Polyhydramnios during pregnancy is a disease and requires treatment

Polyhydramnios during pregnancy is an excessive amount of amniotic fluid accumulated by the pregnant uterus. Polyhydramnios is diagnosed in 0.2-1.3% of pregnant women in both early and late stages, and, despite such a small incidence, it is considered a serious pathology with negative consequences for the outcome of pregnancy.

All reliable causes of polyhydramnios in pregnant women have not yet been determined, but the most common ones are known. Among these, pathological conditions of the developing fetus (infections, malformations) and maternal diseases (infectious-inflammatory, pathologies of the cardiovascular system, endocrinopathies) dominate.

Speaking about the pathology of amniotic fluid, we should initially dwell on its origin and significance for pregnancy. After fertilization, the egg (zygote) begins to move along the fallopian tube towards the uterine cavity for further development. Once in the endometrium, it “arranges” a place for the future fetus. The developing embryo must be reliably isolated from negative external influences of infectious and mechanical origin, eat properly and be able to change position; for this, nature placed it in a kind of sealed “bag” filled with a sterile liquid - amniotic fluid. Its wall is formed by the fetal membranes - amniotic and chorionic. By the end of the second week of pregnancy, the amniotic sac fills the entire uterine cavity.

The amount of amniotic fluid increases as the fetus develops. Almost 97% of it consists of water, in which substances necessary for the child are dissolved: proteins, mineral salts, immune-active complexes. The source of amniotic fluid in the early stages is the maternal circulatory system; in the later stages, the kidneys and lungs of the fetus participate in its formation. Until the 14th week of pregnancy, the substances contained in the amniotic fluid reach the baby through the skin, and when its skin accumulates keratin and becomes thick, the amniotic fluid penetrates the child’s body through the digestive tract, when the baby literally swallows the surrounding water and then removes everything “unnecessary” in it with urine. Thus, the composition and amount of amniotic fluid is very important for the health of the unborn fetus.

In addition to the function of nutrition and metabolism, amniotic fluid also performs other tasks that are no less significant for the health of the child:

— Protect the fetus from mechanical damage. Being in an aquatic environment, the child does not depend on the physical activity of the mother, so a pregnant woman can move and undergo acceptable physical activity without fear of damaging the fetus. The waters protect him from the shocks and noises of the outside world.

— Create free space for the physical activity of the fetus in the uterus. As the baby grows, it changes its position in the uterus, taking a more comfortable position. He can change position several times a day without harming himself or his mother.

— Maintain a constant temperature balance. A developing fetus is not able to maintain a comfortable body temperature on its own and change it depending on environmental changes. This function is performed by the amniotic fluid, maintaining a constant temperature of 37°C.

- Protect the embryo, and then the fetus, from potential infection. While the fetal immune system is in the formative stage, its functions are taken over by the immunoglobulins contained in the amniotic fluid.

- Participate in the birth process. We can say that the amniotic fluid “gives the command” to the uterus to start the birth process, which starts along with the outpouring of the “front” waters. During the birth process, water helps the baby move properly, protects the umbilical cord from damage, and also washes the birth canal.

Studying the quantitative and qualitative composition of amniotic fluid allows us to obtain valuable information about the condition of the developing fetus and the timing of the upcoming birth. When the amount of fluid in the pregnant uterus exceeds one and a half liters, they speak of excess amniotic fluid - polyhydramnios. More often, polyhydramnios develops in the last two trimesters, so the diagnosis “polyhydramnios during pregnancy 33 weeks” or, for example, “polyhydramnios during pregnancy 37 weeks” and so on is more common.

Moderate polyhydramnios during pregnancy is diagnosed more often; it does not cause serious disorders, and therefore is not always considered as a pathology requiring intervention. Polyhydramnios can develop quickly, like an acute pathology, or develop gradually (chronic polyhydramnios). Acute polyhydramnios almost always implies emergency delivery.

An examination allows one to suspect the presence of excess water when the size of the uterus does not correspond to the gestational age, and the final diagnosis can only be made by ultrasound scanning.

After establishing the fact of polyhydramnios, a diagnostic search for its cause begins, including laboratory research and functional tests. It is extremely important to find out how this pathology affected the fetus.

A very unfavorable condition is polyhydramnios in multiple pregnancies. Filling the uterus with an excessive amount of fluid, already overstretched by several fetuses, is fraught with premature termination of pregnancy and birth trauma.

Treatment for polyhydramnios depends on the examination results and the condition of the pregnant woman and fetus. As a rule, after the timely elimination of the provoking factor, the fluid in the uterus stops increasing in volume.

