Polyhydramnios in the last stages of pregnancy causes. Polyhydramnios during pregnancy: causes and consequences. Treatment of polyhydramnios. What is the danger of polyhydramnios for a baby

Update: October 2018

Amniotic fluid plays a huge role in the development of the unborn child and the course of childbirth. Not only the condition of the future baby, but also the mother depends on their quantity and quality.

Polyhydramnios, as an obstetric pathology, is not uncommon, but few pregnant women attach particular importance to this complication, although it, like all other deviations from the physiological course of pregnancy, needs, if not treatment, then careful monitoring.

The consequences of polyhydramnios are very serious and can become sad, up to the loss of an unborn child.

What is amniotic fluid for?

Everyone knows that life on Earth first originated in water, and then appeared on land. Man is no exception, and his embryo passes the initial period of its existence in the aquatic environment, that is, in the amniotic fluid.

The embryo develops in the fetal bladder (another name is amnion), which is filled with a biologically active medium - amniotic fluid, in other words, amniotic fluid. Amniotic fluid is of great importance, because it depends on their quantitative and qualitative composition whether the existence of the embryo and the course of childbirth will be comfortable. Amniotic fluid performs many different functions.

provides nutrition to the fetus, due to the nutrients contained in it, which are swallowed by the future person, and in the early stages they are absorbed by the skin.
provides optimal, and, most importantly, constant temperature conditions (about 37 degrees).
maintains pressure inside the fetal bladder, prevents squeezing of the umbilical cord and parts of the fetus.
amniotic fluid protects the future person from mechanical influences from the outside (for example, blows to the stomach) and protects the fetus from external noise effects.
amniotic fluid contains immunoglobulins - antibodies that prevent infection of the embryo, and the waters themselves are protected from the external environment and various infections due to the impermeability of the fetal bladder.
amniotic fluid provides freedom of movement of the fetus in the uterus, especially in the early stages.

Polyhydramnios: what does it mean?

Polyhydramnios is a pathological condition that occurs during the period of gestation, when an excessive amount of amniotic fluid accumulates. For example, at the 36th week of pregnancy, that is, at the end of the gestation period, the amount of amniotic fluid reaches 600 ml - 1.5 liters, then with this pathology the volume of amniotic fluid exceeds the agreed norm (1500 - 2000 ml).

The amount of amniotic fluid is directly related to the gestational age, and as it increases, the volume of water also increases (see). For example, at 10 weeks the amount of water is insignificant and is only 30 ml, and by 14 weeks the volume of amniotic fluid reaches 100 ml, and so on. The incidence of polyhydramnios is 0.3% - 1% of all registered pregnancies.

What is polyhydramnios

In its course, polyhydramnios can be both acute and chronic. In prognostic terms, acute polyhydramnios is unfavorable chronic and is characterized by a rapid increase in symptoms over several days and even hours. As a rule, the described pathology is observed at short stages of pregnancy, which requires its immediate termination. If polyhydramnios is chronic, then the volume of water increases gradually and the symptoms are smoothed out. Most often, chronic polyhydramnios is diagnosed in the last stages of pregnancy.

There are three degrees of severity of chronic polyhydramnios:

mild degree, when the amount of amniotic fluid does not exceed 3000 ml
moderate degree- the amount of water is in the range of 3000 - 5000 ml
severe - if amniotic fluid exceeds 5 liters (more common at the end of pregnancy).

There is another gradation of polyhydramnios:

relative polyhydramnios- does not pose a danger and is set according to the ratio of the amount of water and the size of the fruit;
tendency to polyhydramnios or borderline polyhydramnios- the amount of amniotic fluid corresponds to the upper limit of normal;
idiopathic polyhydramnios- the prerequisite for its occurrence is not known;
moderate polyhydramnios during pregnancy - in this case, there are no external manifestations, and the volume of water only slightly “rolls over”;
pronounced polyhydramnios- has the characteristic signs of the described pathology, the stomach grows rapidly.

Why polyhydramnios occurs

To date, the causes of polyhydramnios in pregnant women have not been studied enough. All factors that determine the development of this pathology are divided into 4 groups:

maternal factors

Factors Caused by Pregnancy Complications

Complications of this pregnancy can also cause an excess of amniotic fluid. These include:

(damage to blood vessels, in particular the placenta)
(cm. )
pathology of the placenta (chorioangioma and others)

fruit factors

various fetal anomalies(infection of the esophagus, chromosomal diseases, pathology of the urinary system, brain, fetal immobility, etc.)
multiple pregnancy, and more often one of the fetuses develops polyhydramnios, and the other oligohydramnios due to the development of feto-fetal transfusion syndrome

Idiopathic polyhydramnios occurs without a cause

The mechanism of development of polyhydramnios is a violation of the exchange of amniotic fluid. This exchange consists in the excretion and consumption of amniotic fluid. If in the short term of pregnancy the amnion only secretes fluid, then in the later stages, the replacement of amniotic fluid occurs through the amniotic area of the placenta. And any pathology of it leads to a change in the volume of water. The amount of amniotic secretion also increases due to the urine that the fetus secretes, and its absorption is carried out through the lungs and digestive tract of the child.

