Polyhydramnios in the last stages. Increased amount of amniotic fluid. Reasons for the development of polyhydramnios

The value of amniotic fluid for the baby is invaluable. It is they who perform a protective function, ensure the normal supply of the baby with all the necessary substances and serve as protection for the umbilical cord even from the slightest squeezing. But the volume of fluid in the amniotic cavity has clear norms. Exceeding these indicators is a pathological condition, so it is important for the expectant mother to know why polyhydramnios is dangerous during pregnancy and how to behave in cases where this violation has manifested itself.

The first signs of polyhydramnios that a pregnant girl can appreciate

Normative indicators of the amount of amniotic fluid vary significantly at different times. If at the tenth week of embryo development there should be only 30 ml of liquid, then already at the fourteenth their volume reaches 100 ml. And in the last weeks of pregnancy, the fetus should be surrounded by at least 1-1.5 liters of fluid.

Exceeding the amount of amniotic fluid requires the mandatory intervention of a specialist, but it is important for a woman to know how to determine the possible development of pathology. This condition is easily diagnosed by ultrasound. But an ultrasound examination is carried out only 4 times with the correct development of the baby and the normal health of the woman, so the expectant mother should be informed by the doctor if the following symptoms appear:

feeling of heaviness in the abdominal cavity and possible pain;
difficulty breathing, which is a consequence of increased pressure on the diaphragm during polyhydramnios;
swelling in the legs;
frequent weakness and feeling tired;
bouts of sudden increased heart rate;
a sharp increase in the volume of the abdomen and the appearance of strong stretch marks;
sensation of gurgling in the abdomen.

All this should be the reason for an urgent visit to the doctor who leads the pregnancy, since in this case it is necessary to immediately carry out specialized treatment.

What can cause this condition

At the moment, there are no clearly identified reasons for the appearance of polyhydramnios. But there are risk groups that more often than others suffer from an increase in the amount of amniotic fluid. Most often, this pathology appears in such cases:

infectious diseases of any localization;
chronic diseases of female organs;
diabetes mellitus and other diseases of a chronic nature;
during the bearing of a multiple pregnancy, oligohydramnios may be observed in one fetus and polyhydramnios in another;
kidney failure;
Rhesus conflict between mother and fetus.
bearing a large fetus;
malformations in the development of the baby.

These reasons can provoke an increase in the amount of amniotic fluid, which must be treated after a detailed examination of the pregnant woman. Modern medicine allows you to help endure pregnancy in most of these cases, but the condition requires serious attention from doctors.

What are the dangers of this condition

Every expectant mother needs to know that this pathology is quite dangerous for her and the baby. The amount of amniotic fluid increases dramatically. This process takes from several hours to several days. This provokes difficulty in the circulation of fluid around the baby and complicates the normal excretion of its waste products and the supply of all important substances and oxygen.

The consequences of this condition may be as follows:

frequent vomiting occurs, provoking uterine tone;
in a quarter of cases, premature birth occurs;
there is an incorrect location of the fetus, which can cause traumatic childbirth;
in some cases, damage to the nervous system of the fetus is observed;
fetoplacental insufficiency, leading to a violation of the development of the fetus and even to its death;
in the presence of an infectious disease, there is a risk of intrauterine infection of the fetus;
in the later stages there is a possibility of late gestosis, which is dangerous for intoxication of the mother and baby;
the risk of bleeding, which can lead to the need for emergency childbirth and seriously threaten the life of the fetus and the pregnant woman;
overstrain of the uterus, leading to a decrease in labor activity;
in rare cases, there is a need to terminate the pregnancy.

It is obvious that exceeding the norm of amniotic fluid has serious consequences, therefore, at times, quite serious therapy is carried out in order to maintain the pregnancy and enable the woman to cope with the birth process. But often in such cases, the birth of a baby in a natural way carries great dangers, therefore, a caesarean section is performed - a fairly effective way to save the baby and mother with polyhydramnios.

How is the disorder diagnosed?

Only a doctor can determine polyhydramnios after a series of procedures. Ultrasound is the most effective. But even after the doctor saw the threat of polyhydramnios in the ultrasound images, another group of diagnostic procedures is carried out. The main ones are:

blood test for infectious diseases;
a blood test for the presence of antibodies that indicate a Rh conflict;
diagnosis of the presence of protein in the urine;
analysis of the flora of the vagina with a smear;
electrocardiogram;
dopplerometry.

If necessary, additional procedures are carried out to accurately establish the diagnosis and develop a treatment program. It is individual for each pregnant woman, so you should not listen to the recommendations of women who have encountered this problem, you need to go to a specialist.

In most cases, polyhydramnios is treated in a hospital using a large group of drugs.

The main goal of treatment is to prevent preterm birth and ensure the normal functioning of the fetus.

