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Increased amount of amniotic fluid. Polyhydramnios during pregnancy is a serious pathology requiring treatment.

- a condition characterized by an increase in the amount of amniotic fluid in the amnion. Pathology manifests itself at different stages of embryogenesis, accompanied by a deterioration in general well-being, fluctuation, swelling and severe toxicosis. It is possible to diagnose polyhydramnios during pregnancy on the basis of data from an objective examination and ultrasound. Treatment of pathology involves hospitalization in the obstetric department, where antibiotics, drugs that improve blood flow in the placenta, and vitamins are prescribed. Depending on the severity of the patient's condition, expectant management or emergency delivery may be used.

Causes of polyhydramnios during pregnancy

The pathogenesis of polyhydramnios during pregnancy may consist in two opposite mechanisms: a violation of the secretory activity of the villi of the membranes and a pathological increase in the volume of OPV due to malabsorption. Normally, the absorption of amniotic fluid is carried out through the lungs and intestines of the baby, as well as directly by the amniotic membrane itself. Polyhydramnios during pregnancy can also develop in case of impaired swallowing activity of the fetus. At the same time, a normal volume of OPV is released, but the waters do not have time to go through the absorption cycle (normally, the amniotic fluid is updated every 3 hours, and the child swallows up to 4 liters per day).

So far, it has not been possible to finally find out the causes of polyhydramnios during pregnancy. Doctors believe that the risk of developing obstetric pathology increases significantly if a woman has metabolic disorders, in particular, diabetes mellitus. Polyhydramnios during pregnancy often occurs due to diseases of the kidneys, the cardiovascular system. The likelihood of polyhydramnios increases against the background of Rhesus conflict. Another common cause of polyhydramnios during pregnancy is infection, and in this case there is a threat of intrauterine infection of the fetus. The most dangerous pathogens are rubella and herpes, toxoplasma and cytomegalovirus.

Polyhydramnios during pregnancy can be triggered by disorders in the development of the fetus. According to statistics, an obstetric anomaly is more often diagnosed if there are abnormalities associated with chromosomal mutations. Polyhydramnios during pregnancy often occurs in the presence of malformations of the kidneys, intestines, lungs, central nervous system, heart. The risk group for the formation of this pathology includes women who, after conception, suffered viral and bacterial infections, including influenza, SARS. A certain role in the development of polyhydramnios during pregnancy is played by the impact of negative factors: smoking, drug and alcohol use, work in hazardous enterprises, insufficient intake of nutrients.

Classification and symptoms of polyhydramnios during pregnancy

Depending on the rate of increase in the volume of amniotic fluid in obstetrics, two types of this condition are distinguished:

  • Chronic polyhydramnios during pregnancy- the most favorable variant of the course of the pathology, in which there is a high probability of carrying the fetus before the expected date of birth. In this case, polyhydramnios during pregnancy develops gradually, is accompanied by minor clinical manifestations and responds well to conservative treatment.
  • Acute polyhydramnios during pregnancy- a severe form, characterized by a rapid increase in the volume of OPV (in just a few hours). More often, such a pathology develops at 16-18 weeks of gestation, leading to a serious condition of the mother and baby. This form causes spontaneous abortion in the later stages, severe congenital anomalies, stillbirth and provokes serious complications on the part of the patient.

The severity of polyhydramnios during pregnancy is determined by the amount of amniotic fluid: mild - OPV volume up to 3 liters, moderate - from 3 to 5 liters, severe - over 5 liters.

Symptoms of polyhydramnios during pregnancy

Polyhydramnios during pregnancy can manifest itself in different ways, the clinical picture depends on the severity and rate of progression of the pathology. The most characteristic sign of an obstetric anomaly is late toxicosis, accompanied not only by intense bouts of nausea, but also by severe vomiting. In a woman suffering from polyhydramnios during pregnancy, swelling of the anterior abdominal wall is observed, and accumulation of fluid in the subcutaneous fatty tissue of the lower extremities is also possible. Almost every patient has fluctuation - "squishing" of the amniotic fluid, which increases with movement.