Therefore, any pathology of the fetus associated with the gastrointestinal tract
urinary system
lungs, leads to a violation of the exchange of water.

The clinical picture of polyhydramnios

Manifestations of polyhydramnios are associated with both the severity and the course of the disease.

Acute polyhydramnios

As it was written earlier, acute polyhydramnios is more severe and the clinical picture is pronounced. Acute polyhydramnios often occurs in the second trimester, around 16-20 weeks. Symptoms develop within hours. The woman notes a sharp increase in the abdomen, pain and heaviness in the lower abdomen and in the perineum, severe shortness of breath, and so on.

Chronic polyhydramnios

The clinical picture of chronic polyhydramnios is more blurred. Since the accumulation of water occurs gradually, the manifestations of this pathology do not appear immediately. In some pregnant women, there are no signs of polyhydramnios at all, and an excess amount of water is detected by chance, during the next ultrasound examination. Chronic polyhydramnios usually occurs between 30 and 33 weeks of gestation. Its features are primarily:

discrepancy between the size of the abdomen and the gestational age, that is, the values of the height of the fundus of the uterus and the circumference of the abdomen are more than normal.
the doctor listens to the muffled fetal heartbeat, which is associated with an excess of amniotic fluid, which makes it difficult to auscultate. The pregnant woman herself may notice too active movements and mobility of the fetus, which on palpation is detected as an incorrect position of the baby (breech presentation, transverse or oblique position).
women may complain about:
- shortness of breath even after minor physical exertion (the uterus "supports" the diaphragm)
- heartburn
- sudden tachycardia
- bouts of weakness
- characteristic and persistent swelling of the legs
- pain or heaviness in the lower abdomen
- due to an increase in the abdomen, multiple pregnancy stretch marks (stretch marks) appear on the abdominal wall.

During examination and palpation of the abdomen, the doctor notes its tension, fetal mobility and high presenting part.

Diagnostics

A doctor may suspect polyhydramnios based on examination data (abdominal size, incorrect position / presentation of the fetus, dull heartbeat) and the presence of complaints.

ultrasound

To confirm the diagnosis, an ultrasound scan is mandatory, with the help of which the amniotic fluid index (abbreviated AFI) is calculated. The AAI calculation method is the summed value of all "pockets", that is, places free from small parts of the fetus and umbilical cord in the four quadrants of the uterine cavity.
The amniotic fluid index is the gold standard for diagnosing amniotic fluid pathology.
The AFI data changes daily (water is changed every 3 hours).
The calculated IAI is compared with physiological parameters for a given gestational age (there is a special table).

Gestational age	Amniotic fluid index, cm
Gestational age	5th percentile	50 percentile	95th percentile
14 weeks	2,8	5,0	8,6
16 weeks	3,6	5,8	9,6
18 weeks	4,6	6,8	11,1
20 weeks	5,5	8,0	12,9
22 weeks	6,3	9,3	14,9
24 weeks	7,0	10,7	16,9
26 weeks	7,5	12,0	18,7
28 weeks	7,6	13,0	19,9
30 weeks	7,5	13,6	20,6
32 weeks	7,1	13,6	20,4
34 weeks	6,4	12,9	19,4
36 weeks	5,6	11,8	17,9
38 weeks	4,7	10,3	15,9
40 weeks	3,7	8,6	13,9

In addition to the examination and ultrasound, the woman is assigned the following tests

blood for sugar (exclusion/confirmation of diabetes mellitus);
vaginal smear for microflora;
polymerase chain reaction (blood or vaginal swabs) for TORCH infections;
clinical blood and urine tests;
blood for antibodies (if the woman's blood is negative);
cardiotocography, dopplerometry to monitor the condition of the fetus.

If a pregnant woman is being treated in a hospital, then her stomach is measured daily, the fetal heartbeat is heard and its position is determined.

Treatment

How to treat polyhydramnios during pregnancy depends on the cause that caused it. All women with this pathology, especially those with moderate and severe degrees, are subject to hospitalization in the department of pathology of pregnant women.

If gestational diabetes mellitus is detected, the treatment of polyhydramnios consists in correcting blood glucose, and if immunological Rh incompatibility is detected, appropriate therapy is carried out (treatment or prevention of hemolytic disease of the unborn child).
However, in most cases, the cause of polyhydramnios remains unidentified, then therapy is aimed at normalizing uteroplacental blood flow:
- antiplatelet agents: chimes, trental
- tocolytics: ginipral, partusisten
- antispasmodics: nosh-pa
- shows the introduction of vitamins (ascorbic acid, vitamin E, B vitamins)
- there is evidence of the advisability of prescribing indomethacin tablets for polyhydramnios.

Regardless of whether an infection is detected during the examination or not, a woman must be prescribed antibiotic therapy, while using broad-spectrum drugs from the macrolide group (erythromycin, josamycin, and others).
In the case of severe polyhydramnios, amniocentesis is performed by puncturing the abdominal wall, inserting a needle into the uterine cavity and taking a certain amount of water.

Complications

Why is polyhydramnios dangerous during pregnancy? - a similar question interests every woman with this pathology.