How to deal with polyhydramnios

Prevention of the appearance of this pathology practically does not exist. It is important for a woman to follow the doctor's recommendations regarding nutrition and lifestyle, as well as carefully monitor her general condition. At the slightest violation, and even more so with the appearance of edema, it is necessary to consult a doctor.

Treatment is carried out until the severe stage of polyhydramnios, that is, until there are respiratory and circulatory disorders of the fetus from an increase in the volume of amniotic fluid. In such cases, a wide range of procedures is used:

the mother is prescribed a multivitamin complex, taking into account the individual characteristics of the state of health;
medications are prescribed to normalize the state of the placenta;
drugs are used to restore uteroplacental blood flow, which ensures normal fetal life support;
amniocentesis procedure for slow artificial removal of fluid - allows you to reduce the amount of amniotic fluid by 200 ml;
antibacterial drugs are prescribed;
diuretics and herbal decoctions are used.

All this is done in order to help the body remove excess fluid and ensure the normal renewal of amniotic fluid. This becomes the key to successful pregnancy and prevents the development of chronic diseases in the crumbs.

The purpose of these procedures is to help the body remove excess fluid and ensure the normal renewal of amniotic fluid. This becomes the key to successful pregnancy and prevents the development of chronic diseases in the crumbs.

But during polyhydramnios, the condition of a pregnant woman can change very dramatically, so daily medical monitoring is carried out, which consists in weighing the expectant mother, as well as cardiotocography of the fetus.

Every 5-7 days, ultrasound and dopplerography are performed. This approach allows doctors to comprehensively assess the condition of the mother and baby and, if necessary, conduct an emergency birth. Doctors also speed up delivery if the condition does not improve during treatment, but, on the contrary, worsens.

A pregnant woman should remember that it is necessary to inform the doctor about all noticed deviations from the normal state. Ignoring this problem will not lead to anything good, and without the intervention of doctors, the condition will not improve.

Specialists can now save 90% of pregnancies with polyhydramnios, so it is important to provide timely assistance to the expectant mother. In many ways, the success of treatment depends on how carefully the woman herself treats her condition.

Amniotic fluid plays an important role during the bearing of a baby and is simply vital for its growth and development. In the amniotic fluid, the baby not only moves freely and develops basic skills (motor, swallowing, peristaltic), but also receives many nutrients. In addition, the waters protect the baby from mechanical damage, create and maintain comfortable living conditions.

But when it becomes less or more than normal, then doctors consider this condition as a pathology that threatens the normal course of pregnancy and the development of the child. Exceeding the allowable amount of water is called, if it is insignificant, then we are talking about moderate polyhydramnios.

Such a diagnosis leads future mothers to some bewilderment: does “moderate” mean “dangerous” or is it closer to “safe”?

Why does moderate polyhydramnios occur during pregnancy?

There can be a large number of reasons for the occurrence of polyhydramnios during pregnancy, including moderate ones, and often they are idiopathic (almost a third of all cases), that is, they have an unidentified nature. Among other factors, the excess of the allowable volume of amniotic fluid can be affected by:

intrauterine infections;
placental disorders;
various diseases of a woman (cardiovascular, renal, systemic);
preeclampsia;
anatomical features (saddle uterus);
various pathologies in the development of the fetus (underdevelopment of the gastrointestinal tract, malformations of the central nervous system);
genetic disorders and other pathologies;

How is moderate polyhydramnios manifested during pregnancy?

Despite the fact that many women are diagnosed with this already in the first trimester of pregnancy, polyhydramnios can only be discussed after the completion of the formation of the placenta, that is, after 16 weeks.

Moderate polyhydramnios is diagnosed, as a rule, during a planned ultrasound scan by a pregnant woman. Often a doctor can suspect a deviation from the norm during an internal examination. Sometimes a woman herself feels a “tide”: the uterus becomes as if edematous, the stomach becomes elastic and stretched, “rolls” of water are heard when changing body position, the baby is excessively active (after all, he has somewhere to swim!).

If polyhydramnios is suspected, a pregnant woman is sent for examination:

examination by a gynecologist;
cardiotocography (if the diagnosis is confirmed).

A little advice: when undergoing a second ultrasound examination, do not admit to a specialist that you have been given moderate polyhydramnios. Often this diagnosis is erroneous, much, for example, depends on the position of the child at the time of the “examination”. It also happens that with severe polyhydramnios, the uzist does not see any deviations from the norm.

Why is moderate polyhydramnios dangerous during pregnancy?

Moderate polyhydramnios is not as dangerous as pronounced and especially acute. With moderate polyhydramnios, the volume of amniotic fluid increases slightly and gradually, so there is time for observation and action.

However, inaction in this case can be quite dangerous. Even moderate polyhydramnios can cause weak labor activity, overwearing, the development of defects and pathologies in a child, and even its intrauterine fading. But mostly with further progression and lack of control over the situation!

