Polyhydramnios during pregnancy: signs and treatment
Polyhydramnios is a pathological condition during pregnancy when the amniotic fluid in the amniotic cavity exceeds the norm. The value of amniotic fluid for normal development and life of the fetus is invaluable. It protects the fetus from external mechanical impact, provides the embryo with freedom of movement, protects the cord from squeezing, and it’s also involved in metabolism. Amniotic fluid is in constant motion and systematically renew.
At different stages of pregnancy norms of amniotic fluid are different: in the 10th week, for example, the volume is 30 ml, in the 14th week — 100 ml, in the 37th -38th weeks of pregnancy — 1−1,5 l. If this volume by the end of any period is exceeded, we speak about polyhydramnios in pregnant women. But how can you learn how much of this fluid you have? There are certain symptoms, which can tell a woman that something bad is happening. In this case, it is necessary to consult your gynecologist.
- feeling of heaviness and pain in the abdomen;
- malaise, weakness;
- shortness of breath (because of the high standing of the diaphragm);
- increased heart rate;
- swelling of the feet;
- volume of the abdomen at the umbilicus level reaches 100−120 cm or more;
- stretch marks on stomach;
- distinct gurgling in the abdomen (fluctuation).
Why is polyhydramnion dangerous?
While acute polyhydramnios, the quantity of amniotic fluid increases rapidly and dramatically, which is very dangerous. Everything happens in just a few hours or days: the size of the abdomen of a pregnant woman increases, she feels pain in the groin and waist, and doctors observe the voltage of the walls of the uterus and noticeable swelling of the anterior abdominal wall. While chronic polyhydramnios, the volume of fluid increases gradually, but it also causes a number of complications.
The consequences of polyhydramnion can be very sad.
In 28.4% of difficult cases premature termination of pregnancy happens. 36% of women have vomiting. Abnormal position and presentation of the fetus is diagnosed in 6.5% of women. Fetoplacental insufficiency and chronic hypoxia may develop and they lead to fetal loss. Possible malformations of the central nervous system and gastrointestinal tract of the fetus, early outpouring of amniotic fluid and premature birth are among possible complications. If infectious process was the cause of polyhydramnion, the fetus may be also infected. 38.4% of women experience bleeding (in 41,3% of cases if acute polyhydramnios, and in 6,2% - if chronic). Late gestosis occurs in 5−20% of pregnant women with polyhydramnios.
Causes of polyhydramnion during pregnancy.
Causes of polyhydramnion still remain uncertain. Doctors know, what women are at risk of having polyhydramnios. However, in 30% of cases doctors cannot figure out what the cause of polyhydramnion are.
These are factors that can be causes of polyhydramnion (although not necessarily):
- infectious diseases;
- kidney diseases;
- cardiovascular diseases;
- Rh incompatibility;
- multiple pregnancy;
- reduced excretory function of the fetus;
- violation of the functions of ingestion;
- malformations of the fetus.
Treatment of polyhydramnion.
Mainly, the diagnosis of polyhydramnion is made according to the results of the ultrasound examination. Since the detection of pathology, the mother should be under constant medical supervision. If there is no explicit disorders of circulatory and respiratory systems (light and medium polyhydramnion), doctors strive to keep the pregnancy. Otherwise, there is a need for an early delivery, as the situation may pose a threat to a woman’s life. If pregnancy is saved, it is necessary to establish the reason of polyhydramnion, because it can cause the development of chronic oxygen starvation of the fetus. Depending on the identified causes of the disease, the pregnant woman gets appropriate treatment. The treatment of polyhydramnion includes antibiotic therapy, if the reason has viral etiology. Immunomodulating therapy, diuretic remedies and vitamins, abdominal amniocentesis are among possible methods of treatment.