Firstly, polyhydramnios, especially acute, is dangerous by abortion, which is carried out artificially for medical reasons up to 28 weeks.
In addition, polyhydramnios often causes premature birth (the uterus overstretched by water and the strained fetal bladder cause opening of the uterine os and uterine contractions), prenatal outflow of water, bleeding in the first 2 hours after birth and in the afterbirth period (due to impaired uterine contractility).
Also, polyhydramnios, especially in childbirth, can cause premature detachment of the placenta, and this is an indication for an emergency caesarean section. During the outpouring of water, small parts of the baby or a loop of the umbilical cord may fall out, which also means an emergency and surgery.
Due to the high motor activity of the fetus, its incorrect position / presentation and entanglement with the umbilical cord are often observed.
With polyhydramnios, the uteroplacental blood supply is disturbed, which leads to intrauterine hypoxia and fetal growth retardation.
Gestosis in polyhydramnios is much more common than in other cases, as well as arterial hypertension and indomitable vomiting.

Polyhydramnios during pregnancy is a pathological condition in which the amount of amniotic fluid exceeds the levels considered normal for a certain period.

Amniotic fluid ensures the full intrauterine development of the unborn baby. They protect the fetus from external influences and enable it to move, participate in the metabolic process and prevent clamping of the umbilical cord. The amniotic fluid is regularly replaced (about every 3 hours) and gradually increases. If at week 10 the volume is approximately 30 ml, then in the prenatal period it is already 1-1.5 liters.

They talk about polyhydramnios when there is more than one and a half liters of fluid in the later stages.

Causes of polyhydramnios during pregnancy

The exact cause of polyhydramnios has not been established to date. There is an opinion that genetic (family) predisposition has a certain value. Allocate a risk group; in women included in it, this pathology of pregnancy is much more common.

Predisposing factors:

large size of the fetus;
multiple pregnancy;
kidney pathology;
Rhesus conflict;
infections;
pathology of the excretory system of the unborn child.

Note:the likelihood of developing a pathological condition increases with infection with viruses, and. Often leads to polyhydramnios.

Among the predisposing factors is a violation of the function of swallowing in the fetus. In the later stages, he absorbs up to 4 liters of amniotic fluid daily.

Symptoms

There are a number of clinical signs that make it possible to suspect polyhydramnios during pregnancy.

The following symptoms may appear:

Note:the cause of shortness of breath is the so-called "high standing" of the dome of the diaphragm.

According to the nature of the course, polyhydramnios is divided into acute and chronic. Of particular danger is the acute variant of development, most often diagnosed during II trimester. It is characterized by a sharp increase in the volume of water in a very short time - from several hours to 1-3 days. The circumference of the patient's abdomen at the level of the navel increases rapidly, and in the inguinal and lumbar region there is pain of medium or high intensity. During the examination, swelling of the abdominal wall and hypertonicity of the myometrium are determined.

In the chronic form, the volume of amniotic fluid increases gradually, but the likelihood of complications is also very high.

According to the severity of the course of the pathological process, mild, moderate and severe degrees are distinguished.

Consequences of polyhydramnios during pregnancy

Polyhydramnios during pregnancy in many cases leads to serious consequences, especially in the absence of early diagnosis and adequate medical care.

Possible complications of the pathological condition are:

spontaneous abortion (in almost 30% of cases);
(almost 40% of cases);
fetoplacental insufficiency;
early and massive discharge of water;
intrauterine malformations (most often the nervous system and gastrointestinal tract of the fetus suffer);
, oblique or transverse presentation;
premature detachment of the placenta;
childbirth ahead of time.

Fetoplacental insufficiency leads to a lack of oxygen by the fetus (), which can cause the death of the unborn baby or serious developmental disorders.

If a bacterial or viral infection has led to the pathology, the probability of infection of the fetus is high.

According to medical statistics, almost 20% of patients diagnosed with polyhydramnios develop late (preeclampsia).

Important:pathology can lead to a weakening of labor activity in the 1st and 2nd periods, since there is an overstretching of the uterine wall, which negatively affects muscle tone. During childbirth, against the background of a rupture of the fetal bladder and a massive outpouring of water, the umbilical cord or parts of the child's body may fall out. Often postpartum hemorrhage develops.

Diagnostics

The basis for suspicion of polyhydramnios is the data of the anamnesis (the presence of certain symptoms) and general examination (with measurement of the circumference of the abdomen).

During the examination, it is necessary to study the parameters of blood (and) and urine. In case of Rh-conflict, antibodies are examined.

The laboratory also examines the smear for the possible presence of pathogenic microflora.

During palpation, the tension of the uterus and the discrepancy between its size (increasing) and the duration of pregnancy are determined. The high mobility of the fetus is also characteristic; he is constantly trying to change his position.

Important:excessively free position of the fetus and its active movements often lead to entanglement with the umbilical cord, which is fraught with asphyxia.

Verification of the diagnosis is carried out in the course. With ultrasound, the largest area between the uterine wall and the fetus is measured, receiving the so-called. amniotic fluid index.

Table of indicators of amniotic fluid:

Among the very informative diagnostic methods are CTG (cardiotocography is needed to assess the condition of the fetus) and dopplerometry.