Dear moms, do not immediately panic if you have been diagnosed with such a diagnosis, and read less horror stories. Quite often, moderate polyhydramnios during pregnancy is temporary and does not pose a threat to either the baby or his mother. The main thing is to undergo an examination and keep the situation under medical control. If necessary, you will be prescribed treatment.

Everything will be fine! Moderate polyhydramnios is far from the worst of the many complications of pregnancy. With such a diagnosis, women give birth to beautiful healthy babies!

Especially for- Elena Kichak

Polyhydramnios is a pathological condition during pregnancy when the amniotic fluid in the amniotic cavity exceeds the norm.

The value of amniotic fluid for the normal development and life of the fetus is invaluable. They protect it from external mechanical impact, provide the embryo with freedom of movement, participate in metabolism, and protect the umbilical cord from squeezing. Amniotic fluid is in constant motion and is systematically updated. At different stages of pregnancy, the norms of amniotic fluid are different: in, for example, the volume of water is 30 ml, in - 100 ml, by 37-38 weeks of pregnancy - 1-1.5 liters. If this limit is exceeded by the end of the term, we are talking about polyhydramnios in pregnant women.

But how do you know how many of these waters you have there? There are certain symptoms, the presence of which can tell a woman that something is wrong. In this case, you need to contact a gynecologist and tell everything about it.

Signs of polyhydramnios during pregnancy:

feeling of heaviness and pain in the abdomen;
malaise, weakness;
shortness of breath (due to the high standing of the diaphragm);
swelling of the legs;
the volume of the abdomen at the level of the navel reaches 100-120 cm or more;
the stomach with polyhydramnios can be strenuously covered with stretch marks;
a distinct gurgling inside the abdomen (fluctuation) is often heard.

Why is it dangerous?

There are acute polyhydramnios, in which the amount of amniotic fluid increases rapidly and sharply, which is very dangerous. Everything happens literally within a few hours or days: the size of the pregnant woman's abdomen increases dramatically, pain in the groin and lower back, tension of the walls of the uterus and noticeable swelling of the anterior abdominal wall are noted. In chronic polyhydramnios, the volume of water increases gradually, but this also causes a number of complications.

The consequences of polyhydramnios can be very sad:

28.4% of pregnant women experience premature termination of pregnancy;
36% of women experience vomiting;
incorrect positions and presentation of the fetus are diagnosed in 6.5% of women;
fetoplacental insufficiency may develop and, consequently, chronic hypoxia and fetal death;
possible malformations of the central nervous system of the fetus and the gastrointestinal tract;
if the cause of polyhydramnios was an infectious process, infection of the fetus is possible;
38.4% of women experience bleeding (with acute polyhydramnios - 41.3%, with chronic - 6.2%);
late gestosis observed in 5-20% of pregnant women with polyhydramnios;
early outpouring of amniotic fluid and;
possible prolapse of the handle or leg of the fetus or umbilical cord during childbirth;
indications for caesarean section (due to the increased space inside the uterus, the child often takes the wrong position: transverse, oblique, pelvic);
due to overstretching of the uterus, weakness of labor, premature, postpartum hemorrhage and other complications may occur.

Causes of polyhydramnios during pregnancy

The causes of polyhydramnios are still not exactly established. But doctors distinguish women at risk, in whom polyhydramnios develops more often than others. However, in 30% of cases, doctors still cannot find out what is the cause of polyhydramnios. With any of the following phenomena, polyhydramnios may (although not necessarily) develop:

if a woman has;
with infectious diseases;
kidney disease;
cardiovascular diseases;
Rhesus conflict in mother and child;
multiple pregnancy (moreover, polyhydramnios of one fetus is often combined with oligohydramnios of another);
large fruit;
decreased excretory function of the fetus;
violation of the swallowing function (at the end of pregnancy, the child absorbs about 4 liters of amniotic fluid every day, which are completely renewed every 3 hours);
with fetal malformations.

Treatment of polyhydramnios in pregnant women

Mostly the diagnosis of polyhydramnios is made according to the results of an ultrasound examination. From the moment the pathology is detected, the expectant mother should be under constant medical supervision. If there is no pronounced circulatory and respiratory disorder (mild and moderate polyhydramnios), doctors tend to keep the pregnancy until its physiological completion. Otherwise, there is a need for early delivery, as the situation may pose a threat to the woman's life.

If the pregnancy is saved, the cause of polyhydramnios should be established, since it threatens the development of chronic oxygen starvation of the fetus. Depending on the identified cause of the disease, appropriate treatment is carried out.

Treatment of polyhydramnios includes antibiotic therapy for viral etiology, immunomodulatory therapy, the appointment of diuretics and vitamins, abdominal amniocentesis. As a rule, hypothiazide, B vitamins are prescribed, in some cases, broad-spectrum antibiotics (except tetracycline), biyoquinol. With weakness of labor, appropriate treatment is prescribed.

