sudden swelling of the belly, edema, abdominal tightness, frequent urination, breathing difficulties, and an increase in weight and palpitations. Should you notice the presence of any of the aforementioned symptoms, please notify your practitioner.

How is one diagnosed with polyhydramnios?

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The amount of amniotic fluid in the uterus can be checked through an ultrasound scan. Although individual differences can account for the difference in amniotic fluid levels in expecting moms, the usual range is about 500-700 ml. Polyhydramnios means that there is an amount of 800 ml and above present. Other tests will be able to provide insight into why it is so – the mother might have an infectious disease or diabetes, among other possible reasons.

There are two methods of measuring amniotic fluid. One is the single deepest vertical pocket (SDVP) technique and if a measurement of 8 cm and above is recorded, that is an indication of polyhydramnios. The more commonly used method is called the amniotic fluid index (AFI) method. An AFI reading of 25 cm or more means the mother has polyhydramnios.1

Your practitioner might tell you that you have more amniotic fluid than the average woman, but if you don’t see or feel any symptoms, then your practitioner will not term your condition “polyhydramnios”.

Treatment for polyhydramnios

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Treatment for polyhydramnios differ depending on the symptoms, but if you have polyhydramnios, the first few things you need to do is to reduce salt and fluid intake, take diuretics and try to expel excess water out of your body. If gestational diabetes is the underlying cause of polyhydramnios, then it must first be treated. Polyhydramnios carries with it the risk of a breech baby or a preterm premature rupture of membranes (PPROM), so spend the rest of your pregnancy days as quietly as possible.

There might be a need for a short stay in the hospital depending on the mother’s condition. Excess amniotic fluid might also be removed through an intravenous tube. As the removal of excess amniotic fluid only provides a temporal solution to the problem, this procedure has to be repeated several times.

If you are already far along into the pregnancy and your expected delivery date is drawing close, you might want to consult your practitioner and ask whether the birth can be brought forward. As polyhydramnios can lead to more complications, delivery is usually done via a caesarean section. If you’re uncomfortable with doing a C-section, however, ask your practitioner about the other options you have.

Effects of too much amniotic fluid on the baby

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Polyhydramnios doesn’t always mean that the fetus will be born with congenital defects, but the risk still exists. Polyhydramnios often leads to a breech baby as the baby is able to move around more freely. Also, the weight of the uterus compresses the stomach more than in usual pregnancies, and the risk of contractions becoming stronger means that the risk of preterm labor and a preterm birth is also higher as well.

Treatment starts with you: Stay positive!

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If your practitioner tells you that you have polyhydramnios, you might feel like the whole world came crashing down around you. As this concerns both you and your baby, it’s only natural to feel uneasy. However, think of this as positively as you can: The symptoms you see are the only methods your baby have to try to communicate their problems to you.

Although you might be at a loss as to what to do, try to take it one step at a time – get advice from your practitioner, talk about it to the people around you, and decide which treatment is most suitable for you!