Treatment of polyhydramnios during pregnancy and prognosis

If mild or moderate severity is detected, obstetrician-gynecologists make every effort to keep the pregnancy up to physiological delivery. In severe cases, disorders of vital functions are possible, therefore, early (operative) delivery is often indicated to save the patient's life.

To determine the medical tactics, it is important to identify the factors that provoked the pathological condition.

If multiple pregnancy is due to infection, bacterial pathogens require(it is advisable to prescribe broad-spectrum drugs - Rovamycin or Erythromycin).

Important:during pregnancy, the use of tetracycline antibiotics is unacceptable!

According to indications, diuretics are prescribed (Hypothiazid, Furosemide), and and.

To improve uterine and placental blood flow, Actovegin and Curantil are recommended.

Note:pregnant women diagnosed with polyhydramnios should have daily cardiotocography, weight and blood pressure measurements. Ultrasound and dopplerography to assess uterine and placental blood flow are performed at least weekly.

Polyhydramnios may be an indication for an abdominal amniocentesis procedure, during which a puncture is performed, followed by a slow removal of excess amniotic fluid (pumped up to 200 ml).

With a weakened labor activity, its drug stimulation is carried out.

With a mild degree, therapy can be carried out at home, but moderate severity is already becoming an indication for hospitalization.

The prognosis for the chronic form of polyhydramnios is quite favorable. If there are no contraindications, childbirth is carried out naturally.

To prevent a sudden rupture of the fetal bladder, they resort in advance to a puncture of the membranes - amniotomy. Through this procedure, the amniotic fluid is poured out in a thin stream, and the uterus contracts. In emergency cases, it is shown.

Prevention of this pathology involves early registration in the antenatal clinic, regular examination by a specialist, strict adherence to medical prescriptions. It is important for pregnant women to observe the daily routine, eat right and take daily walks in the fresh air.

Plisov Vladimir, medical commentator

Future mothers can face the problem of increasing the amount of amniotic fluid at any time, however, polyhydramnios during late pregnancy causes the greatest concern among doctors. Do you know why?

It turns out that at this time, pathology can provoke, at best, premature birth, and at worst, bleeding during labor, or even endanger the health and life of the baby. And after all, it can be prevented and independently identified, the main thing is to know how.

The amniotic fluid surrounds the baby in the womb. It performs several functions at once: it protects, provides freedom of movement, takes part in metabolic processes, and is also responsible for the development of basic skills in the fetus (swallowing, motor). They say that it smells like milk, and this explains how a newborn baby finds the breast so quickly.

Nature intended that this fluid be regularly updated. That is why its volume is different for different periods:

at 10 weeks it is about 10 ml;
at 14 - 100 ml;
at 21 - 22 - 400 ml;
at 30 - 32 - 700 ml;
at 37 - 38 - up to 1500 ml (this is the maximum);
in 39 - 40 - about 800 ml.

This is ideal. And if the volume significantly exceeds the norm, they put polyhydramnios. As a rule, doctors are alarmed by a significant excess - by 1.5 - 2 times. The most interesting thing is that modern medicine distinguishes between several types of polyhydramnios, sometimes making a borderline diagnosis, which sounds like a "tendency to polyhydramnios." In other words, there is no pathology yet, but the risk of its development has been identified.

How to suspect and detect

To answer this question, it should be recalled that there are two stages of polyhydramnios: acute and chronic. Moreover, the signs in both cases are the same, the difference is only in the speed of their manifestation.

In the first case, the amount of amniotic fluid increases sharply and quickly, literally in a day, or even a few hours. Changes are visible to the naked eye, as the woman's tummy also grows. The situation is aggravated by the appearance of pain in the perineum, lower back, swelling of the abdominal wall, and finally, a sharp increase in pressure, due to which the fetal heartbeat is poorly heard.

But in the later stages, you should not worry about this: acute polyhydramnios is most often diagnosed in the first trimester, which cannot be said about chronic. It is from him that expectant mothers in demolition suffer. How is it characterized?

Slow and gradual increase in the volume of water.
As a result, a gradual increase in the size of the abdomen, which a woman may not even pay attention to.
Less commonly - swelling in the lower extremities, nausea, abdominal pain.

You may also experience:

weakness;
worsening condition;
feeling of heaviness in the abdomen;
shortness of breath.

At this time, you can often hear gurgling in the stomach. He himself, with polyhydramnios, reaches a volume of 100 - 120 cm. A lot of stretch marks appear on it.

If you suspect these symptoms in yourself, you should not postpone going to the doctor. Simply because the condition is dangerous not only for the mother, but also for the child. But first things first.

Why does

Modern medicine can name the main reasons for the development of polyhydramnios, but not all. In about 30% of cases, it is not possible to understand why this happened. Most often, the situation arises when the woman herself is not large (she is small and fragile), and the child she bears is a hero.

But there are other factors, including:

(leads to the development of pathology in 95% of cases);
diabetes mellitus (it is the cause in every third case);
intrauterine infection;
diseases of the cardiovascular system;
placental disorders;
kidney disease;
preeclampsia and the same nausea in the later stages;
multiple pregnancy;
infectious diseases transferred in an interesting position;
malformations of the fetus (problems with the central nervous system, decreased excretory function, problems with swallowing).

Few people know that almost before childbirth, the child absorbs up to 4 liters of fluid per day, and so every day. But you should not worry about this, because it is updated every three hours.