Polyhydramnios during late pregnancy provokes much fewer complications.

Late polyhydramnios has the most favorable prognosis; during pregnancy of 37 weeks or more, it is often safe, since the child is almost “ready” for birth.

Causes

Unfortunately, doctors cannot name with absolute certainty the specific prerequisites for polyhydramnios. By the way, about a third of cases remain without clarification of the reasons. However, it is possible to distinguish a category of women with an increased tendency to polyhydramnios. This is the so-called risk group, in which pathology is observed more often than in others.

The risk of developing polyhydramnios is highest in pregnant women with the following conditions:

Diabetes mellitus is what doctors put first on the list of reasons for the increased likelihood of polyhydramnios.
Kidney diseases, heart defects, vascular diseases.
Infection with classic infections: toxoplasma infection, rubella, cytomegalovirus, herpes (abbreviated TORCH infection). During pregnancy, it is especially dangerous to encounter a virus to which you do not yet have immunity. Such an infection is characterized by increased circulation of microbes in the blood that can penetrate the child’s body. Viruses of the TORCH group have mild symptoms and are difficult to diagnose. With moderate polyhydramnios, the causes of its occurrence may not be identified and the development of pathology occurs almost asymptomatically.
Rhesus conflict pregnancy.
Multiple pregnancy. It is noteworthy that polyhydramnios in one fetus is often combined with severe oligohydramnios in the second.
A large fetus can also cause this deviation.

The list of causes of polyhydramnios includes disorders of the excretory function and real pathologies of the fetus itself.

The latter include:

genetic abnormalities;
heart defects;
defects of the central nervous system;
deviations in the development of the stomach and intestines.

In the third trimester, polyhydramnios in pregnant women can be caused by impaired swallowing function in the baby. The fact is that a grown-up child absorbs up to four liters of amniotic fluid per day, which is renewed every three hours.

If you have one of the described disorders, there is a real risk of developing acute or chronic polyhydramnios. And although there is a chance that you will not get sick, constant monitoring by a gynecologist is mandatory. Do not forget that this disease can and should be treated. And the sooner the diagnosis is made, the higher the chances of a full pregnancy and safe childbirth.

Reasons for the development of polyhydramnios

In general, there is no direct provoking factor for polyhydramnios. In every third woman, doctors cannot find the cause of this condition. However, there are some diagnoses that increase the risk of developing polyhydramnios.

Infectious diseases of the mother.
Diabetes of the first or second type.
Various pathologies of fetal development.
Infection of an organism caused by a virus or bacteria.
Some diseases of the cardiovascular system.
Pregnancy with two or more fetuses. Moreover, if the twins are fraternal, multiple births can develop in only one child.
Disorders of the renal system.
Polyhydramnios often occurs if the fetus is large.
If the mother and child have different Rh factors, a conflict may arise, against which polyhydramnios develops.
Normally, a child in later stages swallows a certain amount of amniotic fluid. If this does not happen due to any violations, polyhydramnios develops.

If you have chronic diseases, during pregnancy you need to be as attentive as possible to your body and consult a doctor if there are any changes in your health. After all, poor health, fatigue, lower back pain and swelling of the legs are not always symptoms of a healthy pregnancy. Sometimes these signs can indicate something more serious. But why is polyhydramnios dangerous?

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Signs

Many signs that women are accustomed to considering as an acceptable norm can actually signal polyhydramnios.

The range of symptoms of polyhydramnios is quite wide:

a feeling of heaviness, discomfort and frequent pain in the abdominal cavity;
almost continuous attacks of weakness;
shortness of breath with minimal physical effort, it can be caused by the diaphragm being too high;
sudden increase in heart rate;
constant profuse swelling of the legs;
a condition in which the abdomen at the level of the navel in girth becomes more than 100 cm;
the appearance of many rough stretch marks;
distinct squelching in the abdomen when moving (fluctuation);
enlargement of the uterus disproportionate to the term.

Polyhydramnios in the last stages of pregnancy is usually accompanied by constant tension in the uterine area, excessive deviation of its size from the norm, and increased fetal anxiety. There is also an increase in the height of the uterine fundus above the womb.

Symptoms

There are a number of clinical signs that suggest polyhydramnios during pregnancy.

The following symptoms may appear:

severe general malaise;
a constantly pursuing feeling of weakness;
shortness of breath due to minor exertion;
heaviness and discomfort in the abdomen;
lower abdominal pain;
tachycardia;
constant swelling of the legs;
abdominal circumference ≥ 100-120 cm;
pronounced stretch marks (striae);
fluctuation (fluid gurgling in the abdomen);
vomit.

