Polyhydramnios is a condition which affects the uterus of a pregnant woman. In this condition, too much amniotic fluid (the liquid that surrounds the baby in the womb) collects in the uterus. When this happens, the uterus becomes larger than normal.
Amniotic fluid has a significant role in the baby’s growth. Typically, amniotic fluid is swallowed by the baby in utero and then urinated out. This steadies the amount of fluid in the uterus.
This condition can present itself as soon as 16 weeks into the pregnancy. However, more often it will show as the pregnancy progresses into later weeks.
How common is polyhydramnios?
Polyhydramnios is considered rare. This condition affects roughly 1 percent of pregnancies.
Who is affected by polyhydramnios?
Any pregnant woman can be affected by polyhydramnios. However, it is distinguished as a rare condition.
For women experiencing a mild case of polyhydramnios, there may not be any symptoms. Women experiencing a more severe form of the condition could have these symptoms:
- Sensation of tightness in stomach
- Indigestion
- Difficulty with bowel movements (constipation)
- Producing less urine
- Enlargement of vulva
- Breathing troubles
- Swelling of leg, thigh, hip, ankle and/or foot
What causes polyhydramnios?
For most women, the cause of their polyhydramnios condition remains a mystery. Women with mild cases most likely have symptoms due to the increasing amount of fluid in their uterus. Moderate to severe polyhydramnios could be caused by the following:
- Birth defect affecting the baby’s ability to swallow
- High blood glucose levels (mother has diabetes either before or after becoming pregnant)
- Carrying identical twins with transfusion syndrome (TTTS)
- Differing blood types (mother has Rh-negative, baby has Rh-positive)
- Problem in the baby’s stomach
- Issues with the placenta
- Too much fluid in the baby
- Complications with the heart rate of the baby
- Baby develops an infection
A doctor will measure your stomach and determine if your uterus is too large. Typically, that means you are measuring two or more weeks ahead of your expected due date. In addition, polyhydramnios can be diagnosed if the doctor has difficulty locating the heartbeat of the baby or feeling for the baby.
Ultimately an ultrasound will be done to determine the amount of amniotic fluid.
Polyhydramnios is generally not treated if it is a mild case. Your doctor may schedule additional appointments to check on the size of the growing uterus. The baby should be born healthy and without complications.
If the size of the uterus becomes more of an issue and the condition more severe, a treatment plan can be formulated by your doctor. This plan will more than likely focus on the cause of the polyhydramnios. For example, medication can be taken to control the baby’s urine production while in the womb. Other treatments include:
- Bed rest
- Draining amniotic fluid using a large needle
- Inducing labor early
What are the complications associated with polyhydramnios?
During polyhydramnios, the distended uterus puts pressure on other organs. This can cause pregnancy complications, especially if the condition shows itself early into the pregnancy. Other complications from a severe form of the condition include:
- Mother going into labor too early
- Baby being born too early
- Baby growing too quickly and becoming too large while in the womb
- Placenta detaching from uterus (placental abruption) before birth of baby
- Mother suffering from too much bleeding (hemorrhage) after giving birth
- Umbilical cord falling out before baby is born (umbilical cord prolapse)
- Baby laying in wrong position in the womb (fetal malposition)
- Baby being born without signs of life (stillbirth)
What can I do to help relieve symptoms of polyhydramnios?
If you are diagnosed with polyhydramnios, you can try to relieve the symptoms through the following ways:
- Remain calm
- Rest for longer periods of time
- Be upfront with your doctor about how you envision your labor and birth process to proceed, especially if it occurs prematurely
- Contact your doctor if you feel other symptoms occur, your belly becomes larger quickly or you are feeling fearful about the baby’s growth
- Join an online forum to speak to other women with similar issues
For patients who have polyhydramnios, they will be advised to give birth in a hospital, rather than at home. The baby’s heartbeat will be evaluated during labor to make sure the baby is not going through too much stress. You may also pass a large amount of fluid as you give birth, which is normal during this time.
The baby’s stomach may be evaluated after birth to make sure there is nothing abnormal. Typically, the babies born to moms with polyhydramnios are healthy.
A doctor should be called to further evaluate your condition of polyhydramnios if your belly becomes larger in a very short amount of time. This may cause you to deliver the baby early.
Last reviewed by a Cleveland Clinic medical professional on 01/21/2019.
References
- American Pregnancy Association. Polyhydramnios: High Amniotic Fluid During Pregnancy. (//americanpregnancy.org/pregnancy-complications/polyhydramnios-high-amniotic-fluid/) Accessed 1/23/2019.
- National Health Service. Polyhydramnios (too much amniotic fluid). (//www.nhs.uk/conditions/polyhydramnios/) Accessed 1/23/2019.
- March of Dimes. Polyhydramnios. (//www.marchofdimes.org/pregnancy/polyhydramnios.aspx) Accessed 1/23/2019.
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Amniotic fluid supports a developing fetus in the womb during pregnancy. Sometimes, levels of this fluid are too low, but a person can increase these by taking certain steps.
The right levels of amniotic fluid are essential as the fluid helps to protect a fetus, as well as to regulate the surrounding temperature.
Amniotic fluid also helps prevent any squeezing of the umbilical cord, which might otherwise cut off food and oxygen to the fetus.
We look at how to increase amniotic fluid during pregnancy, as well as the risks of very high or low levels.
Share on PinterestIncreasing water intake may help improve amniotic fluid.
Amniotic fluid levels vary throughout the different stages of pregnancy.