Especially for- Elena Kichak

Amniotic fluid performs many important functions. First of all, they provide nutrition to the child, create the necessary conditions for its full development and protect against various diseases. The amount of amniotic fluid increases with the course of pregnancy. Under certain circumstances, their volume may exceed the allowable limits. In such a situation, polyhydramnios is diagnosed.

The concept of the norm of the amount of amniotic fluid

It is impossible to establish the norm for the amount of intrauterine fluid with an accuracy of a milliliter. On average, it ranges from 0.6 to 1.5 liters.

You can bring the average values of the norm weekly. It will look like this:

1. After the 10th week - 30 ml.

2. After the 13th week - about 100 ml.

3. After 18 weeks - about 400 ml.

4. Toward the end of the term - up to 1.5 liters.

As a rule, in the last weeks of pregnancy, the amount of water decreases to an average of 800-1000 ml.

Polyhydramnios: description and classification of the disease

The amount of fluid around the fetus gradually decreases starting from 35-37 weeks. The child regularly swallows water, and then it is excreted from his body along with urine. This is how the level of intrauterine fluid is monitored.

If this balance is disturbed, the volume of water increases and this causes the development of polyhydramnios. In especially severe cases, the liquid can be up to 5 liters, which exceeds the allowable rate by 5 times.

Depending on the intensity of severity, polyhydramnios can be:

light - the amount of intrauterine fluid reaches almost 3 liters;
medium - up to 5 liters;
heavy - over 5 liters.

In accordance with the characteristics of the clinical disease, it is classified into acute and chronic.

Acute form of polyhydramnios

In the acute form, polyhydramnios is diagnosed earlier. It is characterized by a sharp rapid increase in the volume of intrauterine fluid. This condition is very dangerous. This form of polyhydramnios develops in a few days, and sometimes even hours. Outwardly, it manifests itself as a too strong increase in the girth of the abdomen.

A woman begins to experience uncomfortable, and often very painful sensations in the groin and lower back. There is severe swelling of the abdominal wall. Shortness of breath appears. Listening to the baby's heartbeat becomes more difficult. Due to such a rapid increase in the volume of amniotic fluid, rupture of the tissues of the uterus can occur.

Chronic polyhydramnios

It is necessary to consult a doctor in a timely manner and follow the recommendations received.

In the chronic form of deviation, intrauterine waters increase in volume more moderately. Usually, such a disease begins to develop towards the end of pregnancy and does not have particularly pronounced symptoms. Women most often get used to the uncomfortable sensations that are characteristic of pregnancy. Because of this, timely diagnosis is very often omitted. It is important to understand that even the chronic form of the disease can lead to very serious consequences.

Regardless of its form, polyhydramnios indicates the presence of abnormalities. The development of a chronic variety of the disease is usually caused by genitourinary infections, viral diseases, inflammation in the appendages, problems in the kidneys and cardiovascular systems, diabetes.

With a chronic violation, there are good chances for full-term and natural birth of a child. You just need to consult a doctor in a timely manner and follow the recommendations received. In the absence of a reaction to the problem, the baby can suffer significantly.

The concept of moderate and severe polyhydramnios

In accordance with the intensity of the process, it is classified into moderate and pronounced.

At moderate polyhydramnios the deviation of the volume of intrauterine fluid from the norm is insignificant. Symptoms increase gradually. External signs in most situations are absent.

For expressed the same type of polyhydramnios is characterized by a rapid increase in the size of the abdomen. The patient begins to feel the movements of the child more pronounced. There are painful sensations in the perineum, abdomen and lower back.

It is important to understand that even in the absence of severe symptoms, polyhydramnios can lead to adverse consequences for both the fetus and the expectant mother.

Polyhydramnios: why is it dangerous?

The main danger of the pathology under consideration is the threat of premature miscarriage. This is how it ends in about 30-35% of cases.

In more than 35% of clinical cases, the presence of very severe toxicosis is observed, often turning into regular uncontrollable vomiting. For mom, this situation is dangerous dehydration.

In some situations, the disease causes a transverse or pelvic presentation of the baby.

The risk of developing placental insufficiency is not excluded (occurs in about 30% of cases). The condition is extremely dangerous. In its presence, a violation of the normal functioning of the placenta occurs, from which the fetus inevitably suffers. Oxygen starvation develops, and this already leads to harm to the whole organism.

In the early stages of pregnancy, oxygen deficiency slows down the development of the baby. In the later stages, growth retardation, pathologies of the nervous system, and deterioration of immunity can be noted due to it.

Polyhydramnios can lead to violations of labor, up to the death of the child. Also, the disease is fraught with severe bleeding during childbirth.

Due to polyhydramnios, childbirth can begin earlier than expected. Often, the amniotic sac ruptures on its own, resulting in a profuse and abrupt outflow of fluid. Because of this, prolapse of the umbilical cord or limbs may occur.

