Polyhydramnios

When a woman becomes pregnant, a sac is formed around the fertilized egg (embryo) and later the growing baby (fetus). This sac is called the amniotic sac. The amniotic sac is filled with fluid. It gets bigger as the pregnancy grows. When there is too much fluid in the sac, it is called polyhydramnios. All babies born with polyhydramnios should be looked at for congenital abnormalities.

The amniotic fluid cushions and protects the baby. It also provides the baby with fluids and is crucial to normal development. Your baby breathes this fluid into its lungs and swallows it. This helps promote the healthy growth of the lungs and gastrointestinal tract. Amniotic fluid also helps the baby move around, helping with the normal development of muscle and bone.

RELATED COMPLICATIONS

  • Early (premature) rupture of the membranes.

  • Premature delivery.

  • Prolapse of the umbilical cord.

  • Placenta abruption (separation).

  • The baby stops growing at a normal rate.

  • Fetal death/stillborn.

  • Women with polyhydramnios are more likely to have a Cesarean delivery. There is a high risk of bleeding (hemorrhage) after the delivery.

CAUSES

  • Diabetes mellitus.

  • Downs Syndrome, fetal abnormalities of the intestinal tract and anencephaly (the fetus has no brain) can prevent the fetus from swallowing the amniotic fluid.

  • One twins passes (transfuses) their blood into the other twin (twin-twin transfusion syndrome).

  • Medical illness of the mother or heart.

  • Kidney disease.

  • Tumor (chorioangioma) of the placenta.

SYMPTOMS

  • The uterus enlarges beyond the size it should be for that particular time of the pregnancy.

  • The mother may feel more pressure and discomfort than should be expected.

  • The mother may notice a quick and unexpected enlargement of her stomach.

DIAGNOSIS

  • Your caregiver notices your uterus is beyond the size that is consistent with the time of the pregnancy when he/she measures you.

  • An ultrasound is then used (abdominally or vaginally) to see if there are twins or more, measure the growth of the baby, looks for birth defects and measures the amount of fluid in the amniotic sac.

  • Amniotic Fluid Index (AFI). AFI measures the amount of fluid in the amniotic sac in four different areas. If there is more than 24 centimeters, you have polyhydramnios.

TREATMENT

  • Removing some fluid from the amniotic sac.

  • Take medications that lower the fluids in your body.

  • Stop using salt or salty foods because it causes you to keep fluid in your body (retention).

  • If your caregiver thinks you have polyhydramnios, you will likely need more testing. You will be watched for the rest of your pregnancy.

HOME CARE INSTRUCTIONS

  • Keep all your prenatal appointments. Follow your caregiver's recommendations.

  • Do not eat a lot of salt and salty foods.

  • If you have diabetes, keep in it control.

  • If you have heart or kidney disease, treat the disease as advised by your caregiver.

SEEK MEDICAL CARE IF:

  • You think your uterus has grown too fast in a short period of time.

  • You feel a great amount of pressure in your lower belly (pelvis) and are more uncomfortable than expected.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a gush of fluid or are leaking fluid from your vagina.

  • You stop feeling the baby move.

  • You do not feel the baby kicking as much as usual.

  • You have a hard time keeping your diabetes under control.

  • You are having problems with your heart or kidney disease.