What is dangerous

The consequences of the development of polyhydramnios can be deplorable if no action is taken. First of all, the condition is dangerous for the crumbs themselves, who are now becoming more active and at risk of “earning” an entanglement with the umbilical cord.

What else is dangerous condition?

The development of late gestosis, if they were not. This happens, for example, if the amount of amniotic fluid increases at 32-33 weeks.
Premature birth due to early outflow of water.
Placental insufficiency, which can provoke chronic fetal hypoxia and, as a result, a threat to its normal development.
Complications in childbirth.

It has been proven that polyhydramnios prevents the child from taking the correct position immediately before delivery. As a result, they make a diagnosis of "previa", with which they are sent to, of course, if the situation does not change.

Other possible consequences:

Weakness of labor activity, which is due to excessive stretching of the uterus. Under such conditions, the placenta may exfoliate even ahead of time, which will lead to the development of bleeding.
Prolapse of the umbilical cord at the time of delivery or the handle, the legs of the child, which, on the one hand, will increase the risk of developing injuries in him, and on the other hand, will complicate the work of doctors, prolong the process. At the same time, asphyxia sometimes occurs, which in the future can affect mental development. At risk are women who were diagnosed with polyhydramnios at 36-37 weeks.

But the worst thing is that polyhydramnios at any time, including at 38-39 weeks, can cause the appearance of intrauterine pathologies that, at a minimum, threaten the health of the child, and at most, his life.

Diagnostics

Polyhydramnios is detected during an additional ultrasound, where the doctor sets the amniotic index, that is, the volume of fluid.

There are rules for different periods. So:

at 16 - 18 weeks, the indicator should be in the range of 73 - 220 ml;
at 22 - 26 weeks - 89 - 238 ml;
at 32 - 34 weeks - 77 - 278 ml.

Polyhydramnios is an insidious pathology, so if at 34-35 weeks, when the mother feels great, she is given the upper limit of the norm and hospitalization is recommended, she must agree. This pathology must be constantly monitored in order to prevent the terrible! Remember this!

Sometimes the diagnosis of Polyhydramnios is preceded by the diagnosis of Moderate Polyhydramnios. What does it mean? The presence of a problem and its slow, rather than abrupt development. That is, the amount of water is increasing, although not as fast as it could, but there is time to correct the condition.

When the pathology is revealed, it's time to find its causes, because the treatment depends on them. Therefore, the mother is prescribed:

To confirm the diagnosis, cardiotocography may be prescribed.

Prevention and treatment

Ideally, therapy is prescribed, depending on the identified cause of the pathology. So:

with Rhesus conflict, immunoglobulins are administered;
intrauterine infection - prescribe antibiotics that are allowed for women in an interesting position;
diabetes mellitus - diet and additional therapy to correct sugar levels.

True, due to a third of the unidentified causes of pathologies, the question of how to treat polyhydramnios in each specific case is sometimes not even raised, because there is a “universal scheme” to get rid of the problem for sure.

What does it mean? What is prescribed for the expectant mother all at once:

antibiotic therapy with broad-spectrum drugs;
diet
diuretics;
preparations containing magnesium.

To maintain immunity, improve the general condition of the mother and fetus, vitamin complexes containing vitamins B, C, E are also prescribed.

In extreme cases, at 33-34 weeks, an amniotomy can be done in the chronic course of the pathology. This is a procedure in which the bubble is opened to pour out part of the waters. Thus, doctors can protect themselves and the pregnant woman from a rupture, in which the waters leave rapidly, taking the umbilical cord or limbs of the baby with them and endangering his life and health.

In the later stages, at 36 - 41 weeks, they may decide to stimulate labor.

You can prevent all these problems by planning a pregnancy (this is an examination before conception), regularly undergoing examinations, listening to the doctor's recommendations.

Without exception, all women, having learned about their pregnancy, dream of bearing a strong and healthy baby. However, expectant mothers, like no other, are prone to all sorts of diseases and infections. This is because their immunity is weakening, as a result of which all the protective functions of the body are reduced.

A common phenomenon that can threaten the life of an unborn baby is polyhydramnios during pregnancy. Knowing what kind of disease it is and how to prevent it, sad consequences can be avoided.

Amniotic fluid and their functions

The child in his mother's tummy for all nine months feels warm and comfortable. He is full and warm. And all thanks to amniotic fluid (also called amniotic fluid). This is a kind of biological environment, necessary for the full development of the baby. The amount of water depends on the duration of pregnancy. Of course, a two-week-old embryo needs much less water than, say, a fetus at the twenty-fifth week of development.

Amniotic fluid contains proteins, mineral salts, hormones, enzymes, fats and other substances that are useful for the growth of crumbs. The smell of water is reminiscent of mother's milk. This is why it is easier for a newborn to find the breast. The liquid is updated every three to four hours.

Before the birth itself, the amniotic fluid leaves - the pregnant woman has a feeling that she involuntarily wet herself. By the color of the liquid, we can talk about the prenatal state of the child:

The norm is a yellow, slightly cloudy liquid.
If there are bloody streaks, but nothing bothers the pregnant woman, you should not worry either.
The dark brown color of the liquid often indicates the death of the baby.
Red water - there may be an internal hemorrhage that threatens the life of the child.
Green liquid - defects and deviations in development.