The uterus is subjected to too much stretching, up to exfoliation of the placenta, severe bleeding after childbirth, and other extremely dangerous situations.

To prevent such phenomena, patients often undergo a puncture of the amniotic sac. After the procedure, the amniotic fluid is poured out in a very thin stream, the uterus begins to shrink, as a result of which the contractions intensify. Even more often, the only possible option is a caesarean section.

Reasons for the development of polyhydramnios

A 100% reliable list of the causes of polyhydramnios still does not exist. In about 30-35% of cases, it is not possible to establish specific prerequisites. However, the general trend is still visible. Doctors identify a kind of risk group for women in whom polyhydramnios is more common than in other pregnant women.

First of all, you have to be careful pregnant women with diabetes.

It is he who most often leads to the development of polyhydramnios. Read more about gestational diabetes in pregnancy

Diseases are the next most common causes. cardiovascular system and kidneys, as well as various kinds infections. No less often polyhydramnios causes a child and mother.

Otherwise, the situation develops in the case of multiple pregnancy: one fetus may have polyhydramnios, while the second will suffer from oligohydramnios.

lead to polyhydramnios pathology of the excretory function, as well as developmental disorders of the child, including:

genetic deviations;
malformations of the nervous system, heart and blood vessels;
structural disturbances gastrointestinal tract.

Polyhydramnios can develop against the background of a number infectious diseases(herpes, rubella, toxoplasmosis, etc.). Viruses to which the patient does not yet have immunity are especially dangerous. In the event of infection, microbes will begin to circulate through the blood at a high intensity, which may be enough to penetrate the body of the fetus.

An additional danger of the listed viral diseases is their insufficient severity, which often makes timely diagnosis impossible. For example, patients with moderate polyhydramnios often leave their problem unattended, because. there are no pronounced symptoms.

Often leads to the appearance of polyhydramnios at the end of the term swallowing disorder at the fetus. A developed child is able to absorb up to 3-4 liters of intrauterine fluid per day. The waters are renewed every three hours. That is, the baby may simply not have time to drink enough liquid.

Each of the above violations can lead to the development of polyhydramnios in chronic or acute form. However, even if there are no prerequisites, pregnant women are still strongly recommended to be constantly monitored by a gynecologist, and if the first alarming symptoms appear, consult a doctor.

The sooner the problem is diagnosed, the higher the likelihood of a full bearing of the fetus and its natural birth.

Symptoms and main signs of polyhydramnios in pregnant women

The presence of pathology can be indicated by many different signs. Among the most common symptoms are:

discomfort, feeling of heaviness, too frequent pain in the abdomen;
bouts of weakness and general malaise;
severe shortness of breath even with minor physical exertion;
sudden increases in heart rate;
frequent swelling of the legs;
an increase in the size of the uterus above the norm for the current period;
an increase in the girth of the abdomen at the level of the navel over 1 m;
multiple rough stretch marks on the skin;
frequent and distinctly audible squelching in the abdomen.

In the presence of the problem under consideration in the last stages, deviations in the size of the uterus from normal values, tension in its area, and excessive anxiety of the child are often noted. Among the additional signs, an excessive increase in the height of the fundus of the uterus is often noted.

The presence of any of these symptoms should prompt the pregnant woman to seek immediate medical attention. gynecologist.

The doctor will prescribe the necessary diagnostic measures, during which the amniotic index will be determined and, if possible, the causes of the development of the pathology, followed by the appointment of a course of treatment.

Diagnosis of polyhydramnios

The specialist carefully studies the patient's complaints, conducts an external obstetric examination and prescribes an ultrasound scan.

To date, 2 methods are most often used to determine the volume of intrauterine fluid during ultrasound:

1. Establishment of the amniotic fluid index.

It is different for every stage of pregnancy. This index characterizes the allowable volume of intrauterine water. Diagnostics is performed as follows.

The uterine cavity is conditionally divided into 4 quadrants. In each of these quadrants, the greatest depth of the amniotic fluid free from the child is established. The obtained values are summarized. The result is the amniotic fluid index. We are talking about polyhydramnios with an increase in the index over 97.5%.

In general, you can study the normal indicators of the amniotic fluid and the permissible deviations from the norm at each stage of pregnancy in the following table:

It is important to understand that these fluctuations are quite significant, so even if yours is far from the established norm, this is not necessarily a cause for concern and worry.

2. The size of the largest pocket is determined intrauterine fluid, free from cord loops and parts of the fetus.

The size of the pocket is determined by two mutually perpendicular planes. Polyhydramnios is diagnosed when a value exceeding 80 mm is obtained. During an ultrasound scan, the child's condition is carefully examined in order to establish the presence of characteristic developmental abnormalities.