During weeks 32–34, the amniotic fluid volume may increase to 800 milliliters (ml) or more. From 34 weeks through to labor, the fluid decreases to about 400 ml.
Doctors use a scale called the amniotic fluid index (AFI) to check healthy levels of amniotic fluid.
AFI measurements are in centimeters (cm). A typical AFI score is 5–25 cm. An AFI score lower than 5 cm is too low, and doctors refer to this as oligohydramnios.
If a pregnant woman has low levels of amniotic fluid, they can work with their healthcare team to remedy the situation.
In some cases, drinking more water may help to increase levels. In other instances, a doctor may recommend medical treatments.
A doctor will also suggest more frequent checkups to carefully monitor amniotic fluid levels and ensure treatment is effective.
Some suggestions for how to increase amniotic fluid levels include:
Increasing water intake
If women have slightly lower than usual levels of amniotic fluid, they may be able to increase their levels by drinking more water.
An older 2002 review looked at four studies of 122 pregnant women. It found that women who increased their water intake, by roughly 2 liters over 2 hours, or had intravenous fluid, increased their levels of amniotic fluid.
Researchers need further evidence to know if increasing amniotic fluid in this way improves the health of the fetus.
Supplementation
A 2016 study examined the use of L-arginine supplementation to treat oligohydramnios when amniotic fluid levels are very low.
In the study, 100 pregnant women with a diagnosis of oligohydramnios took 3-gram sachets of L-arginine, three times a day until an increase in amniotic fluid levels occurred.
The study concluded that L-arginine may help treat oligohydramnios by increasing amniotic fluid levels. The benefits include lengthening the pregnancy duration and decreasing the risk of complications.
Rest
A doctor may advise more bed rest and decreasing physical activity for women with low amniotic fluid levels.
Amnioinfusion
A doctor may treat low levels of amniotic fluid with a process called amnioinfusion.
For this treatment, the doctor will introduce a saline solution via the cervix into the amniotic sac to increase fluid levels.
Early delivery
If amniotic fluid drops too low during the final stages of pregnancy, doctors may suggest early labor. Bringing labor forward can help to prevent any potential complications during delivery.
Thorough prenatal care can help to ensure the premature baby is healthy.
While oligohydramnios occurs when a woman has very low levels of amniotic fluid, polyhydramnios is when the fluid levels are extremely high.
Both conditions can cause complications:
Oligohydramnios
Oligohydramnios is a condition where a pregnant woman has too little amniotic fluid. Symptoms and signs of oligohydramnios include:
- fluid leaking from the vagina
- the woman not gaining enough weight
- the fetus not growing as fast as normal
- an ultrasound shows low levels of amniotic fluid
- the uterus is too small for the pregnancy stage
Doctors do not always know what causes oligohydramnios. However, some causes include:
- preexisting health conditions, such as high blood pressure and diabetes
- certain medications, such as high blood pressure drugs
- post-term pregnancy continuing 2 or more weeks past the due date
- congenital disabilities
- the amniotic sac breaking after 37 weeks but before labor
- pregnancy with identical twins that share a placenta
Oligohydramnios is most common in the last 3 months of pregnancy, known as the third trimester.
Polyhydramnios
Polyhydramnios, or hydramnios, is when levels of amniotic fluid are too high. Hydramnios happens if there are problems with amniotic fluid leaving the body, or if the body is creating too much of it.
If a pregnant woman has diabetes, this can cause polyhydramnios.
Other causes are due to the developing fetus.
Hydramnios may happen if a fetus has any of the following:
- central nervous system or chromosome issues affecting swallowing
- heart failure
- infection
- digestive problems, which can cause a blockage in fluid
- congenital disabilities
Polyhydramnios can also occur when identical twins share a placenta.
Symptoms of polyhydramnios include:
- unusually fast uterus growth or large uterus for pregnancy stage
- discomfort in the stomach
- contractions
Untreated polyhydramnios can cause complications for the pregnant woman and the developing fetus. These complications can include early labor or congenital disabilities.
Treatment will depend on the cause and severity of the condition. Options include:
- careful monitoring of amniotic fluid levels
- inserting a needle into the amniotic sac to remove fluid
- medication to reduce the fetus’s urine output, which adds to amniotic fluid
- early delivery if necessary
Women should see their doctor if they notice any symptoms of high or low amniotic fluid levels.
A doctor will take a medical history to check for any preexisting conditions and carry out a physical examination. A doctor will use ultrasounds and measure amounts of amniotic fluid to check levels.
Once a doctor has checked levels and found any possible causes, they can decide on the best treatment options.
If a pregnant woman has low levels of amniotic fluid towards the end of a healthy pregnancy, they may not need any treatment. A doctor may just carry out additional monitoring to keep a closer eye on levels, including more frequent ultrasounds.
Correct levels of amniotic fluid are necessary for keeping a developing fetus safe and healthy.
If a pregnant woman has a lower level of amniotic fluid than usual, they or their healthcare team can remedy this. Drinking more water is a simple way of increasing amniotic fluid while resting and decreasing physical exercise may also help.
In other cases, an individual may need medical treatment. Interventions can include intravenous fluids to increase hydration, or directly inserting a saline solution into the amniotic sac to increase fluids.
If people have any symptoms of low or high amniotic fluid levels, they should arrange a checkup with their healthcare team.
Ultrasounds can help to check amniotic fluid levels, and close monitoring and treatment can ensure both the pregnant woman and the fetus stay healthy.