Polyhydramnios during pregnancy is always accompanied by a significant deterioration in the general condition of the woman. Due to the pressure of the bottom of the uterus on the diaphragm, shortness of breath is noted, sometimes the work of the heart is disrupted, and tachycardia is detected. With polyhydramnios, a pregnant woman is worried about pain in the abdomen, lower back and inguinal region, and increased fatigue. Against the background of strong overstretching of tissues, multiple coarse stretch marks appear on the anterior abdominal wall. On the part of the fetus, polyhydramnios during pregnancy is usually accompanied by signs of hypoxia, breech presentation and cord entanglement are also possible due to sufficient space for motor activity.

Diagnosis of polyhydramnios during pregnancy

An obstetrician-gynecologist can already suspect polyhydramnios during pregnancy on the basis of an objective examination and complaints of the patient. In addition to the deterioration of the general condition of a woman, a characteristic feature is an increase in the standing of the fundus of the uterus, which does not correspond to the gestational age. Also, a significant increase in the circumference of the abdomen indicates polyhydramnios during pregnancy, the indicators sometimes exceed 100-120 cm. Palpation can determine the pathological position of the fetus in the uterine cavity - oblique, transverse or pelvic. If polyhydramnios is suspected during pregnancy, a woman is assigned laboratory diagnostics: general blood and urine tests, a smear from the genital tract for microflora in order to detect infections.

If polyhydramnios during pregnancy is caused by a Rh conflict, a study is indicated to determine the amount of antibodies. The diagnosis is finally established after an ultrasound. During the procedure, it is possible to measure the amount of OPV, as well as to assess the functionality of the placenta and the well-being of the fetus. Rarely, amniocentesis is performed. Polyhydramnios during pregnancy requires careful monitoring of the baby. For this purpose, CTG and uteroplacental dopplerography are performed, allowing to assess the degree of hypoxia, heart function, physical activity, the level of blood flow in the umbilical cord vessels and determine further medical tactics.

Treatment of polyhydramnios during pregnancy

Polyhydramnios during pregnancy requires hospitalization in an obstetric hospital and careful monitoring of the condition of the woman and the fetus. Complete rest is prescribed, it is important to exclude stress factors and physical activity. Drug treatment of polyhydramnios during pregnancy depends on the cause of this condition. Be sure to carry out the therapy of the underlying disease, which contributed to the development of a pathological increase in the volume of OPV. If the etiology of polyhydramnios during pregnancy is not established, the classical scheme is applied - antibiotic therapy in order to prevent intrauterine infection.

Conservative treatment of polyhydramnios during pregnancy also involves the use of drugs to improve uteroplacental blood flow, vitamin complexes, diuretic drugs. In the case of acute polyhydramnios during pregnancy and a significant deterioration in the patient's condition, associated with a threat to her life, depending on the period of embryogenesis, interruption or premature delivery by caesarean section is indicated. If a conservative approach gives a positive trend, pregnancy management is continued until 37-38 weeks.

Delivery in case of polyhydramnios during pregnancy is carried out using a planned caesarean section. It is important to prevent spontaneous opening of the fetal bladder. Due to the large volume of amniotic fluid, its rapid outflow can lead to the loss of small parts of the fetus, as well as weakness of labor. If a decision is made to carry out natural childbirth against the background of polyhydramnios during pregnancy, an amniotomy is required. This further stimulates contractions.

Forecast and prevention of polyhydramnios during pregnancy

In general, the prognosis for polyhydramnios during pregnancy is favorable. Early diagnosis and treatment make it possible to prolong gestation until the expected date of birth and keep the baby healthy. However, this condition is often complicated by birth and postpartum hemorrhage, intrauterine hypoxia, and premature placental abruption. Acute polyhydramnios during pregnancy in most cases leads to fetal death. To prevent the development of obstetric anomalies, conception should be planned, foci of infection should be treated in a timely manner and a consultation with an obstetrician-gynecologist should be made. Prevention of oligohydramnios during pregnancy also consists in moderate physical activity and proper nutrition. A woman during the gestation period should avoid stress and bad habits, be in the fresh air a lot.

Whenever, during the bearing of a baby, it comes to some kind of treatment, any pregnant woman, well, as a rule, always perceives such a prospect without enthusiasm and admiration. And many of us generally prefer to always do without the use of any serious medications, or at least during the period when we are carrying a child. However, to our great regret, such behavior is far from always possible. So, for example, if a pregnant woman has developed such a condition as polyhydramnios, then the expectant mother cannot do without adequate and urgent help from doctors.