3. Optional test can be applied, according to which the patient's blood serum is studied for the content of free estriol, human chorionic gonadotropin, and also alpha-fetoprotein. Material for analysis is taken mainly at 16-18 weeks. This test allows you to timely diagnose the pathology of the development of the placenta and the baby.

Also, the presence of a problem may be indicated by a decrease in the concentration of prolactin below the permissible values for the current period.

Basic Treatments

The optimal procedure for treatment is established by a specialist after carrying out diagnostic measures.

When the diagnosis is confirmed, patients are usually placed in a hospital for regular monitoring by medical staff.

In the case of diagnosing a mild or moderate degree of deviation, in the absence of too severe violations of the respiratory function and blood circulation, doctors will try to keep the pregnancy. In the presence of an acute form of the disease, it may be necessary to terminate the pregnancy, because. this condition is very dangerous for the life of the mother and baby.

Determining the causes of the development of pathology greatly facilitates the treatment process. As soon as the main source of the problem is identified, the doctor has the opportunity to prescribe the optimal and most effective therapy.

Traditionally, polyhydramnios is treated with antibiotics. The main goal of therapy is to normalize uteroplacental blood flow and metabolic processes.

If the disease is of viral origin, immunomodulators are usually prescribed.

Without fail, the doctor prescribes a complex of diuretic and vitamin preparations.

Otherwise, the optimal procedure for treatment is established by a specialist after the necessary diagnostic measures have been taken.

Regardless of the form and intensity of severity, polyhydramnios is a very insidious and rather dangerous disease.

Under any circumstances, this condition indicates the presence of pathologies in the body of a woman and, as a result, the fetus. Therefore, women should try to do everything possible to prevent the development of more serious disorders.

Expectant mothers must timely undergo all examinations that can confirm or refute the presence of any kind of diseases and disorders. A specific list of tests will be issued by the supervising doctor.

It is equally important to stick to and drink the required amount of fluid. For prevention purposes, you need to be in the air more often and, if possible, walk on foot.

It is equally important to avoid excessive physical exertion, stress and generally bad emotions.

The most effective preventive measure is the full compliance with the recommendations of the doctor in charge of pregnancy.

Follow the advice of a specialist, take tests in a timely manner, take the medicines and vitamins recommended by the doctor, and everything will be fine. Health to you and your baby!

Amniotic fluid or amniotic fluid is a nutrient medium in which the embryo grows and develops from the moment of conception to birth. It is responsible for the normal process of fetal development, its full growth and provision with all important substances. At each individual stage of pregnancy, the amount of this fluid is different, but it is very important that all indicators are within the established norms. Only 1% of pregnant women are diagnosed with polyhydramnios, which entails a hidden threat to the fetus and its mother. In order to determine this deviation from the norm in time and prevent negative consequences, you need to know why polyhydramnios is dangerous during pregnancy and how to treat this ailment.

Amniotic fluid is a fluid produced by the inner membrane of the fetus (amniotin). Outwardly, this substance resembles ordinary transparent water. But for a baby, it is comparable to oxygen for humans. It contains useful chemicals that are responsible for the full development of the entire body of the baby.

It is so inherent in nature that the amount of amniotic fluid should be within clear limits of the norm according to the gestational age. Their volume increases in jerks as the period increases up to the 38th week of pregnancy. After this period, the amount of fluid may decrease, which indicates the approach of childbirth.

During the gestational period, the composition of the water also changes. In the first weeks after conception, the amniotic fluid resembles blood plasma. But over time, it becomes contaminated with the waste products of the fetus. Therefore, starting from the second trimester, special attention is paid to the amount and composition of water in a pregnant woman. The results obtained after examination indicate the level of successful pregnancy.

For purification from excess impurities, the water is renewed about 8 times a day.

The normal volume and composition of fetal water is needed for:

Providing the fetus with a nutrient substrate (amino acids, hormones, maternal antibodies, immunoglobulins). This happens when the baby swallows amniotic fluid. And he does this quite often - a teaspoon every hour.
Creation of comfortable conditions for staying in the tummy (reduction of noise vibrations, stable temperature conditions, normal pressure).
Protection against force irritants from the outside (shocks, concussions and blows).
Formation of a barrier against infection with infections, viruses, fungi.

If a failure occurs in the female body, a special pathological condition called polyhydramnios may occur. The very name of the disease suggests that there is too much amniotic water in the fetal bladder. For example, normally the volume of fluid varies from 600 ml to 1.5 liters, and with polyhydramnios this figure exceeds 2 liters.

No matter how careless this pathology may seem, in fact it is a dangerous condition that requires a special approach and competent treatment in a hospital. Without such measures, the process of delivery is complicated for the future woman in labor, and the baby develops a variety of pathologies.

