Giving life is powerful. It is a wonderful experience that all the women aspire to experience at least once in their life-time. It transforms a woman into mother, a relation with several responsibilities and concerns. Every parent imagines giving their best to the new life that they are expecting. But unfortunately, few pregnancies are not normal. There are many complications during pregnancy that may prove adverse either to the mother or to the fetus or to both. One such pregnancy complication is – POLYHYDRAMINOS.
To understand polyhydramnios, it is important to know the basics of amniotic fluid. Amniotic fluid is a clear but slightly yellowish liquid in which the unborn fetus floats in the mother’s womb or amniotic sac. Amniotic fluid forms an important part of pregnancy and fetal development. It nourishes the growing embryo, protects it from external shock, and helps in healthy fetal development. The normal amount of amniotic fluid varies, but generally, women have about 500 to 600mL of amniotic fluid during the 40th week of gestation and slightly higher, 800mL, during 34th week of gestation. Amniotic fluid is formed by the fetal lungs and kidneys. It is actually the fetal urine. Problems in the amount of amniotic fluid occur in about 7% of pregnancies. Both too little and too much amniotic fluid results in pregnancy complications and abnormal fetal development. A condition with too much of amniotic fluid around the developing fetus is called as polyhydraminos. It occurs in about 1% of all pregnancies.
Polyhydraminos is caused by many factors, it may be either due to too much production of amniotic fluid or may be due to abnormal fluid up take or sometime both. Few factors that are associated with polyhydraminos are
- Maternal diabetes
- Abnormal fetal gastrointestinal passage that blocks the fluid
- Abnormal swallowing of amniotic fluid due to problem in fetal central nervous system
- Twins or multiple pregnancy (twin-to-twin transfusion syndrome)
- Fetal heart failure
- Congenital infections like rubella, toxoplasmosis, and syphilis , which is acquired by the fetus during pregnancy
- Baby with Down syndrome or Edward’s syndrome
- Fetal anemia
- Incompatibility between fetal and mother’s blood
- Very rarely placental tumor
- Problems in arteries in the umbilical cord
- Sometime no specific reason is diagnosed.
Every women experience different symptoms of polyhydraminos. Some women may find rapid uterus enlargement with discomfort in the abdomen. The woman may experience uterine contractions also. There could be shortness of breath during walking or climbing a stairs. Other symptoms may be due to the large abdomen pressing on the adjacent organs. These symptoms include heart burn, constipation, swollen legs, varicose veins, and decreased urine production. There may be difficulty in hearing the heartbeat of the fetus due to increased amount of fluid.
Polyhydraminos is a matter of concern because it can lead to complications like
- Preterm labor or delivery
- Rupture of the amniotic sac
- Rupture of amniotic sac results in early placental detachment
- Umbilical cord may fall down through the cervix if amniotic sac is ruptured
- Birth defect in fetus
- Excess fetal growth
- Pregnancy related high blood pressure
- Urinary tract infection during pregnancy
- Cesarean delivery
- Lack of uterine muscle tone resulting in heavy bleeding after delivery
Depending on the symptoms and a large uterus for that stage of pregnancy makes a doctor suspect polyhydraminos. A complete physical and medical examination is done. Usually an ultrasound scanning is done, which measures the amount of fluid in different pockets of the uterus to find out the total amount of amniotic fluid or the Amniotic Fluid Index (AFI). In few, ultrasound scanning also helps to detect the cause of polyhydraminos such as multiple pregnancies or any birth defects. An AFI above 24cm (centimeter) is diagnosed as polyhydraminos.
Treatment for polyhydraminos is based on various factors like pregnancy, medical history, overall health, severity of the condition, mother’s tolerance for few specific medicines, and the patient’s opinion.
Treatment may include frequent follow-up visit and closely monitoring the amount of amniotic fluid. Medicines may be prescribed to decrease urine production by the fetus. If mother is diabetic, treatment procedure will include controlling blood glucose level. Amniocentesis or amnio-reduction may be done, where a needle is inserted into the amniotic sac and a considerable amount of amniotic fluid is removed. This procedure must be repeated frequently. An early delivery can be contemplated if complications endanger the life of mother or fetus.
Being diagnosed with polyhydraminos increases concern about what the condition means to you and your unborn baby. In such conditions, consulting a healthcare provider and learning ways to cope up with polyhydraminos is the best thing a woman can do. Following doctor’s instruction increases the chance of having a normal healthy baby.