Polyhydramnios during pregnancy: causes, treatment, possible consequences for the baby

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

On the way to motherhood, a woman can face many dangers. Fortunately, modern medicine today has stepped far ahead and has the ability to diagnose and treat many pathologies at the initial stages. What is polyhydramnios during pregnancy? What are its causes and consequences for the child?

Definition

Polyhydramnios is a pathological accumulation of a large amount of amniotic fluid in the last trimester of pregnancy. The main function of amniotic fluid is to protect the fetus from external influences, to prevent compression of the umbilical cord, and to provide space for movement.

At different stages of pregnancy, there are different norms for the amount of amniotic fluid. At week 10, the norm is about 30 ml of water, at 14 weeks - 100 ml, at 37-38 weeks - 1.5 liters of liquid. If there is more fluid than is normal, we can talk about polyhydramnios.

Symptomspathology

There can be a large number of reasons for polyhydramnios during late pregnancy, however, despite the reason for the occurrence, they have the same manifestations. Only acute and chronic forms of the course of the pathological condition differ. In the acute form, symptoms develop much faster than in the chronic form. So, for example, they can appear within a few hours. Polyhydramnios can be suspected if the following manifestations are observed:

• Stretches on the abdomen, which indicate the large size of the uterus. In this case, the volume of the pregnant belly may exceed 115-120 cm.
• Abdominal pain, aching in nature.
• Feeling heavy.



• Discomfort, weakness, as if a cold is starting.
• Severe swelling of the lower extremities.
• Increased heart rate.
• When changing position, walking can hear gurgling in the stomach.
• Shortness of breath even with minor physical exertion, such as climbing stairs.

With the rapid development of polyhydramnios, a pregnant woman needs hospitalization. In severe cases, an abortion or artificial birth may be necessary, otherwise there is a chance of a child being born with developmental pathologies.

Causes of polyhydramnios

To date, it is not known exactly what causes the disease. However, there are reasons for polyhydramnios during pregnancy that put a woman at risk:

• Diseases of the genitourinary system, impaired renal function.
• Chronic cardiovascular pathologies.
• Infectious diseases or inflammatory processes in the body.
• Rhesus conflict between mother and fetus, as a result of which the woman's body begins to perceive the child as a foreign body, and attempt to get rid of it.
• In a multiple pregnancy with different amniotic sacs, polyhydramnios can develop in one baby and oligohydramnios in another.
• Reduced excretory function of the fetus.
• Big size and weight baby.
• History of a pregnant woman with type 1 or type 2 diabetes.

• Defects in a child.
• Violation of the swallowing function of the fetus. Normally, amniotic fluid is constantly renewed, as the baby swallows approximately 500 ml of fluid in 24 hours.

One or a combination of several causes of polyhydramnios during pregnancy can cause pathology.

Disease types

Various causes of polyhydramnios during pregnancy lead to the following types of pathological condition:

• Severe - noticeable on examination (large belly, increased activity of the child, woman's complaints of pain in the lumbar back).
• Idiopathic - polyhydramnios during pregnancy with good tests. the reasons for which could not be clarified.
• Mild form at full-term pregnancy, when the volume of amniotic fluid is increased, but does not exceed 3 liters.
• Average is characterized by an increase in amniotic fluid up to 5 liters.
• Severe - diagnosed in case ofpathological increase in fluid volume over 5 liters.
• The chronic form of the development of pathology is noted in the case of a gradual increase in the amount of amniotic fluid.
• Acute - when the water level rises rapidly.

The greatest danger to a woman and fetus is an acute form of the development of pathology, as well as an increase in the amount of fluid to a critical level - above 5 liters. In this case, emergency hospitalization, artificial labor or caesarean section is indicated.

Moderate polyhydramnios

There are several degrees of severity of pathology. Causes of moderate polyhydramnios during pregnancy can be as follows:

• Increase in blood sugar.
• Toxicosis in late pregnancy (preeclampsia).
• Genetic diseases.
• Problems in the functioning of the placenta.

Moderate polyhydramnios does not pose a particular danger to mother and child, since an increase in the volume of fluid is insignificant. However, if the doctor does not control this process, there may be the following complications:

• fetal fading;
• preterm birth;
• anomalies in the development of the child;
• pregnancy prolongation.

In some cases of moderate polyhydramnios, a pregnant woman is advised to stay in a hospital.

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, in chronic polyhydramnios there are suchmanifestations:

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

• pain during fetal movement;
• varicose veins (spider veins, bulging veins, swelling and tired legs);
• increased urge to urinate, while the amount of urine output is minimal (this occurs with increased pressure from the uterus on the bladder);
• reducing 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 pathology in time and minimize risks.