Polyhydramnios during pregnancy - the causes of the pathological condition

Modern medicine has not yet established the exact causes of the development of this disease. But doctors, based on many years of experience, identify a number of pathologies, the presence of which enrolls a woman in a high-risk group. These states include:

Acute bacterial and viral ailments that a woman had a couple of days before conception or during pregnancy. For example, rubella, genital herpes, toxoplasmosis, gonorrhea.
Diabetes in pregnancy.
Multiple pregnancy, especially with identical twins.
Problems with the cardiovascular system.
Too big fruit.
Pathological condition of the placenta. For example, premature aging, phytoplacental insufficiency, tumor formation.
Rh-conflict of a married couple.
Pathological work of the excretory function of the baby.
Anemia.
Genetic anomalies, immaturity of the nervous system, diseases of the fetal organs.
Violation of the work of amniotin.

In 50% of cases, polyhydramnios during pregnancy is a consequence of inflammation of the uterine tissues, which confirms the infectious nature of the disease.

With the advent of the final trimester, the cause of polyhydramnios is the abnormal development of the baby's swallowing function. Normally, a child swallows 4 liters of liquid, and then releases it. With some pathologies, for example, with a splitting of the palate, he cannot do this, as a result of which an excess of amniotic water appears.

In 30% of cases, it is not possible to establish the true cause of polyhydramnios.

Forms, types and severity of polyhydramnios during pregnancy

An increase in the amount of amniotic fluid can be acute or chronic.

acute form characterized by rapid accumulation of water over several hours or days. At the same time, the stomach grows right before our eyes, women are disturbed by pains that radiate to the lumbar and inguinal regions. This form of polyhydramnios develops in the first months of gestation (14-20 weeks) and may result in miscarriage or uterine rupture. Such a disease occurs very rarely and mainly with monozygotic twins or viral diseases. Malformations in the fetus are determined in 100% of cases.
Chronic form involves a gradual increase in the volume of water, which begins to exceed the permissible level. A woman rarely feels unwell, because she easily adapts to subtle symptoms, her condition is stable and normal. Such polyhydramnios occurs in the last stages of pregnancy and rarely ends in serious complications in the baby.

There are three degrees of severity of polyhydramnios:

Light - the volume of amniotic water is less than 3 liters.
Medium - the volume of liquid ranges from 3 to 5 liters.
Severe - the volume of water exceeds 5 liters and can reach up to 12 liters.

Taking into account the causes of the appearance and general indicators of a woman's health, polyhydramnios is divided into several types:

Relative polyhydramnios - nothing threatens the condition of the woman and the fetus, provided there is no infection in the uterine cavity. This happens when the fetus is too large.
Atmeasured polyhydramnios during pregnancy - amniotic fluid only slightly exceeds the upper acceptable threshold. If the situation is not corrected, a characteristic symptomatic picture appears over time.
Border polyhydramnios - a condition when the water level is between the norm and pathology. Only close monitoring of the condition of the woman and the baby is appropriate here.
idiopathic polyhydramnios - excess of amniotic secretion for no apparent reason. Regardless of what caused the pathology, adequate treatment is carried out.
Expressed polyhydramnios is a strong increase in the volume of water, which is noticeable even without diagnostics. The girth of the abdomen is rapidly growing in a woman, pain, weakness, and nausea occur.

The health of the fetus and the method of delivery depend on the timely diagnosis of polyhydramnios and the elimination of the causes of its occurrence.

Signs of polyhydramnios during pregnancy

The disease can develop without symptoms or show only some of the signs that a woman perceives as a variant of the norm.

What symptoms to look out for:

Any discomfort in the abdomen at the level of the fundus of the uterus.
Chronic causeless weakness.
A sharp increase in heart rate.
Shortness of breath without any physical activity.
Severe swelling of the legs, genitals.
Mismatch between the girth of the abdomen and the height of the day of the uterus to the gestational age.
Reducing daily diuresis.
Increased physical activity of the baby.
Strong "squishing" (fluctuation).
The appearance of wide and deep striae.
Tension of the uterus, its soreness on palpation.
Gynecological examination revealed tension of the fetal bladder.
In the last weeks of pregnancy, women may experience severe nausea or vomiting.

Diagnosis of polyhydramnios during gestation

To confirm the diagnosis of polyhydramnios, a list of patient complaints, the results of clinical tests and all data from an external obstetric examination are collected. But the main tool for determining the pathology and its severity is ultrasound.

There are two ways to determine the status of amniotic fluids using ultrasound:

Calculation of the amniotic fluid index or AFI. This diagnostic procedure looks like this: the abdomen is divided into 4 segments, then the maximum depth of the liquid pocket is calculated in each conditional square. Then all the data are summed up, and the IAI is obtained. An index of less than 5% indicates oligohydramnios, and above 97.5% indicates polyhydramnios.
Measurement of the largest pocket of amniotic fluid free of fetal body parts and umbilical cord. Normally, this indicator is 2-8 cm, less than 1 cm - oligohydramnios, more than 8 cm - polyhydramnios.

