Depending on the pregnant woman, polyhydramnios can take on different forms. Medical treatment is not always necessary.
What is polyhydramnios?
Polyhydramnios (also known as hydramnios or polyhydramnios) occurs when a pregnant woman has an above-average amount of amniotic fluid. See polyhobbies for Meanings of Peroneal Paralysis.
The amount of amniotic fluid from which medicine speaks of polyhydramnios is based, among other things, on the so-called amniotic fluid index (AFI) – if this index exceeds a value of 20 cm in a pregnant woman, then, according to medical definition, there is an above-average amount of amniotic fluid. A further parameter for an existing polyhydramnios is a quantity of amniotic fluid of more than 2 liters at the time of birth.
Polyhydramnios is often associated with an enlarged abdomen in the pregnant woman and consistent fluid movement in the womb (the uterus). The heart sounds of the unborn child may be weakened. Polyhydramnios occurs in about 1-3% of all pregnancies.
Causes
Possible causes of polyhydramnios can be found in both the fetus and the expectant mother.
Possible causes of increased amniotic fluid levels on the part of the mother include, for example, an existing diabetes mellitus disease (also known as diabetes): in the fetus, the mother’s diabetes can lead to so-called polyuria, i.e. increased production of urine. As a result, polyhydramnios develops. Diseases such as syphilis in a pregnant woman can also promote polyhydramnios.
In the unborn child, for example, heart defects or various infections can cause polyhydramnios to occur. Malformations of the gastrointestinal tract, developmental disorders of the cerebrum, bone formation disorders, chromosomal abnormalities or a cleft lip and palate in the fetus occasionally lead to an increased amount of amniotic fluid in the uterus. Finally, polyhydramnios can also be favored if an embryo absorbs little or no amniotic fluid through drinking.
Symptoms, Ailments & Signs
In a so-called polyhydramnios, the amount of amniotic fluid in the amnion is greater than two liters. In about three percent of all pregnancies, this condition can occur before the completion of the 37th week of pregnancy. This can result in complications for both the mother and the child.
Polyhydramnios is noticeable through persistent lower abdominal pain, severe abdominal tension, contractions, pulling in the lower abdomen, shortness of breath and dizziness. Various pregnancy complaints such as indigestion, constipation, heartburn, swollen legs, varicose veins or stretch marks increase. Since polyhydramnios can be caused by various diseases, other symptoms are also possible, but these point to the underlying disorder.
In addition, there is a weakening of the child’s heart sounds. If these symptoms appear in the 37th week of pregnancy, there are many indications of polyhydramnios. To avoid complications for mother and child, emergency treatment should be initiated immediately. Symptoms such as placental rupture, premature rupture of membranes, umbilical cord protrusion or an unusual birth control of the child are possible complications.
Furthermore, as a result of the increased amount of amniotic fluid, the mother can develop increased blood pressure. The risk of urinary tract infections is also increased. The child is at risk of premature birth. If necessary, the birth must be initiated in the 37th week of pregnancy by a caesarean section. The child’s birth weight may be low. In extreme cases, infant death occurs.
Diagnosis & History
Polyhydramnios is usually diagnosed using sonography (an imaging method based on ultrasound). Using the images of the abdomen of an expectant mother created in this way, the amount of amniotic fluid can be determined, for example according to the criteria of the AFI.
For this purpose, the abdomen shown is first divided into four quadrants (quarters). The largest amniotic fluid deposits in the individual quadrants are now summed up and can thus provide information about the presence of polyhydramnios.
If a polyhydramnios does not regress on its own or is treated accordingly, various complications can arise during the course of the pregnancy. For example, polyhydramnios can lead to premature rupture of the amniotic sac. Polyhydramnios can also result in an umbilical cord prolapse (a prolapsed umbilical cord) on the part of the expectant mother or a rupture of the placenta (the placenta). Last but not least, an increased amount of amniotic fluid occasionally impairs a suitable position for the child.
Complications
Polyhydramnios can present with a variety of symptoms. However, the symptoms and complications are very different for most women, so that a general prediction cannot usually be made. The abdominal circumference of those affected increases considerably and the skin around the abdomen is very tight.
The patient’s resilience also decreases significantly due to the polyhydramnios and breathing difficulties and shortness of breath occur, among other things. Furthermore, those affected often suffer from heartburn or abdominal pain. Polyhydramnios also leads to constipation and general digestive problems or stomach pain. The patient’s quality of life is significantly reduced by this disease.
Due to the swollen legs, patients sometimes suffer from restricted mobility and often also have varicose veins. Polyhydramnios does not always have to be treated. In most cases, the symptoms go away on their own, so there are no particular complications. Surgical interventions are rarely necessary. However, the lives of the mother and the child are not endangered.
Treatment & Therapy
A polyhydramnios does not always have to be treated medically; an increased amount of amniotic fluid can also regress on its own in various cases. If there is no independent regression of the amniotic fluid, a so-called amniocentesis is carried out in various cases of pronounced polyhydramnios.
As part of such an operation, a hollow needle is inserted into the amniotic sac; in further treatment steps, excess amniotic fluid can now be drained. Alternatively, polyhydramnios can also be treated with medication; active ingredients are usually used here that have an inhibiting effect on the production of amniotic fluid.
Whether an existing polyhydramnios requires treatment and which therapeutic measures are used if necessary depends, among other things, on factors such as the severity of the polyhydramnios and the state of health of the embryo and the mother-to-be. If polyhydramnios is caused by diseases in the mother, a possible elimination of excess amniotic fluid is often accompanied by therapeutic measures aimed at the underlying disease.
Prevention
Since in many cases the causes of polyhydramnios cannot be clearly diagnosed, appropriate prevention is hardly possible. If an expectant mother is aware of her own metabolic diseases such as diabetes mellitus, consistent treatment of the underlying disease can reduce the risk of polyhydramnios; suitable action steps can be requested from the doctor treating you, for example.
Aftercare
In most cases, those affected with polyhydramnios have only a few and only limited follow-up measures available. For this reason, a doctor must be consulted at an early stage in the case of this disease, so that there are no further complications or complaints that can limit the quality of life of the person affected. However, treatment of the disease cannot always be carried out, although it is not always necessary.
In many cases, the symptoms can go away on their own, although constant monitoring by a doctor is very important in order to identify complications and other symptoms at an early stage. The child should also be checked regularly after the successful birth to ensure normal development of the child.
In most cases, there are no further complications or symptoms. If a miscarriage occurs, those affected need intensive psychological support. The support of one’s own family in particular has a very positive effect on the further course of the disease. Further follow-up measures are usually not available to those affected with polyhydramnios.
You can do that yourself
If the waist circumference is unnaturally large during pregnancy, a doctor should be consulted. If polyhydramnios is present, the woman should refrain from exercising and watch carefully for any unusual symptoms. Treatment is only necessary if there is an acute danger to the baby. Therefore, no further measures need to be taken at first.
However, should pain or other symptoms appear, medical advice is required. Affected women can survive a puncture of the abdomen better if they do not eat heavy food before the procedure. After the procedure, you should take it easy for a few days. The amniotic sac must rest to avoid complications during childbirth. Affected women can relieve the symptoms after an operation by drinking soothing teas, having a professional massage and, above all, getting plenty of rest.
If the discomfort does not go away, the gynecologist must prescribe a suitable medication and carry out another ultrasound examination. However, polyhydramnios usually progresses without major complications. In many cases, the excess amniotic fluid does not need to be treated.