Please note: the cause of shortness of breath is the so-called “high standing” dome of the diaphragm.

According to the nature of its course, polyhydramnios is divided into acute and chronic. Of particular danger is the acute variant of development, most often diagnosed in the second trimester. It is characterized by a sharp increase in water volume in a very short time - from several hours to 1-3 days. The patient's abdominal circumference at the level of the navel quickly increases, and moderate or high intensity pain appears in the groin and lumbar region. During the examination, swelling of the abdominal wall and hypertonicity of the myometrium are determined.

In the chronic form, the volume of amniotic fluid increases gradually, but the likelihood of complications is also very high.

Based on the severity of the pathological process, mild, moderate and severe degrees are distinguished.

Varieties

According to severity, polyhydramnios is divided into mild, moderate and severe. According to the course – acute and chronic.

Lung

The volume of amniotic fluid is more than 1.5 liters, but less than 3 liters. Treatment of women with mild polyhydramnios at home is allowed. In this case, every 1–2 weeks you need to visit a doctor for an ultrasound. This is necessary to assess the health of the fetus and monitor the increase or decrease in the amount of amniotic fluid (amniotic fluid).

Pregnancy with mild polyhydramnios usually does not lead to negative consequences; with this diagnosis, spontaneous childbirth without complications is possible.

Moderate

Sometimes with this form a diagnosis of moderate polyhydramnios can be made. Usually it is placed in the external absence of any tangible changes and complaints. This may also mean that the deviation in the amount of amniotic fluid is insignificant and the fluid arrives gradually. Often, with moderate polyhydramnios, there is a high chance of full pregnancy and spontaneous childbirth. But this disease will certainly affect the fetus.

The baby's nervous system is at greatest risk. This is explained by changes in blood circulation in the placenta. As a result, the circulation of oxygen in the child’s brain is disrupted. In order to minimize the consequences and the possibility of developing polyhydramnios during pregnancy, you need to listen sensitively to the slightest deviations in your general condition. Swelling, pain and heaviness in the abdomen are already a good reason to visit a doctor.

Heavy

Severe polyhydramnios is considered to be an increase in the volume of water to 5 liters or more, the distance from the fetal body to the walls of the uterus is more than 18 cm. With severe polyhydramnios, the volume of the abdomen does not coincide sharply with the gestational age.

Severe or severe polyhydramnios is uncommon, but a woman with such a diagnosis must be treated in a hospital.

Ultrasound and CTG (cardiotocography) are prescribed to such patients almost daily, since the condition of the fetus must be carefully monitored. If the amnimatic fluid index (AFI) increases, as well as if the child’s vital functions deteriorate, emergency delivery is performed.

Acute

The acute form of the disease is subject to early diagnosis. This is a sharp increase in amniotic fluid, which is considered extremely dangerous. The development of this form of polyhydramnios occurs over several days or even hours. An external sign of pathology is a sudden excessive increase in abdominal volume.

Also, a pregnant woman begins to experience pain or discomfort in the lumbar and groin area. The abdominal wall is noticeably swollen. The expectant mother experiences severe shortness of breath. Listening to the fetal heartbeat is difficult. Such rapid development of the disease may be accompanied by rupture of uterine tissue.

Chronic

Another form of polyhydramnios in pregnant women is called chronic. With it, the increase in the volume of amniotic fluid is more moderate. Basically, this form appears in the later stages and has less pronounced symptoms.

Often, pregnant women already get used to the feeling of discomfort associated with their position. Therefore, diagnosing chronic polyhydramnios can be difficult. Yet this form of the disease can also lead to negative consequences.

First of all, this disease indicates deviations from the norm in the body. The chronic form of polyhydramnios usually develops against the background of viral diseases, genital infections, inflammatory processes in the kidneys or appendages, cardiovascular diseases, and diabetes mellitus.

Polyhydramnios during pregnancy

Developing inside the mother's body, the fetus is already surrounded by a small amount of amniotic fluid from the 10th week. Throughout the entire period of the child’s formation and development, this environment is considered the most favorable, comfortable and safe. It protects the fetus from infections, absorbs all shocks and compressions, muffles sounds, and allows movement. Amniotic fluid is a nutrient medium for the child and participates in its metabolism. Thanks to this fluid, constant pressure and temperature are maintained inside the fetal bladder. The outpouring of water at the beginning of labor provokes contractile work of the muscles of the uterus - contractions, without which the normal course of labor is impossible.