If, according to the results of the diagnosis, polyhydramnios is confirmed, the woman is offered to do a triple test for possible malformations of the fetus or placenta. Additionally, they may prescribe a determination of the level of prolactin in the blood, which is greatly reduced with polyhydramnios. With polyhydramnios during late pregnancy, such studies are not informative.

Given that polyhydramnios may be the result of a chronic infection or Rh conflict, a woman is screened for TORCH infection and for antibodies to the Rh factor.

Polyhydramnios during pregnancy - consequences for the child

Exceeding the limit values of amniotic waters can significantly complicate the course of pregnancy and cause the death of the fetus or newborn. In addition, 20 out of a hundred babies are diagnosed with multiple malformations. For example:

Hydrocephalus.
Atresia of the esophagus or colon.
Diaphragmatic hernia.
Gastroschisis.
Chromosomal abnormalities.
Hirschsprung syndrome.

Depending on the form and severity of the course of polyhydramnios, there is:

Violation of the placenta (phytoplacental insufficiency, placental abruption, bleeding).
Wrapping the baby's neck with the umbilical cord, which during delivery can cause suffocation.
Severe forms of preeclampsia (in 21% of cases).
Leakage or complete outpouring of water is premature.
Hypertensive crisis or bouts of vomiting in a pregnant woman.
Fetal hypoxia with predicted developmental delay or neonatal death.
Intrauterine infection to the fetus, especially if it is the cause of polyhydramnios.
Presentation of the baby, which entails a caesarean section.
Low labor activity caused by excessive stretching of the uterine muscles.
The inability of the uterus to contract on its own after childbirth.

A favorable outcome is noted with moderate polyhydramnios with effective treatment.

Polyhydramnios during pregnancy - treatment

Treatment of women with such a diagnosis is carried out in a hospital. If the tests confirm pathologies incompatible with life in the fetus, the pregnancy is terminated. If the baby is healthy, the patient is prescribed treatment taking into account her condition and the severity of polyhydramnios.

In general, the treatment of polyhydramnios is reduced to the appointment of such funds:

A course of antibiotics if the pathology is caused by an infection. More often, broad-spectrum drugs are prescribed, for example, Rovamycin or Erythromycin.
Vitamin therapy, including all B vitamins, as well as ascorbic acid and tocopherol.
Diuretics in the presence of edema (Furosemide, Veroshpiron)
Preparations for the normalization of uteroplacental circulation (Kurantil).

How to treat polyhydramnios during pregnancy is decided by an obstetrician-gynecologist. Self-administration of any drugs is strictly contraindicated due to the risk of death.

In extremely severe cases, when there is a risk of uterine rupture, amniocentesis is prescribed. This is a procedure that involves drawing a small amount of water from the amniotic sac using a needle. But the risk of serious complications after that is very high.

Throughout the entire period of treatment, the woman's blood pressure is measured daily, her weight is determined, and fetal cardiotocography is performed and dopplerography once a week.

How to prevent the development of polyhydramnios - preventive measures

Realizing the seriousness of the situation, expectant mothers are wondering how to prevent polyhydramnios. Unfortunately, there are no specific measures to prevent this pathology, since provoking factors have not yet been established.

The only thing that remains for women is to undergo a full examination before pregnancy, and after conception, visit the gynecologist regularly and maintain a healthy lifestyle.

Tactics of conducting childbirth with polyhydramnios

Depending on the form of polyhydramnios and the severity of the general symptomatic picture, a woman may be prescribed a planned caesarean section.

If polyhydramnios is in an acute form and progresses strongly, a decision is made to stimulate preterm labor if the gestation period is more than 35 weeks or to terminate the pregnancy.

The natural method of delivery in women in labor with polyhydramnios often passes with various complications. To reduce the danger to mother and baby, the birth process takes place using the following preventive measures:

Carrying out a gentle amniotomy - a puncture of the bladder from the side, just above the cervix of the uterus. During the procedure, the obstetrician-gynecologist controls the rate of outflow of fetal fluids in order to prevent partial loss of parts of the baby's body or the umbilical cord.
Careful use of stimulation - the introduction of oxytocin is carried out no earlier than 2-3 hours after the passage of water, so that the placenta does not exfoliate prematurely.
The willingness of neonatologists to provide resuscitation care to the newborn.

Polyhydramnios during pregnancy - reviews

Most women who are faced with polyhydramnios managed to safely endure and give birth to a baby. Subject to all the doctor's prescriptions, the pregnancy developed normally, and the babies were born healthy and full.

But in the presence of severe forms of polyhydramnios, women did not tolerate the last months of pregnancy: their body swelled, their back hurt, breathing was difficult.

Remember, if you have been diagnosed with polyhydramnios, you should take this situation seriously. Refusing treatment and completely ignoring the problem can result in irreparable consequences for you and your baby.