Polyhydramnios, causes and symptoms

The overproduction of the amniotic fluid that surrounds the baby during the nine months of pregnancy is called polyhydramnios. According to the American Pregnancy Association this condition occurs in 1% of all pregnancies.

This overproduction occurs when the AFI (amniotic fluid index) is greater than 24 centimeters, and when the MVP (Maximum Vertical Pocket) measures more than 8 cm.

Fetal disorders that polyhydramnios can lead to include:

  • gastrointestinal disorders, including duodenal or oesophageal atresia, gastroschisis, and diaphragmatic hernia,
  • disorders of the brain or nervous system, such as anencephaly or myotonic dystrophy,
  • achondroplasia, a bone growth disorder,
  • fetal heart rate problems,
  • infections,
  • Beckwith-Wiedemann syndrome, a congenital growth disorder
  • fetal lung abnormalities,
  • fetal hydrops in which an abnormal level of water builds up within multiple areas of a fetus’s body,
  • twin-to-twin transfusion syndrome in which one child receives more blood flow than the other,
  • blood mismatch between mother and child, such as Rh incompatibility or Kell disease.

Poorly controlled maternal diabetes also increases the risks.

Too much amniotic fluid can also be produced during multiple pregnancies, when the mother is carrying more than one fetus.

Maternal symptoms may include abdominal pain and difficulty breathing due to the enlargement of the uterus.

Other possible complications can be:

  • a preterm birth,
  • premature rupture of membranes,
  • placental abruption,
  • stillbirth,
  • postpartum hemorrhage
  • a fetal malposition,
  • a prolapse of the umbilical cord.

To monitor the levels of amniotic fluid in the uterus, tests for maternal diabetes and frequent ultrasounds may be ordered.

Mild cases of polyhydramnios typically resolve without treatment.

In severe cases, the fluid may need to be reduced with amniocentesis or a drug called indomethacin. This drug reduces the amount of urine your child produces.

Sometimes, amniotic fluid leaks out before the water breaks. Only 1 in 10 women will have a dramatic flush of fluids when their waters break: For the most part, it will start as a trickle or leak.

Sometimes what may seem like a leak is actually urine caused by the uterus pressing on the bladder.

If the fluid is colorless and odorless, it is amniotic fluid – then you should contact a healthcare professional as labor will usually start early.

If the liquid is green, brownish-green, or foul-smelling, this may indicate the presence of meconium or an infection. In that case, you should contact your doctor.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform, Maternicity.com.

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