What is polyhydramnios?

Sometimes amniotic fluid may be present in excess. Then the doctors make a diagnosis - polyhydramnios. You can determine the normal amount of fluid by feeling the bottom of the uterus (it will be raised in the pathological state of the waters) or using ultrasound diagnostics.

There are three forms of polyhydramnios - acute, chronic and moderate. What is dangerous polyhydramnios during pregnancy:

Sharp form. Extremely difficult for both mother and baby. The amount of fluid increases rapidly and uterine rupture can occur in a matter of hours. The disease requires immediate treatment and hospitalization. Fortunately, this form is extremely rare.
Chronic form. Less dangerous than the previous one. It is more common in the last stages of pregnancy (33 - 35 weeks). develops evenly. Needs specialist treatment and supervision.
Moderate polyhydramnios during pregnancy is a minor deviation from the norm and is quite common. You can recognize the disease already for a period of 16-20 weeks.

Each of the three forms of polyhydramnios poses a potential threat to the baby and his mother. Treatment at the time of diagnosis cannot be avoided. Otherwise, placental abruption and fetal death may occur.

Causes of an increase in the amount of amniotic fluid

By itself, polyhydramnios develops very rarely. There must always be a logical explanation for that.

Polyhydramnios during pregnancy has a variety of causes:

Maternal diseases (chronic - diabetes mellitus, vascular disease, defects; infectious - chlamydia, trichomoniasis, ureoplasmosis and other STDs).
TORCH - infections.
Rhesus conflict.
Pregnancy of twins.
Large fruit.
Pathologies in the development of the baby.

Only a doctor can make a diagnosis of polyhydramnios after examination and the results of ultrasound diagnostics.

Symptoms of polyhydramnios during pregnancy

The development of polyhydramnios can be judged by the following symptoms:

Heaviness in the abdomen, which causes discomfort, and sometimes accompanied by pain.
Weakness, fatigue.
Increased blood pressure.
Nausea.
Dyspnea.
Swelling of extremities, mainly lower.
A noticeable increase in the abdomen, which does not correspond to the term.
The appearance of a large number of stretch marks.
With the development of an acute form, pressure is observed in the perineal region.

The seriousness of the disease is that all the symptoms are taken by the pregnant woman for granted. Therefore, they may be detected late by a doctor. The final diagnosis can only be made after ultrasound.

Why is polyhydramnios dangerous?

Like any disease, polyhydramnios, if not properly treated, can cause unpleasant consequences, including the death of a mother or baby.

An increased amount of amniotic fluid can cause:

Early discharge of amniotic fluid and intrauterine infection of the fetus.
Birth before the due date.
Miscarriage.
Bleeding.
Violations of the functions of the organs of the fetus.
Oxygen starvation.
Placental abruption and death of the baby.

Polyhydramnios is also the reason for the lack of labor activity, as a result of which doctors very often perform a caesarean section.

Therefore, in order to avoid polyhydramnios during pregnancy, it is better to prevent the causes of the disease than to treat it. A pregnant woman should always be responsible for her health. Any changes accompanied by pain and discharge are a signal to call an ambulance. Ignoring the symptoms always leads to dire consequences. Often - to death.

Moderate polyhydramnios during pregnancy

Acute and chronic forms of polyhydramnios are extremely rare. But moderate polyhydramnios is a common phenomenon and can be observed in every tenth pregnant woman.

With moderate polyhydramnios, amniotic fluid accumulates gradually. Most often, such a deviation is not diagnosed in a pregnant woman. The diagnosis can be made on the basis of ultrasound diagnostics, as well as during a doctor's examination. In the second case, the uterus is raised above normal by 3 centimeters.

Moderate polyhydramnios, like its other forms, needs treatment. Otherwise, premature birth and some fetal pathologies, in particular, prematurity, hypoxia and developmental delay, cannot be avoided.

There are times when a moderate form of polyhydramnios is temporary and soon goes away on its own. However, this is more the exception than the rule.

How to lower the level of amniotic fluid?

Polyhydramnios during pregnancy in recent years, doctors diagnose more and more often. The disease has unpredictable consequences for the mother and her baby, and therefore requires mandatory treatment.

A woman suffering from polyhydramnios has severe swelling of the limbs, shortness of breath. It is difficult for her not only to stand and move, but even to sit and lie down. The pulse is disturbed and the pressure rises. Self-medication is very dangerous for the health of both mother and baby. Indeed, in order to treat this ailment, it is necessary to determine in what form it proceeds. What only an experienced specialist is capable of.

Polyhydramnios in the last stages of pregnancy, as well as at any other time, is often treated in a hospital under the supervision of a doctor. You can choose the right treatment tactics with the help of tests:

blood (total and glucose);
urine;
smear on flora;

Drugs to improve the functions of the placenta.
Diuretics.
Drugs aimed at stabilizing the blood flow of the placenta.
Complex of vitamins.
Sometimes antibiotics (if there is an infection).

In acute and chronic forms, the doctor can perform amniodrainage (pumping out excess water through a special needle).

