Polyhydramnios during pregnancy: What's it, causes, symptoms, diagnostics, treatment, prevention

Polyhydramnios; Pregnancy – polyhydramnios; Hydramnios – polyhydramnios

Polyhydramnios is a disorder, characterized by excessive accumulation of amniotic fluid in the uterus during pregnancy. The normal volume of amniotic fluid ranges from 500 to 1000 ml, but with polyhydramnios the volume may exceed 2000 ml. This condition is not very common., affecting about 1% pregnancies.

Amniotic fluid is a liquid, that surrounds your baby during pregnancy. Amniotic fluid is in the amniotic sac. The amniotic sac is forming inside your uterus (womb) during pregnancy. It contains your baby and amniotic fluid.

Being in the womb, baby swimming in amniotic fluid. It surrounds and protects the baby during pregnancy.. The maximum amount of amniotic fluid is in 34-36 weeks of pregnancy. Then the number slowly decreases, until the baby is born.

amniotic fluid:

• Allows the baby to move in the womb, promoting muscle and bone growth
• Helps baby's lungs develop
• Protects baby from heat loss, maintaining a constant temperature
• Softens and protects the baby from sudden impacts outside the uterus

Causes of polyhydramnios

The exact cause of polyhydramnios is not always known., but there are several factors, which may contribute to this condition. These include:

maternal factors

• Diabetes
• High blood pressure
• Polycyesis (dvoynii, triplets and t. d.)
• Obesity
• Thyroid disease

Fetal factors

Polyhydramnios may occur, if the baby does not swallow or suck amniotic fluid in normal amounts. This can occur, if the child has certain health problems, including:

• Gastrointestinal disorders, such as duodenal atresia, esophageal atresia, gastroschisis and diaphragmatic hernia
• Problems with the brain and nervous system, such as anencephaly and myotonic dystrophy
• Axondroplazija
• Beckwith-Wiedemann Syndrome
• Dropsy of the fetus in a child

Sometimes a specific cause of polyhydramnios is not found.

Symptoms of polyhydramnios

In many cases, polyhydramnios may not cause any symptoms., and can be detected during a routine ultrasound. Nonetheless, some common symptoms of polyhydramnios may include:

• Pain or discomfort in the abdomen
• Breathlessness
• Swelling of the hands or feet
• Difficulty walking or doing daily activities.
• Early start of contractions
• Miscarriage
• Membrane leakage or rupture

When to see a doctor

If you are experiencing any of the symptoms, mentioned above, it is important to contact your doctor immediately. Your health care provider will perform a thorough examination and recommend appropriate diagnostic tests to determine the cause of your symptoms..

Questions, that your doctor may ask

During your appointment with your healthcare provider, you may be asked a few questions, related to your medical history, including:

• When did you first notice the symptoms?
• Did you have complications during pregnancy?
• Do you have any comorbidities?
• Have you had diabetes or high blood pressure?
• Have you had complications during previous pregnancies?

Diagnosis of polyhydramnios

If your healthcare provider suspects polyhydramnios, he will perform a diagnostic ultrasound, to measure the amount of amniotic fluid in the uterus. He may also recommend additional tests., such as a fetal echocardiogram, to check for any fetal abnormalities.

Treatment of polyhydramnios

Treatment for polyhydramnios depends on the severity of the condition and the underlying cause.. In mild cases, close monitoring of the pregnancy may be recommended.. However, in more severe cases, a doctor may recommend the following treatments:
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• Amnioreduction is a procedure for removing excess amniotic fluid from the uterus..
• Bed rest
• Medicines to control blood sugar or blood pressure, if they are contributing factors.
• Birth of a child, if the condition is severe and poses a risk to the mother or baby.
• Treatment of any underlying disease, which may contribute to polyhydramnios.

Home treatment for polyhydramnios

Despite, that there are no specific home treatments for polyhydramnios, there are some steps, you can take, to reduce discomfort and manage symptoms, eg:

• Rest as much as possible and avoid strenuous activities.
• Wear comfortable, free clothes.
• Get your feet up, to reduce swelling.
• Drink plenty of fluids, to avoid dehydration.
• Eat often and in small portions, to prevent heartburn and indigestion.
• Talk to your healthcare provider about any concerns or questions, that you may have.

Polyhydramnios prevention

Although there is no guaranteed way to prevent polyhydramnios, there are several steps, you can take, to reduce the risk of developing this condition, eg:

• Treatment of any comorbidities, such as diabetes or high blood pressure.
• Maintaining a healthy diet and regular exercise.
• Getting regular prenatal care and attending all scheduled appointments.
• Reducing stress and getting enough rest
• Talking to your doctor about any concerns or questions, that you may have.

In conclusion, polyhydramnios – this disease, characterized by excessive accumulation of amniotic fluid in the uterus during pregnancy. Although the exact cause of this condition is not always known, it may be related to maternal or fetal factors. If any symptoms appear, it is important to see a doctor immediately, because early diagnosis and treatment can help prevent complications. With proper medical care and management, many women with polyhydramnios continue to have healthy pregnancies..

Used sources and literature

Buhimschi CS, Mesiano S, Muglia LJ. Pathogenesis of spontaneous preterm birth. In: Real R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 7.

Gilbert WM. Amniotic fluid disorders. In: Landon MB, Galan HL, Junior ERM, et al, eds. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 28.

Suhrie KR, Tabbah SM. The fetus. In: Kliegman RM, St. Geme JW, Bloom NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 115.