In order for both organisms, mother and fetus, to function normally, the amount and composition of amniotic fluid must be normal. In rare cases, the volume of water may change. Experts have determined the average norm to be 1.5-2 liters. Exceeding this volume - polyhydramnios - leads to complications and is considered a pathology. Despite the fact that this diagnosis significantly complicates the life of a pregnant woman, serious complications occur in only 15% of cases of polyhydramnios.

Manifestations of polyhydramnios are difficult to miss. Even with the chronic form of polyhydramnios, when fluid accumulates gradually, a woman will eventually notice a number of changes and ailments:

the belly has grown too much;
due to increased weight, the stomach has dropped;
pain appeared in the lower back and perineum;
constant swelling of the legs, regardless of the time of day;
The enlarged uterus puts pressure on the internal organs. As a result, the woman does not have enough breath, shortness of breath appears, and the pulse quickens;
Regular vomiting appears, caused by a compressed diaphragm.

A number of changes can also be noticed on the part of the fetus:

he becomes very active;
listening to the heart rhythm is difficult;
it is difficult to palpate large parts of the fetus;
when measuring the size of the uterus, an excess of the norm is observed.

Based on these symptoms, the gynecologist makes a preliminary diagnosis. The only way to definitively verify excess water accumulation is by ultrasound results.

In 30% of cases, the cause of polyhydramnios cannot be determined. It is generally accepted that the accumulation of amniotic fluid can be caused by:

viral diseases and various infections, including genital infections;
the woman has kidney disease, heart disease, diabetes mellitus;
multiple pregnancy, especially if we are talking about identical twins;
in rare cases, the cause is a Rh conflict between mother and child.

Very often, in 20% of cases, pathology develops due to fetal malformations. During the second half of pregnancy, the fetal digestive system can regulate the volume of amniotic fluid. If the baby has a poor swallowing mechanism and problems with the gastrointestinal tract, he will not be able to swallow and defecate amniotic fluid properly. As a result, the balance will be upset. Chromosomal abnormalities (Down syndrome) can also be one of the causes of polyhydramnios. In a similar way, the body tries to get rid of a poor-quality pregnancy.

If the fact of polyhydramnios is confirmed by ultrasound results, they try to establish the cause of the pathology. First, “maternal” reasons are identified. A woman donates blood for analysis to confirm or rule out diabetes mellitus, as well as for antibodies if she suspects a Rh conflict. A smear is taken to detect infections of the reproductive system. If there are suspicions of abnormalities in the development of the fetus, it is necessary to undergo an ultrasound again, but with a specialist who practices specifically in this field of medicine. In addition, Doppler measurements and CTG will be performed to find out how polyhydramnios affects the development of the child.

Another diagnostic method is amniocentesis, in which amniotic fluid is taken for analysis. In this way, it is possible to identify or exclude chromosomal abnormalities of the fetus and determine the presence of infection inside the amniotic sac.

Even if the fact of polyhydramnios is established, the situation is not considered critical. Most often, experts observe a moderate form, in which a slight increase in the volume of amniotic fluid is detected. The woman’s health is satisfactory, and no negative prognosis is expected for the further course of pregnancy and childbirth. At the same time, monitoring the condition of the fetus continues using Doppler and CTG in order to detect a deterioration in its condition in time.

In the acute form of polyhydramnios, fluid accumulates rapidly in a very short period of time. The woman immediately notices a deterioration in her condition: severe pain appears in the lower back, the uterus becomes “stone-like,” the stomach swells, and there is not enough air for normal breathing.

With chronic polyhydramnios, the process of fluid accumulation occurs gradually. With the help of treatment, it can be stopped and the amount of water reduced to normal levels. But in rare cases, treatment methods are ineffective or provide only temporary relief. Therefore, consequences can appear both during pregnancy and during childbirth:

polyhydramnios causes late miscarriages;
due to strong pressure on the amniotic sac, premature birth often occurs - the membranes rupture and water is released much earlier than expected;
when there is an excess of amniotic fluid, symptoms of preeclampsia appear - severe swelling and high blood pressure;
displacement of internal organs, primarily the lungs, makes breathing difficult, which leads to hypoxia of both the woman and the fetus;
with polyhydramnios, there is a risk of infection of the fetus if the woman has suffered a viral or infectious disease;
excessively stretched muscles of the uterus cannot actively contract during childbirth, delaying the birth process for a long time;
the pressure of amniotic fluid on the walls of the uterus can lead to detachment of a normally located placenta;
the skin on the abdomen does not have time to stretch, which leads to tissue rupture - stretch marks;
active movements of the fetus lead to entanglement of the umbilical cord;
excess space does not contribute to the formation of the correct position of the fetus before birth (head down).

