(pol-e-hy-DRAM-nee-os) is the excessive accumulation of amniotic Fluid — the Fluid that surrounds the baby in the uterus during pregnancy. Polyhydramnios occurs in about 1 percent of pregnancies.
Most cases of polyhydramnios are mild and result from a gradual buildup of amniotic Fluid during the second half of pregnancy. Severe polyhydramnios may cause shortness of breath, Preterm labor, or other signs and symptoms.
If you’re diagnosed with polyhydramnios, your health care provider will carefully monitor your pregnancy to help prevent complications. Treatment depends on the severity of the condition. Mild polyhydramnios may go away on its own. Severe polyhydramnios may require treatment, such as draining the excess amniotic Fluid.
Polyhydramnios symptoms result from pressure being exerted within the uterus and on nearby organs.
Mild polyhydramnios may cause few — if any — signs or symptoms. Severe polyhydramnios may cause:
• Shortness of breath or the inability to breathe, except when upright
• Swelling in the lower extremities, vulva and abdominal wall
• Decreased urine production
Your health care provider may also suspect polyhydramnios if your uterus is excessively enlarged and he or she has trouble feeling the baby or hearing the heartbeat.
Some of the known causes of polyhydramnios include:
• A birth defect that affects the baby’s gastrointestinal tract or central nervous system
• Maternal Diabetes
• Twin-twin transfusion — a possible complication of identical twin pregnancies in which one twin receives too much blood and the other too little
• A lack of red blood cells in the baby (fetal Anemia)
• Blood incompatibilities between mother and baby
Often, however, the cause of polyhydramnios isn’t clear.
Polyhydramnios is associated with:
• Premature birth
• Premature rupture of membranes — when your water breaks early
• Excess fetal growth
• Placental abruption — when the placenta peels away from the inner wall of the uterus before delivery
• Umbilical cord prolapse — when the umbilical cord drops into the vagina ahead of the baby
• C-section delivery
• Heavy bleeding due to lack of uterine muscle tone after delivery
The earlier that polyhydramnios occurs in pregnancy and the greater the amount of excess amniotic Fluid, the higher the risk of complications.
TREATMENTS AND DRUGS
Mild cases of polyhydramnios rarely require treatment and may go away on their own. Even cases that cause discomfort can usually be managed without intervention.
In other cases, treatment for an underlying condition — such as Diabetes — may help resolve polyhydramnios.
If you experience Preterm labor, shortness of breath or abdominal pain, you may need treatment — potentially in the hospital. Treatment may include:
• Drainage of excess amniotic Fluid.
Your health care provider may use amniocentesis to drain excess amniotic Fluid from your uterus. You may need to repeat the procedure — sometimes referred to as amnioreduction — multiple times as your pregnancy progresses. Amnioreduction carries a small risk of complications, including Preterm labor, Placental abruption and premature rupture of the membranes.
Your health care provider may prescribe the oral medication indomethacin (Indocin) to help reduce fetal urine production and amniotic Fluid volume. Indomethacin isn’t recommended beyond 31 weeks of pregnancy. Due to the risk of fetal heart problems, your baby’s heart may need to be monitored with a fetal echocardiogram and Doppler ultrasound. Other side effects may include nausea, vomiting, acid reflux and inflammation of the lining of the stomach (Gastritis).
After treatment, your doctor will still want to monitor your amniotic Fluid level approximately every one to three weeks.
If you have mild to moderate polyhydramnios, you’ll likely be able to carry your baby to term, delivering at 39 or 40 weeks. If you have severe polyhydramnios or if the cause of the excessive Fluid threatens the baby’s well-being, labor may be induced around 37 weeks — possibly earlier — to try to avoid serious complications.