Why is polyhydramnios during pregnancy urgently needed to be treated?

As we all know, the amniotic fluid constantly surrounds the child and so on throughout the entire period while the baby develops in utero. This liquid, or as we are more accustomed to call it, the waters not only serve as a habitat for the as yet unborn baby, but they also provide him with absolute freedom of movement in the tummy. In addition, waters also have a protective function, they perfectly protect the crumbs from quite probable mechanical damage that may appear from the outside, and in general, water supports a small and constantly growing organism in a normal way. Modern scientists argue that, as a rule, amniotic fluid even smells almost like mother's milk. Actually, that's why the angel, literally just born into this world, being still very small and helpless, always knows exactly where exactly the warm mother's chest is right now.

But during the entire period of pregnancy, the total amount of amniotic fluid is almost constantly changing. So at the beginning of pregnancy, they constantly and very rapidly increase in volume, and then, on the contrary, the amniotic fluid should become less and less in relation to the growing child. However, as you understand, constantly, throughout the entire period of pregnancy, there is a certain norm, which doctors must be guided by, examining every pregnant woman.

A downward deviation from this norm determined by physicians is the so-called oligohydramnios, but upwards, respectively, polyhydramnios. Moreover, the latter does not occur at all so often, but at the same time it can be fraught with many real dangers. So, being in too much of the same amniotic fluid, the baby is more active precisely in the later stages of pregnancy, when normally its movements should already be really constrained by the constant decrease in the space surrounding it. And believe me, there is nothing good in this state, because, tumbling freely like this, your baby may well wrap itself around its own umbilical cord, and sometimes even more than once.

In addition, the female fetal bladder overflowing with water really runs the risk of bursting prematurely, which, of course, is fraught with the onset of all labor activity much earlier than the due date. Childbirth during a polyhydramnios pregnancy is usually extremely difficult, and labor activity is usually weak, sometimes it can stretch itself excessively, and because of this, too much bleeding can occur during childbirth. Definitely, there is also a risk of development, premature aging, or even placental abruption. In addition, polyhydramnios is also dangerous by the development of the so-called fetoplacental insufficiency, and as a rule, the postpartum period with polyhydramnios also always proceeds with the most dangerous complications.

With polyhydramnios, the unborn baby usually also suffers. Real complications during childbirth usually prevent the baby from being born normally and easily. And in particular, there is a huge risk of developing such a condition as asphyxiation of an infant, as well as oppression of the child's central nervous system, and possibly the gastrointestinal tract system. Recall that even during the period of intrauterine development of a baby, polyhydramnios may well become a real reason for the development of some of the most dangerous pathologies in crumbs, this is exactly what modern doctors think.

How should polyhydramnios usually be treated during pregnancy?

The main ones to date have not been studied well enough, however, among the available probable causes, modern doctors distinguish diseases such as diabetes mellitus, nephritis, a condition such as Rhesus conflict, some diseases in the cardiovascular system, as well as intrauterine infections and many others.

And of course, before starting the treatment of polyhydramnios that occurred during pregnancy, which is mainly carried out in a hospital, your doctor will have to establish the real reason why this condition has developed at all. But for this, any pregnant woman will have to be sent for a number of specific examinations (this is an ultrasound with Doppler, and CTG, and a general blood test and, of course, a smear for possible infections, and in case of a Rh conflict, an analysis for existing antibodies).

Actually, your further tactics will depend on the real cause of this condition. So, with the existing Rh conflict in mother and child, it is quite possible that an urgent administration of immunoglobulin will be necessary, but, for example, intrauterine infections are unequivocally treated only with antibiotics. It should, however, be recognized that in almost a third of all available cases, the causes of such a pathology remain not fully elucidated. That is why, over the years, our doctors have already developed a completely “universal” standard scheme for the treatment of polyhydramnios during pregnancy. Most often, the complex of mandatory appointments in the event of polyhydramnios includes multivitamins (and vitamins of groups B, E and, of course, C), necessarily magnesium preparations, rather strong diuretics, and some kind of antibiotic with a wide spectrum of action, at least special dietary nutrition is also important.

But in general, the treatment of such a condition as a high-water pregnancy is directed directly to a sharp decrease in the amount of the same amniotic fluid. Also, the maximum improvement and even stabilization of the general condition of the baby itself is expected from the treatment. Of course, in the process of this treatment, the condition of the woman herself and her child will almost always have to be monitored by experienced specialists.