After all the necessary research has been carried out and the cause of polyhydramnios has been established, treatment is prescribed. If an infection is detected, a course of antibiotics and multivitamins is prescribed. To quickly remove fluid, diuretics may be recommended. If the cause of polyhydramnios is diabetes mellitus, therapy aimed at lowering glucose is carried out. First of all, treatment is aimed at eliminating the cause of polyhydramnios, and at the same time reducing the volume of amniotic fluid.

In cases where the increase in fluid slightly exceeds the norm, does not lead to a deterioration in the well-being of the pregnant woman and does not cause abnormalities in the development of the fetus, treatment is not prescribed. The woman is advised to maintain a drinking regime and limit salt intake. Treatment comes down to monitoring the condition of the woman and the fetus.

If the volume of fluid increases significantly, a procedure is performed to remove amniotic fluid using a catheter, when the abdomen and amniotic membrane are punctured. This is a temporary measure. If the underlying disease progresses, the procedure will be ineffective.

If all therapeutic measures do not bring the desired result, and a deterioration in the condition of the fetus is detected, a decision is made on early delivery. Mostly, with polyhydramnios, natural childbirth is carried out. Due to decreased contractility of the uterus, they can last much longer. To intensify contractions, the obstetrician punctures the amniotic sac. With polyhydramnios, there is a risk of premature rupture of the membranes and sudden rupture of water, which can cause prolapse of the umbilical cord and parts of the child’s body. To avoid such complications, the bladder is opened before labor begins and the fluid is released very slowly. Then the birth proceeds as usual.

Polyhydramnios is considered an infrequent pathology - only 1-1.5%. And in many cases, it is not possible to determine the cause of excess fluid accumulation. Therefore, it is difficult to talk about any preventive measures. A woman needs to visit her gynecologist at the appropriate time and undergo recommended procedures and examinations.

Consequences of polyhydramnios

Polyhydramnios during pregnancy can lead to placental abruption, infection of the birth canal, and developmental abnormalities. Excessive accumulation of fluid leads to constant tension of the uterus, which can provoke a miscarriage. Also, polyhydramnios in pregnant women interferes with the correct positioning of the fetus.

Polyhydramnios in the early stages

The main threat with polyhydramnios is considered to be premature spontaneous termination of pregnancy. About a third of all cases end this way.

The second side effect of polyhydramnios in 36% of cases is severe toxicosis, turning into frequent uncontrollable vomiting. This is very dangerous and threatens the expectant mother with dehydration.

Polyhydramnios in later stages

Sometimes the disease leads to pelvic or transverse presentation of the fetus. In some cases, fetoplacental insufficiency may develop. The problem is relevant for 30% of pregnant women. This is a dangerous condition in which all functions of the placenta are disrupted. As a result, the fetus suffers from hypoxia. First of all, oxygen starvation affects metabolic processes.

In early pregnancy, hypoxia slows down fetal development. In the later stages, it leads to growth retardation, affects the nervous system and reduces the baby’s immunity. Also, placental insufficiency can cause abnormalities in labor, which often leads to fetal death.

Polyhydramnios during pregnancy has dangerous consequences for the central nervous system and gastrointestinal tract of the unborn baby. The disease is also fraught with heavy bleeding. Polyhydramnios sometimes leads to very dangerous late gestosis.

What is amniotic fluid needed for?

Each organ of the human body has a specific purpose. Amniotic fluid plays a very important role in a healthy pregnancy. Let's consider what main functions it performs.

Amniotic fluid creates favorable conditions for the baby to move. The baby can calmly move his legs and arms, nothing is squeezing him, there are no obstacles. A small amount of amniotic fluid can lead to the fetus developing various pathologies and deformities, usually in the extremities.
Amniotic fluid protects the baby from external negative factors. Even the impact of a fall of average strength is softened many times, precisely due to amniotic fluid.
Amniotic fluid protects the umbilical cord from compression. In water, the umbilical cord simply moves and is very difficult to squeeze. And blocking the umbilical cord is a very serious pathology - the baby is deprived of nutrition, oxygen, etc.
Amniotic fluid also plays a vital role during childbirth. They help the cervix open. Women whose waters break completely and long before the birth process itself have a much more difficult time giving birth.
Amniotic fluid protects the baby from loud sounds.
The water contains nutrients that the baby absorbs through the skin during early pregnancy. In later stages, the child often swallows amniotic fluid - this is absolutely safe and even beneficial.
Amniotic fluid creates favorable conditions for the life of the baby - a certain temperature and pressure.
If the mother gets sick, even with a serious infection, the amniotic fluid creates a kind of barrier to protect the baby. In 80% of cases, the baby does not become infected.