Early polyhydramnios

As a rule, a pregnant woman suffers from the problem of excessive amounts of amniotic fluid in the later stages. However, idiopathic polyhydramnios occurs during pregnancy up to 28 weeks, the causes of which are not fully known. In most cases, it is harmless and resolves on its own over time.

Possible risks

Dangers in pathology lie in wait for a number of reasons. The consequences of polyhydramnios during pregnancy can be as follows:

• There is a strong stretching of the walls of the uterus, because of which there is a risk of placental abruption.
• Premature birth.
• Too much space in which the baby is placed can prevent him from getting into the correct position before birth (head presentation).
• Plentifulbleeding during and after childbirth.
• The occurrence of toxicosis in late pregnancy.
• Frequent and unexplained vomiting, which can lead to dehydration.
• The development of pathologies in the child from the gastrointestinal tract and nervous system.
• Reduced fetal immunity and risks of infectious diseases.

Cesarean section is often recommended for polyhydramnios, as natural childbirth can be complicated by the following points:

• weak labor activity;
• prolapse of the umbilical cord or limbs of the child;
• rupture of the amniotic sac;
• transverse or breech presentation of the baby.

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

Diagnosis of disease

Finding out the causes of polyhydramnios during pregnancy and treating the consequences is impossible without modern diagnostic methods. Feeling the first symptoms, the woman turns to the gynecologist, who, based on the patient's complaints, prescribes the necessary studies:

• Ultrasound diagnostics is the most accessible and informative way to determine polyhydramnios. An image is displayed on the monitor of the device, after analyzing it, you can diagnose the problem.
• Cardiotocography, which is necessary to assess the condition of the fetus.
• Dopplerography of vessels for the study of the uterus and the child.
• Complete blood count.

Laboratorysmear tests to check for vaginal infections

It is important not to ignore the need for testing and research, as these are key to prescribing the correct treatment for polyhydramnios.

Treatment of pathology

Depending on the causes of polyhydramnios during pregnancy, adequate therapy is prescribed at 33 weeks. First of all, it is necessary to exclude the factor that provoked an increase in the amount of amniotic fluid. The therapy consists of the following points:

• After diagnosing a problem, it is necessary to deal with the root cause. For example, when a water infection is detected, drugs can be injected into the amniotic sac. If polyhydramnios is provoked by diabetes, the expectant mother is prescribed drugs to maintain normal blood sugar levels and stabilize carbohydrate metabolism.
• Fight against fetal hypoxia, which may occur due to an increase in the level of amniotic fluid. Drugs are used to improve blood flow in the vessels: Curantil, Trental.

• With an increased tone of the uterus, drugs are needed to reduce it. Often used are tocolytics such as Ginipral, Partusisten, Indomethacin, and antispasmodics: No-Shpa, Spasmalgon, Papaverine.
• Drug "Actovegin" for the normalization of glucose-oxygen metabolism in the placenta.
• Vitamin complexes to increase the level of immunity inpregnant woman.
• Diuretics to reduce the level of amniotic fluid. In rare cases, mechanical removal of excess fluid using amniocentesis is necessary.

In the acute course of pathology, medications may not give the expected result. In such cases, premature birth or termination of pregnancy is indicated, depending on the gestational age.

Childbirth with pathology

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

• The puncture of the bladder is necessary to pour out excess amounts of amniotic fluid. At the same time, it is carried out carefully so as not to hook a part of the child's body with the tool.
• When the amniotic sac ruptures, the doctor must place a hand in the vagina to prevent the baby's umbilical cord or limb from protruding.
• If it is necessary to stimulate labor with oxytocin or other drugs, it is necessary to avoid premature abruption of the placenta. To do this, the drug is administered no earlier than 2 hours after the outflow of water.
• For weak labor, drugs are used that stimulate contractions.

Depending on the causes, the consequences for a child with polyhydramnios during pregnancy can be different. In most cases, the baby requires being in intensive care during the first days of life.

Disease prevention

For the prevention of pregnancy complicationsThe expectant mother should adhere to the following recommendations:

• History of chronic diseases should be brought into remission. This is especially true for diabetes, hypertension.
• Check with a gynecologist for urogenital diseases and treat them in a timely manner.
• Take vitamin complexes at the beginning of pregnancy.
• Regularly visit the gynecologist and follow his appointments.

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

In closing

The causes of polyhydramnios during pregnancy at 32 weeks and other terms are varied, and in most cases it is impossible to establish exactly what triggered the development of the pathology. In addition to the discomfort and pain experienced by a woman with this diagnosis, complications can also be from the respiratory system, as the enlarged uterus presses on the diaphragm, making it difficult for air to enter. In addition, polyhydramnios can cause early detachment of the placenta, weakness of labor, excessive bleeding during childbirth. It is important not to let pregnancy with pathology take its course, as the consequences can be dire.