And almost always, doctors try to both maintain and extend the existing high-water pregnancy as close as possible to the originally intended, correct date of birth. But if, with the observance of all the necessary measures, a real tendency to improve the condition is not observed, then, as a rule, a decision is made to carry out early delivery. In cases where this is not possible at all (for example, in the very early stages of pregnancy), doctors can also resort to removing a certain strictly defined amount of amniotic fluid. And they usually do this by simply piercing the fetal bladder (or amniocentesis). But believe me, it really rarely comes to this.

But the determining factor in the appointment of treatment for polyhydramnios that occurred during pregnancy will be the timely appeal for qualified help to doctors. Therefore, never delay your visit to the doctor if it seems to you that you are observing some likely signs of the onset of such a condition as. Usually, we can talk about polyhydramnios when, against the background of general severe malaise, constant weakness, shortness of breath, and even a sharp increase in heart rate, a pregnant woman begins to notice that the total number of stretch marks is rapidly increasing directly in her abdomen.

Also, a real symptom of polyhydramnios is considered to be sensations when, at the slightest change in the position of the body, or rather the abdomen, a woman feels some gurgling and even rolling water. In addition, with polyhydramnios, there is a sharp swelling of the legs, and even pain or heaviness is felt directly in the abdomen. In the event that you notice that the volume of your abdomen is also increasing too rapidly, as they say, right before your eyes (meaning within one day or hours), your uterus is sharply tense, and the anterior abdominal wall itself is constantly swelling, then we are definitely talking about the acute state. Moreover, in this condition, you should go to the nearest hospital, just immediately, without even losing time to arrive, usually an ambulance. We hasten to reassure you, in real life, such dangerous cases are very rare. However, be as vigilant as possible! And let everything go well with your future baby!

Amniotic fluid is the first living environment of every person. The well-being of a woman and the development of the fetus, the features of labor activity depend on their number and composition.

The volume of amniotic fluid increases every week as the baby grows. In some women, the amount of water does not correspond to the norm.

Both polyhydramnios and oligohydramnios during pregnancy can bring various unpleasant surprises to the expectant mother, so such a deviation cannot be ignored.

Polyhydramnios during pregnancy: what does it mean

Polyhydramnios during pregnancy is an excess of the volume of amniotic fluid in the amniotic sac. The role of amniotic fluid in the development of the child is enormous: maintaining the body in space, ensuring freedom of movement, a source of nutrients, protection from damage and infections. But their number should always correspond to the norm.

During an ultrasound examination, the doctor determines the amniotic fluid index (AFI) - an indicator of the amount of amniotic fluid, and compares it with the table.

When determining the IAI, the sonologist visually divides the cavity of the amniotic sac into 4 equal parts and in each determines the space that is filled with water and does not contain parts of the baby's body (vertical pocket). If the largest pocket has a depth of 2 cm or less, oligohydramnios is diagnosed; if the depth is more than 8 cm, polyhydramnios is diagnosed.

Gynecologists distinguish different forms of polyhydramnios:

1 Relative polyhydramnios- a slight deviation from the norm at this time, usually associated with the bearing of a large fetus, and in the absence of other pathologies, it can be safe for the woman and the fetus.

2 border state, or a tendency to polyhydramnios during pregnancy - a case when the amount of water reaches the upper limit of the norm, and it is possible that in the future their excess may appear.

Due to polyhydramnios, a woman may not develop labor activity, so in the last weeks she should be under the supervision of doctors, and if necessary, she is done.

Polyhydramnios during pregnancy: treatment

How to treat polyhydramnios during pregnancy depends on the cause of the disorder. If amniotic fluids accumulate due to a woman's illness, appropriate therapy is needed.

In severe cases, with a sharp deterioration in the mother's condition, it is necessary to terminate the pregnancy in order to save the woman's life. If the situation is not so critical, the pregnant woman will simply have to spend some time in the hospital and undergo a course of treatment to save the baby.

Polyhydramnios- this is a pathological condition during pregnancy, when the amount in the amniotic cavity exceeds the normal values ​​characteristic of this period.