It is now clear that amniotic fluid is a very important component of a healthy pregnancy. But why does this liquid become so abundant? How to recognize polyhydramnios?

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Childbirth with polyhydramnios

With polyhydramnios, labor usually occurs prematurely. Rupture of the amniotic sac can occur suddenly, causing amniotic fluid to flow out abruptly and abundantly. Against this background, prolapse of an arm, leg or umbilical cord may occur. Also, early effusion provokes a significant weakening of labor, sometimes there are no contractions at all.

In addition, excessive stretching of the uterus occurs, which is fraught with placental abruption, heavy postpartum bleeding and other extremely dangerous consequences.

In addition, due to the suddenly increased space, the baby may take an incorrect position - gluteal or transverse.

To prevent such a situation and stop the outpouring of amniotic fluid, an early amniotomy is performed - a puncture of the amniotic sac.

Thanks to this procedure, amniotic fluid flows out in a thin stream, the uterus contracts and contractions become stronger. However, in most cases, doctors insist on a caesarean section.

Possible risks

There are dangers in pathology for a number of reasons. The consequences of polyhydramnios during pregnancy can be:

There is a strong stretching of the walls of the uterus, which creates a risk of placental abruption.
Premature birth.
Too much space in which the baby is positioned can prevent him from getting into the correct position before birth (cephalic presentation).
Heavy bleeding during and after childbirth.
The occurrence of toxicosis in late pregnancy.
Frequent and causeless vomiting, which can lead to dehydration.
Development of pathologies in the child’s gastrointestinal tract and nervous system.
Decreased fetal immunity and risks of infectious diseases.

Often with polyhydramnios, a cesarean section is recommended, since natural childbirth can be complicated by the following points:

weakness of labor;
prolapse of the baby's umbilical cord or limbs;
rupture of the amniotic sac;
transverse or breech presentation of the child.

This condition should be under medical supervision. Only in this case can many unpleasant consequences be avoided.

Diagnostics

The main method for diagnosing polyhydramnios is ultrasound. Its results reveal an excess amount of amniotic fluid. Additionally, Dopplerometry is performed to identify disturbances in the blood flow of the vessels of the uterus and umbilical cord.

It is also important to examine a pregnant woman - measuring the circumference of the abdomen and the height of the uterine fundus. When palpating the anterior abdominal wall in a pregnant woman with polyhydramnios, it is impossible to determine the presenting parts of the fetal body.

Diagnosis of the disease

Necessary tests and examinations Examination of the uterus allows you to diagnose polyhydramnios: an enlarged uterus, elastic and tense, indicates a disease. By palpating, the doctor notes its round or barrel-shaped shape.

Also, with polyhydramnios, the fetus is highly mobile - it constantly changes its position.

The diagnosis is confirmed using ultrasound, and CTG is required to assess the child’s condition.

A blood test is also performed to detect intrauterine infection.

Treatment

The choice of treatment will depend on the causes of polyhydramnios.

At the initial stages of treatment, a standard scheme is used:

Broad-spectrum antibacterial drugs. Frequently used ones are Ceftriaxone, Cefotaxime, Vilprafen. The use of tetracycline antibiotics is prohibited.
Drugs that improve uteroplacental blood flow - “Actovegin”, “Curantil”. They have a beneficial effect on the functioning of blood vessels and help remove excess bioactive liquid substance - amniotic fluid.
Antiplatelet agents - Trental, Pentoxifylline. Necessary to prevent the formation of blood clots in the vessels of the uterus and umbilical cord.
Systemic diuretics – diuretics – can also be used to remove fluid.
To improve the general condition of a woman, multivitamin complex preparations and magnesium preparations are also prescribed.
To relieve the symptoms of spasms, antispasmodics are prescribed - “No-Shpa”, “Papaverine”.

Treatment will also depend on the identified cause of polyhydramnios. If a woman has diabetes mellitus, she will need to be prescribed antihyperglycemic drugs; if the cause lies in cardiac pathology, treatment will be prescribed by a cardiologist; if the cause is an infection, anti-inflammatory drugs will be required.