Polyhydramnios at 32 weeks of gestation is mostly treatable. A woman has a chance to bring the child to the appointed time. However, for this it is necessary to consult a doctor for help as soon as possible. In rare cases, therapy of the disease does not bring results. There are premature births. The child is born premature, but may not have malformations.

Polyhydramnios at 38 weeks of gestation almost always ends in childbirth. The main task of the doctor is to prevent the death of the baby, which occurs as a result of early discharge of water and suffocation.

Prevention of polyhydramnios

Any disease is always better to prevent than to cure. This also applies to polyhydramnios. Especially when the disease poses a serious danger to the life of the crumbs.

The best prevention of polyhydramnios is a correct and healthy lifestyle, namely:

Proper, balanced nutrition. If there is a tendency to be overweight, it is better to stick to light diets so as not to feed the baby. After all, a large fruit is one of the causes of polyhydramnios.
Compliance with the drinking regime. Do not use too salty and spicy, after which the intake of water increases.
Hiking, physical education, exercise and yoga are always good for health.
Avoid stressful situations and negative emotions. Stress is the beginning of many diseases.
Do not forget about vitamins. In the case of polyhydramnios, vitamins B, C, E, which are found in large quantities in greens and vegetables, in meat and fish, in cereals and cereals, are excellent.

Treatment of polyhydramnios during pregnancy is a complex process. It is not always possible to bring the child to the due date.

As already mentioned, there can be several causes of the disease. However, the most common are chronic and infectious diseases of the mother. Therefore, when planning a pregnancy, you should pass all the tests and be treated in advance. When a baby is already living under the heart, it is much more difficult to do this. And most importantly - never bring any disease to a chronic form!

Childbirth with polyhydramnios

Polyhydramnios during pregnancy is always a prerequisite for difficult childbirth. In the future crumbs, an excessive amount of amniotic fluid causes:

Oxygen starvation (hypoxia).
Wrong presentation.
Large weight.
Prolapse of the umbilical cord, stem or handle during the discharge of amniotic fluid.

Natural childbirth becomes impossible, and doctors perform a caesarean section. Childbirth almost never occurs at term. Amniotic fluid always leaves earlier than expected. Therefore, a pregnant woman with a diagnosis of "polyhydramnios" should be hospitalized earlier, and be observed by a doctor until the very birth.

Low water - good or bad?

The second common phenomenon during pregnancy is the insufficiency of amniotic fluid or oligohydramnios. It occurs in 7-10% of women. The reasons for this condition may be:

Smoking.
Maternal defects, in particular kidney disease.
Chronic diseases and STIs.
Viral diseases transmitted during pregnancy.
Pregnancy of twins.
Improper development of the placenta (premature aging).

Only a doctor can determine oligohydramnios after examination and ultrasound results. The following symptoms may also indicate the disease:

Low standing of the fundus of the uterus.
The movements of the baby cause discomfort and pain.
The lower abdomen is painful.
The general condition of the pregnant woman is characterized by weakness, nausea and fatigue.

Insufficiency of amniotic fluid leads to a decrease in the uterus and, as a result, a child can be born:

With a curved spine, dislocations or clubfoot.
Lagging behind in development. Oxygen starvation of the brain develops.
Before the deadline.
Dead.

Often there is a fading of the fetus in the early stages. Low water during pregnancy is much more difficult to treat. Drugs that would increase rather than decrease the amount of amniotic fluid are very difficult to find.

The main task of the doctor remains the maintenance of the placenta and the baby. This is possible with the help of vitamins and drugs that improve blood flow in the placenta.

Oligohydramnios is a dangerous phenomenon in the early stages of pregnancy, because it can be fatal. At a later date, premature birth occurs. Generic activity in this case is poorly expressed. Doctors often perform a caesarean section. The child may be born with abnormalities.

Conclusion

Expecting a baby is a great happiness and joy, which can be overshadowed by such an unpleasant phenomenon as the pathology of amniotic fluid.

Polyhydramnios during pregnancy, as well as oligohydramnios, have a negative impact on the development of the fetus and lead to malformations. Labor almost always begins prematurely and is often performed by caesarean section.

At risk are women carrying twins, as well as those who have chronic diseases and inflammation. Therefore, before planning a pregnancy, it is better to undergo a full examination and cure all ailments before conception.

A common phenomenon that can threaten the life of an unborn baby is polyhydramnios during pregnancy. Knowing what kind of disease it is and how to prevent it, sad consequences can be avoided.

Amniotic fluid and their functions

The norm is a yellow, slightly cloudy liquid.
If there are bloody streaks, but nothing bothers the pregnant woman, you should not worry either.
The dark brown color of the liquid often indicates the death of the baby.
Red water - there may be an internal hemorrhage that threatens the life of the child.
Green liquid - defects and deviations in development.

What is polyhydramnios?

There are three forms of polyhydramnios - acute, chronic and moderate. What is dangerous polyhydramnios during pregnancy:

Sharp form. Extremely difficult for both mother and baby. The amount of fluid increases rapidly and uterine rupture can occur in a matter of hours. The disease requires immediate treatment and hospitalization. Fortunately, this form is extremely rare.
Chronic form. Less dangerous than the previous one. It is more common in the last stages of pregnancy (33 - 35 weeks). develops evenly. Needs specialist treatment and supervision.
Moderate polyhydramnios during pregnancy is a minor deviation from the norm and is quite common. You can recognize the disease already for a period of 16-20 weeks.