The exact amount of amniotic fluid is determined by ultrasound. To do this, the uterine cavity is conditionally divided into four parts and the largest area between the fetus and the uterine wall is measured. The result is an indicator called amniotic fluid index. Its excess above normal values ​​indicates the development of polyhydramnios.

Causes

The exact reasons for the development of polyhydramnios have not yet been established. Allocate multiple risk groups, in which this pathology develops more often:

  1. Women with chronic diseases(diabetes mellitus, diseases of the urinary and cardiovascular systems).
  2. Infectious diseases of any localization.
  3. Multiple pregnancy(polyhydramnios of one fruit is often combined with an oligohydramnios of another).
  4. Large fruit size.
  5. Fetal malformations.

Clinical symptoms

Polyhydramnios can occur in acute and chronic forms.

Information Acute polyhydramnios develops extremely quickly (within a few hours), often occurs in the second trimester and is accompanied by well-defined symptoms. The acute form is severe and, as a rule, leads to early termination of pregnancy, the birth of a fetus with malformations or its death.

With chronic oligohydramnios the volume of amniotic fluid increases gradually, the symptoms are moderately expressed or do not appear at all. The prognosis for the chronic form is more favorable, in most cases this pathology responds well to treatment.

The main symptoms of polyhydramnios:

  1. Inconsistency in the size of the uterus for a given gestational age. The circumference of the abdomen can reach 110-120 cm or more, as a result of which they may appear.
  2. Heaviness, abdominal pain.
  3. General weakness, malaise.
  4. The appearance of shortness of breath due to the high position of the diaphragm.
  5. Severe edema of the lower extremities.
  6. Distinct fluctuation (gurgling) in the abdomen.
  7. Increased heart rate.

Treatment

When identifying the development of any form of polyhydramnios, a woman should be admitted to hospital. Before starting treatment, the doctor will a number of surveys to determine the cause of an increase in amniotic fluid:

  1. General .
  2. General .
  3. Blood test for glucose (sugar).
  4. cardio ().
  5. fetus.
  6. Blood test for antibodies in Rh-conflict.

Further treatment tactics depend on the identified cause of polyhydramnios, but in a third of cases the exact cause remains unclear. In that case, use universal treatment regimen, aimed at improving the condition of the child and reducing the amount of amniotic fluid:

  1. Multivitamin Complex(required with vitamins B, C and E.
  2. Antibacterial therapy using broad-spectrum drugs (Erythromycin, Josamycin).
  3. (Furosemide).
  4. Drugs to improve uteroplacental blood flow ( , ).
  5. Preparations to improve the condition of the placenta.
  6. Therapeutic and diagnostic amniocentesis(slow removal of up to 200 ml of amniotic fluid).

During treatment, it is necessary constant medical supervision for the condition of the woman, the fetus and the volume of amniotic fluid:

  1. Daily weight and blood pressure monitoring
  2. Daily fetal cardio.
  3. Ultrasound, dopplerography every 5-7 days.

With a decrease in amniotic fluid and stabilization of the fetus, the pregnancy is prolonged to 37-38 weeks.

Important If during the treatment of polyhydramnios there is no tendency to improve or the condition, on the contrary, worsens, emergency delivery is indicated, regardless of the duration of pregnancy. In most cases, in the absence of other contraindications, they are carried out through the natural birth canal.

Complications

Polyhydramnios is a serious pathology and can cause a number of complications during pregnancy and childbirth.

For the normal development of the child inside the womb, the value of amniotic fluid is invaluable. They protect the embryo from mechanical stress, participate in metabolism, and provide it with freedom of movement. Amniotic fluid is constantly moving and renewing. However, polyhydramnios during pregnancy is very dangerous, because it is the cause of many diseases in both the woman and the unborn child.

What is polyhydramnios during pregnancy

This is a condition in which a pregnant woman has a large increase in the amount of amniotic fluid. In medicine, there is a classification of polyhydramnios. It should be noted that not always an increase in amniotic fluid is a pathology. Sometimes the term "moderate polyhydramnios" is characterized only by approaching the highest norm, but not exceeding the permissible limit. At different times, the rate of amniotic fluid varies. For example, at 10 weeks of pregnancy, the normal volume is 30 ml, at 14 - 100 ml, and by the 38th week, 1.5 liters will be the norm.