Childbirth with pathology

The causes and consequences of polyhydramnios during pregnancy are varied. Most often, natural childbirth is contraindicated for a woman. Therefore, the following techniques are used to preserve the fetus and normal delivery:

Puncture of the bladder is necessary to release excess amniotic fluid. At the same time, it is carried out carefully so as not to catch part of the child’s body with the instrument.
If the amniotic sac ruptures, the doctor should place a hand inside the vagina to prevent the baby's umbilical cord or limb from falling out.
If it is necessary to stimulate labor with oxytocin or other drugs, it is necessary to avoid premature placental abruption. To do this, the drug is administered no earlier than 2 hours after the water breaks.
When labor is weak, medications are used to stimulate contractions.

Depending on the reasons, the consequences for the child with polyhydramnios during pregnancy may be different. In most cases, the baby requires intensive care during the first days of life.

Prevention

The main task of prevention is to prevent the occurrence of pathologies leading to polyhydramnios. Even in the early stages of pregnancy, it is necessary to exclude the presence of hidden infections and the occurrence of Rh conflict.

Preventive measures that will help reduce the risk of pathology:

timely completion of all medical examinations - tests and ultrasound;
compliance with doctor's recommendations for the treatment and prevention of sexually transmitted infections;
reducing the number of visits to crowded places to prevent ARVI;
avoiding hypothermia;
eliminating stress and unnecessary worries.

A special place in the prevention of polyhydramnios is occupied by the establishment of a diet.

Diet

The main task of the diet for polyhydramnios is to prevent the formation of additional excess fluid in the body. To do this, you must follow the rules:

normalize the drinking regime;
exclude salty foods and canned foods;
exclude sausages and salty cheeses;
eat more vegetables and fruits;
eat fractionally - in small portions, but often.

If the cause of polyhydramnios is gestational diabetes mellitus diagnosed in a woman, then a diet low in carbohydrates is necessary. It will be necessary to completely remove sweets, baked goods, carbonated drinks and other foods with a high glycemic index from the diet.

Disease prevention

To prevent pregnancy complications, the expectant mother must adhere to the following recommendations:

A history of chronic diseases should be brought into remission. This is especially true for diabetes and hypertension.
Check with a gynecologist for the presence of urogenital diseases and treat them in a timely manner.
At the beginning of pregnancy, take vitamin complexes.
Visit your gynecologist regularly and follow his instructions.

When preparing the body for conception, it is necessary to lead a healthy lifestyle. In this case, the likelihood of carrying a child to term without problems increases significantly.

How to relieve polyhydramnios

All unfavorable symptoms of polyhydramnios are associated with increased pressure from the enlarged uterus on surrounding organs. Main manifestations:

dyspnea;
increased heart rate - tachycardia;
swelling.

Women with these symptoms are advised to reduce their level of physical activity. It is advisable to limit carrying heavy objects, going up and down stairs, as well as doing energy-consuming chores.

Another unpleasant sign of polyhydramnios can be heartburn. It occurs due to increased pressure from the growing uterus on the stomach. As a result, acidic gastric juice rises up the esophagus, causing a burning sensation behind the sternum and in the neck.

You can relieve the symptom by changing your diet. It is recommended to eat with heartburn often, but in small portions. It is advisable to avoid fatty, fried, spicy and salty foods. To prevent heartburn from bothering you at night and during rest, it is recommended to use a special pillow for pregnant women for sleeping or raise your regular pillow higher.

Polyhydramnios in a pregnant woman can cause fear and anxiety for the baby. It is recommended to distract yourself from negative thoughts and look for positive ways to spend your time. In severe cases, anxiety states require work with a psychologist.

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Chronic polyhydramnios

This form of pathology is characterized by gradual filling of the amniotic sac with an increase in the amount of fluid. In addition to the standard symptoms of pathology, with chronic polyhydramnios the following manifestations are noted:

deviations in the height of the uterus;
unnaturally large and convex navel;
tight and tense stomach;

pain during fetal movement;
varicose veins (spider veins, bulging veins, swelling and fatigue of the legs);
increased urge to urinate, while the amount of urine coming out is minimal (this occurs when there is increased pressure from the uterus on the bladder);
reduction in the number of fetal movements.

Despite the fact that polyhydramnios occurs in a small percentage of pregnant women, no one is immune from it. That is why you need to regularly visit a gynecologist in order to recognize the pathology in time and minimize risks.

Folk remedies

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Of course, there are no traditional medicines that can eliminate polyhydramnios during pregnancy. When the first signs of a pathological process appear, you should immediately contact a medical institution, where a qualified specialist will prescribe appropriate treatment. Polyhydramnios during pregnancy is a serious gynecological pathology, which without appropriate treatment can lead to various complications. That is why it is extremely important to carefully follow all the doctor’s recommendations and under no circumstances self-medicate at home.

