An adequate supply of amniotic fluid is vital for the healthy development of the baby. Disturbances in amniotic fluid production can lead to too much or too little amniotic fluid being produced. In the case of amniotic fluid overproduction, this is called polyhydramnios. We explain the causes and symptoms of polyhydramnios and what treatments are available.

What Is A Polyhydramnios?

Polyhydramnios, also called polyhydramnios, is an abnormal increase in the amount of amniotic fluid. Colloquially, polyhydramnios is also referred to as amnios.

The opposite of polyhydramnios is oligohydramnios. In oligohydramnios, too little amniotic fluid is formed.

Too Much Amniotic Fluid – How Can You Tell?

Most often, polyhydramnios is discovered during screening examinations. The circumference of the abdomen shows whether it is unusually large for the stage of pregnancy. Furthermore, the doctor or midwife will see if the uterus is too large for the particular stage of pregnancy. When palpating the abdomen, the uterus will feel plump and firm. On ultrasound, an experienced doctor should be able to see if the amount of amniotic fluid is beyond normal.

The doctor will take a more accurate measurement of the amount of amniotic fluid is different from the norm. To do this, the abdomen is divided pictorially into four parts and the amniotic fluid level is measured at the lowest point of each. These values are added and the sum is compared to the amniotic fluid index. The normal value is in the range of up to 20 cm. If your value is higher, you have polyhydramnios.

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How Does A Polyhydramnios Manifest Itself?

Depending on whether you have acute or chronic polyhydramnios, the symptoms will be different.

• Acute polyhydramnios: The amount of amniotic fluid increases significantly within a few days. The pregnant woman experiences symptoms correspondingly quickly. Those affected suddenly feel severely affected.
• Chronic polyhydramnios: The amount of amniotic fluid increases only slowly. The symptoms are therefore also only slowly noticeable or are often only interpreted as a general feeling of discomfort associated with the pregnancy.

Without ultrasound, polyhydramnios can be difficult to detect and in many cases cannot be detected at all. However, pregnant women should be alert to some signs:

• The abdominal girth increases unusually.
• Increased pressure on the bladder, with a frequent need to urinate.
• A strong pressure on the intestines, resulting in constipation.

If the following symptoms are added to these before the 37th week of pregnancy, you should see a doctor immediately: intense abdominal tension, difficulty breathing, dizziness, preterm labor, constant pain, and pulling in the lower abdomen.

What Complications Can Arise From Too Much Amniotic Fluid?

Too much amniotic fluid can result in various complications or diseases. In the mother, increased blood pressure or increased urinary tract infections are often observed. The baby may also be harmed in polyhydramnios and, for example, have a shorter body length and lower weight at birth.

If there is excess amniotic fluid, the increased pressure may cause the uterus to overstretch prematurely or even cause premature rupture of the membranes.

What Consequences Can Polyhydramnios Have For The Birth?

Depending on the weight of the baby, a large amount of amniotic fluid can lead to premature birth. Even before the onset of labor, the amniotic sac may break. If this happens to you, please call an ambulance immediately!

In the presence of polyhydramnios, you will be monitored especially carefully before and during delivery – even if you and your baby are doing well – because there could be some complications during delivery.

• The baby may be prevented from lowering its head into the mother’s pelvis by a large amount of amniotic fluid.
• After the water breaks, the umbilical cord could be pulled into the maternal vagina, causing it to lie in front of the baby’s head. In that case, an emergency cesarean section may be needed.
• The risk of bleeding or hemorrhage after birth is increased because the uterus, overstretched by too much amniotic fluid, cannot contract sufficiently. However, proper contraction is necessary for hemostasis. Your doctor may therefore recommend an artificial induction of the afterbirth.
• Due to a large amount of amniotic fluid, the baby’s movement is not very restricted. Therefore, it may lie crosswise in the uterus during birth. In this case, your doctor will advise you to have a cesarean section.

What Are The Causes Of Polyhydramnios?

If you are diagnosed with polyhydramnios, this can be due to various causes. In milder forms of polyhydramnios, it is often not possible to specifically name the cause. The formation of too much amniotic fluid is usually due to the following causes.

Diseases Of The Baby

The baby is involved in the regular renewal of amniotic fluid in advanced pregnancy. From the 14th week of pregnancy, it usually begins to drink amniotic fluid. Through the baby’s kidneys, the ingested fluid is cleansed and then released as fresh amniotic fluid through the urine. This cycle can be disrupted if the baby has problems. If the baby has swallowing problems, not enough amniotic fluid is being removed. The baby may have swallowing problems, for example, if there are malformations of the gastrointestinal tract or if the esophagus is blocked. If kidney function is disturbed, increased urine excretion may be the result. Damage to the genetic material or bleeding in the baby’s brain can also be the cause of excessive amniotic fluid production.

Diseases Of The Mother

Malfunction of the placenta can cause polyhydramnios, as the placenta plays an important role in removing used amniotic fluid. Gestational diabetes is also a possible cause. The baby produces more urine when the mother’s blood glucose level is not properly regulated. Furthermore, an infection, for example with ringworm, or toxoplasmosis can be triggered by too much production or too little removal of amniotic fluid.

Presence Of A Multiple Pregnancy

In multiple pregnancies, there may be an imbalance in amniotic fluid distribution. This means that not all babies get the same amount of amniotic fluid, but one baby gets too much and another gets too little.

Therapy Of Polyhydramnios

Depending on the cause and severity of the condition, polyhydramnios is treated differently.

In mild cases with no apparent cause, your doctor will first wait and observe the further development. In the course of pregnancy, the amount of amniotic fluid regulates itself in most cases. This requires a lot of rest. To ensure that the self-regulation of amniotic fluid formation is not disturbed by stress, your gynecologist will prescribe a ban on working and give you sick leave.

In more severe cases, part of the amniotic fluid can also be aspirated. This reduces the pressure on the amniotic sac and the risk of premature labor. However, infections may occur as a result of the procedure, which may induce labor. Suctioning the amniotic fluid is also no guarantee that fluid will not accumulate again and need to be suctioned out.

Green Amniotic Fluid

If the baby excretes the so-called puerperal feces (meconium) while still in the womb during the first bowel movement, the amniotic fluid will turn a brownish-green color. As a rule, the baby’s meconium is not excreted until one or two days after birth. Even though the color can be described more as brownish-green, the term “green amniotic fluid” is used.

In the sixth month of pregnancy, the baby’s intestines form the first stool. You can find out what else happens during this phase at: https://www.practicalmommy.com/entwicklung-des-babys-die-zweite-haelfte-der-schwangerschaft/

Is Green Amniotic Fluid Harmful To The Baby?

Green amniotic fluid rarely causes an emergency. Children with green amniotic fluid are more often affected by infections, for example of the lungs, than children with normal amniotic fluid. Very rarely, green amniotic fluid is inhaled during birth, causing breathing problems. However, there are no good treatment options for this case.

If it is suspected that green amniotic fluid has been inhaled (meconium aspiration), an attempt is first made to aspirate as much meconium as possible from the mouth and throat. After that, breathing usually returns to normal. The baby will still be monitored but is usually healthy.

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Conclusion

Often, the abnormal increase in amniotic fluid is only detected during a screening examination. Pay attention to the symptoms described and contact your doctor if you observe something similar. Depending on the type of polyhydramnios, there are different treatment methods.