When this limit is exceeded, then we are already talking about polyhydramnios in a pregnant woman. There is a certain classification. The increase in amniotic fluid can be mild, acute, or chronic. The most dangerous condition during pregnancy is acute, when the water level begins to rise very intensively, within a few days or even hours. Chronic polyhydramnios is characterized by a slow increase in fluid volume.

signs

There are certain signs, the presence of which will tell a woman about the presence of pathology. But not always a pregnant woman can diagnose herself. In the chronic course of polyhydramnios, a woman often learns about the pathology only during the next examination by a doctor. In acute pathology, it is easy to notice that the abdomen grows very quickly. Its circumference at the level of the navel sometimes exceeds 120 cm.

A pregnant woman complains of the rapid appearance of stretch marks, fatigue, heaviness when walking, shortness of breath. It is advisable to pay attention to unusual symptoms in order to maintain pregnancy:

  • gurgling inside the abdomen;
  • reduced activity of the child;
  • severe swelling of the legs;
  • feeling of pressure on the perineum;
  • increased heart rate;
  • malaise, weakness.

Acute

Excessive fluid accumulation can be diagnosed immediately. A sharp increase in the abdomen cannot go unnoticed, because the condition develops over a very short time. A pregnant woman experiences discomfort in the abdomen, pain in the lumbar region and inguinal region. The abdominal wall noticeably swells, there is a strong shortness of breath. The woman does not hear the movement of the fetus, and listening to his heartbeat is very difficult. The rapid development of pathology may be accompanied by rupture of uterine tissues.

Chronic

In the case of chronic development of the disease, the growth of amniotic fluid occurs slowly. More often, doctors observe such polyhydramnios at the end of pregnancy. Excess fluid of a chronic nature does not have strongly pronounced symptoms. Pregnant women have time to get used to a certain discomfort, associating it with their position, so the diagnosis of pathology is difficult. For this reason, the chronic form of polyhydramnios is no less dangerous than the acute form and entails very unpleasant consequences for both the mother and the baby.

Causes

Doctors still cannot point out the causes of polyhydramnios during pregnancy with 100% certainty and name specific prerequisites for the development of pathology. However, there are some trends in the occurrence of this disease. The risk group includes pregnant women diagnosed with diabetes mellitus. Next on the list are chronic diseases of the genitourinary system, infections, vascular diseases, and heart defects. High risk of polyhydramnios in a patient with Rh-conflict pregnancy. The reason for the deviation may be too large a fetus or its pathology:

  • deviations in the development of the intestine or stomach;
  • malformations of the heart;
  • defects of the central nervous system;
  • genetic abnormalities.

Forms, types and degrees

As already noted, polyhydramnios in a pregnant woman can be chronic or acute. Pass moderately or develop rapidly. By severity, obstetric pathology is divided into:

  • light, when the amount of water does not exceed 3000 ml;
  • moderate, in which the amniotic fluid has volumes from 3000 to 5000 ml;
  • severe if the amniotic fluid exceeds the volume of 5000 ml.

There are several more basic gradations of polyhydramnios: relative, borderline, idiopathic and pronounced. The first does not pose a danger to the woman and the fetus. Borderline polyhydramnios is also considered normal, but it already requires constant medical supervision. Idiopathic excess of water has no characteristic signs and causes, it develops at any time.

What is dangerous

The main danger of polyhydramnios in pregnant women is the threat of miscarriage. This is how the pathology ends in 35% of women. In most cases, pregnant women have severe toxicosis at any time, which often turns into vomiting, which threatens with dehydration. A large amount of water interferes with the correct presentation of the fetus, so the incorrect position of the child is often observed: pelvic or transverse. The risk of placental insufficiency is not excluded when the work of the placenta is disturbed. The fetus develops oxygen starvation, which harms its full development.

Diagnostics

In addition to studying the complaints of a pregnant woman, the antenatal clinic doctor examines her for the presence of relevant signs. There are several types of diagnosis of polyhydramnios. The most reliable is ultrasound, in which a woman is assigned to determine the amniotic fluid index (AFI). An additional examination method is a triple test to determine the concentration in blood serum (16-18 weeks of pregnancy) of free estriol, human chorionic gonadotropin and α-fetoprotein. Analyzes show possible fetal malformations, often found in polyhydramnios.