In addition, do not forget about the importance of preventive measures, the observance of which will significantly reduce the risk of developing pathology. These include:

pregnancy planning;
timely diagnosis and treatment of infectious and inflammatory diseases of the reproductive organs, including sexually transmitted infections;
the use of barrier methods of contraception (condoms) during sexual intercourse, as well as the exclusion of casual sexual intercourse;
timely registration with the antenatal clinic (no later than 12 weeks of pregnancy);
regular visits to an obstetrician-gynecologist.

Also, do not forget about proper nutrition. It is recommended to consume more dairy products, vegetables and fruits rich in fiber and vitamins. You should not overuse fried and spicy foods, as well as canned foods. It is important to give up bad habits (smoking, drinking alcohol and drugs), which are known to increase the risk of developing pathology. Particular attention is paid to the sleep and rest regime, the observance of which helps to strengthen the general condition of the pregnant woman.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.

Signs of polyhydramnios

The average amniotic fluid volume and permissible deviations are well known. At week 10 the norm is about 30 ml. By the end of the gestation period, the normal volume can reach up to one and a half liters.

When getting acquainted with the normal indicators, pregnant women worry, doubting whether everything is all right with them. There is no need to worry in advance. If problems start in this area, it will be clear from the general condition. The signs are:

pain in the abdomen;
heaviness in the stomach;
general weakness;
cardiopalmus;
dyspnea;
swelling;
abdominal volume exceeding normal;
stretch marks on the stomach;
fluctuation (gurgling sounds).

What does polyhydramnios mean during pregnancy?

Polyhydramnios is a pregnancy pathology that has a “telling” name, meaning that the volume of fluid in the amniotic sac exceeds normal values for a given gestational age.

Doctors diagnose “polyhydramnios” when the volume of amniotic fluid in the last weeks of pregnancy exceeds 2000 ml.

Polyhydramnios is diagnosed in approximately 1% of all pregnant women; this pathology is considered a fairly common occurrence and is by no means harmless.

It can have very negative consequences for the health of the future parent, the fetus, the course of both the gestational period and labor, and can cause problems with the health of the newborn child.

In case of polyhydramnios, a woman must be prescribed treatment, usually in a hospital setting for constant medical supervision.

Childbirth with polyhydramnios requires special tactics on the part of medical staff.

State Definition

Polyhydramnios means the accumulation of amniotic fluid in the uterus above normal. It is known that its main functions are:

protecting the child from various types of damage and external infections;
maintaining the required temperature and pressure;
nutrition.

The mechanism for controlling the amount of water surrounding the fetus is quite simple: after the liquid has been swallowed, it is digested, then excreted first from the baby’s body, and then from the mother in the urine.

When calculating volume, the amniotic fluid index (AFI) is used. To determine it, during an examination with an ultrasound machine, the uterus is divided into four squares and the size of the larger space between the wall of the uterus and the fetus is determined in each of them (the so-called vertical pocket). The resulting numbers are added up and checked against a special table.

As you can see, the indicators gradually increase until the middle of the second trimester. Closer to childbirth, the numbers begin to decline. If the number obtained during the study goes beyond the limits indicated in the table, we can talk about polyhydramnios in pregnant women. It should be noted that doctors measure fluid volume in exceptional cases.

As a rule, the basis for this is the woman’s own complaints. If signs of polyhydramnios are obvious, an unscheduled ultrasound is recommended.

Polyhydramnios at 40 weeks of pregnancy

The baby is surrounded by amniotic fluid in the womb. It performs several functions at once: it protects, provides freedom of movement, takes part in metabolic processes, and is also responsible for the development of basic skills in the fetus (swallowing, motor skills). They say that it smells like milk, and this explains how a newborn baby finds the breast so quickly.

Nature intended that this liquid be regularly renewed. That is why its volume is different at different periods:

at 10 weeks – this is about 10 ml;
at 14 – 100 ml;
at 21 – 22 – 400 ml;
at 30 – 32 – 700 ml;
at 37 – 38 – up to 1500 ml (this is the maximum);
at 39 – 40 – about 800 ml.

This is ideal. And if the volume significantly exceeds the norm, polyhydramnios is diagnosed. As a rule, doctors are alarmed by a significant excess - 1.5 - 2 times. The most interesting thing is that modern medicine distinguishes between several types of polyhydramnios, sometimes making a borderline diagnosis that sounds like a “tendency to polyhydramnios.” In other words, there is no pathology yet, but the risk of its development has been identified.