Polyhydramnios is a high risk pregnancy condition where an excess amount of amniotic fluid surrounds the unborn infant. The amniotic fluid plays an important role in the fetus' motor development in the womb, however when there is too much, a birth defect may be the culprit.
According to the Lucille Packard Children's Health Foundation, Polyhydramnios occurs in 3 to 4% of all pregnancies. It is generally diagnosed during a routine ultrasound. According to the Center for Maternal Fetal Medicine, 65% of Polyhydramnios cases are unkown.
What role does the amniotic fluid have?
The amniotic fluid is formed shortly after the amniotic sac develops, generally around the 12th day after conception, and continues to serve as the life support system. The amniotic fluid aids in the fetus' motor development, as well as the lung and digestive system. The fetus is well protected in this environment and generally around the 20th week, the fetus begins swallowing, practice breathing, and urinating in this "water world".
What are the symptoms of Polyhydramnios?
- abdominal discomfort
- increased and rapid growth of the uterus
- uterine contractions
What causes Polyhydramnios?
Diabetes or gestational diabetes may be a maternal cause of this condition, or the cause may lie with the fetus. The following conditions may be a result of the fetus:
- twin to twin transfusion syndrome
- heart defects / failure
- cleft lip
- cleft palate
- abnormal swallowing due to central nervous system abnormalities
- chromosomal abnormalities
- gastrointestinal abnormalities that inhibit fluid passage
The most common birth defects that cause Polyhydramnios are those that hinder fetal swallowing, generally involving the gastrointestinal tract or the central nervous system.
High risk concerns:
The increased amniotic fluid may cause an overly distended uterus, thus resulting in preterm labor or premature rupturing of the amniotic sac. If a rupture should happen, due to the heavy volume of amniotic fluid leaving the uterus, it may increase the likelihood of placental abruption, or umbilical cord prolapse. If the amnitoic sac ruptures or a cord prolapse is suspected, it is important to seek prompt medical attention.
Treatment options:
- The primary goal of treatment is to provide relief for the mother experiencing discomfort and to continue the pregnancy.
- The obstetrician will monitor you and your baby's progress closely through routine ultrasounds. This will provide information regarding increased amniotic fluid production.
- Medication may be given to decrease fetal urine production.
- Amnioreduction, the removal of amniotic fluid through amniocentesis, which may have to be repeated.
- Early delivery may also be an option if the safety of the mother or unborn baby is of concern.
Patient education and close monitoring is essential for any high risk pregnancy. If a high risk condition exists, or is suspected, it is important to discuss this and address all questions to the obstetrician.