Today, there are two methods for measuring amniotic fluid. The first is called the "gold standard". To do this, the uterine cavity is divided into 4 quadrants, in each of which the doctor determines the depth of the largest pocket of amniotic fluid, free from all parts of the embryo. IAI is the sum of all four values. If the result is below 5%, then a diagnosis of oligohydramnios is made. When the values ​​exceed 97.5%, then this is characterized by polyhydramnios.

IAH

The second option is to determine the largest pocket of fluid that is free from umbilical cord loops and small parts of the fetus, measured in 2 perpendicular planes. The norm is a value from 2 to 8 centimeters. If the result shows 1-2 cm, then this is considered a borderline condition. Polyhydramnios is defined as when the largest pocket of fluid is larger than 8 cm.

Treatment

When a disease such as polyhydramnios occurs during pregnancy, the gynecologist, if possible, should establish its cause and, based on this, prescribe appropriate therapy. A pregnant woman receives classical treatment in a hospital under the strict supervision of doctors. They try to keep the pregnancy to the last. As a rule, antibiotics, B vitamins, drugs that restore uteroplacental blood flow and improve metabolic processes, as well as drugs that improve blood microcirculation and diuretics are prescribed.

If polyhydramnios occurs early in pregnancy, then it is treated without consequences for the fetus and mother. With a sudden and acute course of the disease, doctors often resort to the procedure for opening the fetal bladder (amniotomy) to drain excess amniotic fluid. Otherwise, there is a threat not only to pregnancy complications, but also to the life of the mother and / or child.

Antibiotics

Since the etiology of the disease is very difficult to identify, a gynecologist with polyhydramnios must be very careful in choosing antibiotics. In acute pathology, the doctor often prescribes treatment with Rovamycin or analogues. There are data on therapy with Indomethacin (every 6 hours, 25 mg), but it should be remembered that there is a high probability of premature closure of the ductus arteriosus in the fetus.

Consequences

Polyhydramnios negatively affects the health of the mother and the development of the fetus. If the problem is not eliminated in time, an increase in the amount of amniotic fluid threatens with the following consequences:

  • the uterus, enlarged due to an excess of fluid, compresses large and small blood vessels for a long period, which provokes an increase in blood pressure and edema in the mother;
  • the uterus with polyhydramnios is greatly stretched, which can provoke massive bleeding and placental abruption;
  • childbirth against the background of polyhydramnios in 30% of cases occurs ahead of schedule, because due to the large accumulation of fluid, the uterus increases to the size of a full-term pregnancy;
  • leaving the uterus prematurely, the amniotic fluid can pull out the handle, leg or umbilical cord;
  • early outflow of amniotic fluid weakens labor activity, sometimes to a complete cessation.

For a child

In addition to the complications listed above, polyhydramnios also negatively affects the future baby in the mother's womb. The development of placental insufficiency at an early stage leads to poor development of the embryo, and at a later stage to fetal growth retardation. Doctors call the following negative consequences for the child:

  • intrauterine infectious process;
  • malformations of the gastrointestinal tract;
  • insufficient formation of the nervous system;
  • chronic fetal hypoxia;
  • decreased immunity;
  • birth prematurely.

These pathologies can be latent, and appear only some time after birth. For example, polyhydramnios in the last stages of pregnancy in an infant can cause a delay in mental and mental development, which pediatricians determine after 1-1.5 years. The birth of a baby prematurely threatens with a low level of body defenses and is fraught with the development of respiratory and infection with infectious diseases.

childbirth

As already mentioned, labor activity occurs ahead of schedule with polyhydramnios. At the last stage of pregnancy, a dense bubble can burst suddenly, after which the amniotic fluid pours out profusely and abruptly. At this point, the limb of the fetus or the umbilical cord may fall out, and the woman's labor activity will be weakened. Sometimes a pregnant woman does not feel contractions at all. With polyhydramnios, childbirth is associated with other complications:

  • the unfortunate position of the child inside the womb (for example, down the buttocks);
  • severe bleeding after childbirth;
  • placental abruption.

Prevention

Can polyhydramnios be avoided? Prevention of pathology consists in regular examination of a woman during pregnancy. This will allow to identify and quickly eliminate the pathology. Pregnant women at risk, that is, women with a diagnosis of diabetes mellitus, the presence of a negative Rh blood factor and with chronic diseases of the genital organs, are especially in need of an additional examination.

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