Causes of an increase in the amount of amniotic fluid

By itself, polyhydramnios develops very rarely. There must always be a logical explanation for that.

Polyhydramnios during pregnancy has a variety of causes:

Maternal diseases (chronic - diabetes mellitus, vascular disease, defects; infectious - chlamydia, trichomoniasis, ureoplasmosis and other STDs).
TORCH - infections.
Rhesus conflict.
Pregnancy of twins.
Large fruit.
Pathologies in the development of the baby.

Only a doctor can make a diagnosis of polyhydramnios after examination and the results of ultrasound diagnostics.

Symptoms of polyhydramnios during pregnancy

The development of polyhydramnios can be judged by the following symptoms:

Heaviness in the abdomen, which causes discomfort, and sometimes accompanied by pain.
Weakness, fatigue.
Increased blood pressure.
Nausea.
Dyspnea.
Swelling of extremities, mainly lower.
A noticeable increase in the abdomen, which does not correspond to the term.
The appearance of a large number of stretch marks.
With the development of an acute form, pressure is observed in the perineal region.

Why is polyhydramnios dangerous?

Like any disease, polyhydramnios, if not properly treated, can cause unpleasant consequences, including the death of a mother or baby.

An increased amount of amniotic fluid can cause:

Early discharge of amniotic fluid and intrauterine infection of the fetus.
Birth before the due date.
Miscarriage.
Bleeding.
Violations of the functions of the organs of the fetus.
Oxygen starvation.
Placental abruption and death of the baby.

Polyhydramnios is also the reason for the lack of labor activity, as a result of which doctors very often perform a caesarean section.

Moderate polyhydramnios during pregnancy

Acute and chronic forms of polyhydramnios are extremely rare. But moderate polyhydramnios is a common phenomenon and can be observed in every tenth pregnant woman.

Moderate polyhydramnios, like its other forms, needs treatment. Otherwise, premature birth and some fetal pathologies, in particular, prematurity, hypoxia and developmental delay, cannot be avoided.

There are times when a moderate form of polyhydramnios is temporary and soon goes away on its own. However, this is more the exception than the rule.

How to lower the level of amniotic fluid?

blood (total and glucose);
urine;
smear on flora;

Drugs to improve the functions of the placenta.
Diuretics.
Drugs aimed at stabilizing the blood flow of the placenta.
Complex of vitamins.
Sometimes antibiotics (if there is an infection).

In acute and chronic forms, the doctor can perform amniodrainage (pumping out excess water through a special needle).

Prevention of polyhydramnios

Any disease is always better to prevent than to cure. This also applies to polyhydramnios. Especially when the disease poses a serious danger to the life of the crumbs.

The best prevention of polyhydramnios is a correct and healthy lifestyle, namely:

Proper, balanced nutrition. If there is a tendency to be overweight, it is better to stick to light diets so as not to feed the baby. After all, a large fruit is one of the causes of polyhydramnios.
Compliance with the drinking regime. Do not use too salty and spicy, after which the intake of water increases.
Hiking, physical education, exercise and yoga are always good for health.
Avoid stressful situations and negative emotions. Stress is the beginning of many diseases.
Do not forget about vitamins. In the case of polyhydramnios, vitamins B, C, E, which are found in large quantities in greens and vegetables, in meat and fish, in cereals and cereals, are excellent.

Treatment of polyhydramnios during pregnancy is a complex process. It is not always possible to bring the child to the due date.

Childbirth with polyhydramnios

Polyhydramnios during pregnancy is always a prerequisite for difficult childbirth. In the future crumbs, an excessive amount of amniotic fluid causes:

Oxygen starvation (hypoxia).
Wrong presentation.
Large weight.
Prolapse of the umbilical cord, stem or handle during the discharge of amniotic fluid.

Low water - good or bad?

The second common phenomenon during pregnancy is the insufficiency of amniotic fluid or oligohydramnios. It occurs in 7-10% of women. The reasons for this condition may be:

Smoking.
Maternal defects, in particular kidney disease.
Chronic diseases and STIs.
Viral diseases transmitted during pregnancy.
Pregnancy of twins.
Improper development of the placenta (premature aging).

Only a doctor can determine oligohydramnios after examination and ultrasound results. The following symptoms may also indicate the disease:

Low standing of the fundus of the uterus.
The movements of the baby cause discomfort and pain.
The lower abdomen is painful.
The general condition of the pregnant woman is characterized by weakness, nausea and fatigue.

Insufficiency of amniotic fluid leads to a decrease in the uterus and, as a result, a child can be born:

With a curved spine, dislocations or clubfoot.
Lagging behind in development. Oxygen starvation of the brain develops.
Before the deadline.
Dead.

The main task of the doctor remains the maintenance of the placenta and the baby. This is possible with the help of vitamins and drugs that improve blood flow in the placenta.

Conclusion

Expecting a baby is a great happiness and joy, which can be overshadowed by such an unpleasant phenomenon as the pathology of amniotic fluid.