Polyhydramnios is a condition that occurs during pregnancy. This specific condition is the accumulation of too much amniotic fluid in the womb. Polyhydramnios is sometimes also referred to as amniotic fluid disorder.
Amniotic fluid is the liquid that surrounds the baby in the uterus and is important in keeping the fetus growing and healthy. Specifically, because the baby is suspended in amniotic fluid, it serves to protect and cushion the baby, helps with lung, muscle, and bone development, and keeps the baby’s temperature consistent.
Polyhydramnios can develop because of either maternal or fetal health problems. Maternal diabetes, particularly if it is not controlled, is one potential cause of polyhydramnios. Problems with the fetus’s gastrointestinal tract or their central nervous system may also be a cause for polyhydramnios. Other causes can include lung development problems, other genetic defects, or if the mother is pregnant with multiple babies. There are also many instances in which the exact cause of polyhydramnios is never determined.
Polyhydramnios can cause numerous symptoms. Sometimes, the only signs occur when the pregnant woman goes to in for an ob/gyn appointment and ultrasound. The doctor may notice that the uterus is much larger than it should be based on fetal age. During an examination, the baby’s body parts and limbs may be difficult to palpate as well.
There may also be other signs of polyhydramnios including maternal shortness of breath which may worsen when she is lying down. The mother may also notice a distinct reduction in urine output and could develop swelling in her extremities, swelling in the vulva, and even abdominal swelling that is not consistent with the stage of her pregnancy. Going into premature labor is also a risk and symptom of polyhydramnios.
The causes of polyhydramnios are varied. In about half of the treated cases, there is no known cause for the development of this condition. In other cases, problems with pregnancy can instigate the development of the disease. For instance, there are some birth defects that can affect the ability of a fetus to swallow. Additionally, high concentrations of blood sugar in the body can also instigate polyhydramnios.
Conditions like Rh and Kell diseases, where the blood of the mother is mismatched to that of the fetus, can also be a causal factor in developing the condition. In the case of twins, twin to twin transfusion syndrome (TTTS), where one twin receives less blood flow than the other, can cause polyhydramnios to occur. Additionally, a defective heart rate or an illness in the infant can also produce this condition, during pregnancy.
Most of the time, polyhydramnios can be managed with rest and careful monitoring of the condition. This is because polyhydramnios may simply resolve itself. However, if the condition causes early labor (that is stopped) or causes excessive discomfort, there are medical treatments available to help.
Doctors can perform an amniocentesis or amnioreduction to drain excess fluid from the uterus. Sometimes, this procedure needs to be performed more than once, and it does carry some risks including early labor and placental abruption. There are some prescription medications that may be able to help with amniotic fluid levels as well.
In cases where polyhydramnios is the result of genetic factors, there isn’t much to be done in the way of prevention. In these cases, pregnant women or those interested in conceiving should consult with their doctor to identify the risks of developing the condition. Together, mother and doctor can establish a course of action for reducing the likelihood of polyhydramnios developing in the fetus.
Where polyhydramnios can possibly be caused by untreated diabetes, expectant mothers should take extra effort in getting their blood sugar levels under control. Consulting a doctor and discussing a plan for better management of diabetes will greatly reduce the risk of polyhydramnios developing.
Additionally, the presence of excess amniotic fluid may require draining. By undergoing amniocentesis, the excess fluid can be safely drained, reducing the risk that polyhydramnios will occur. Another option is medication designed to reduce the production of amniotic fluid, eliminating the problem before it can cause polyhydramnios.