Polyhydramnios

#atgPolyhydramnios

#atgoligohydramnios
What is polyhydramnios?

Polyhydramnios means you have too much amniotic fluid in your womb (uterus). Most cases of polyhydramnios are mild or moderate.
The amniotic fluid that surrounds your baby serves as protection from sudden trauma like falls or blow to your tummy, from infection, and it is important in the development of the lungs. 


Unborn babies would normally swallow amniotic fluid, and then pass it out as urine. This cycle is repeated till birth. 

When this delicate balance is disturbed, the volume of amniotic fluid can increase rapidly. 
Towards the end of pregnancy the amount of amniotic fluid usually decreases. 
Polyhydramnios is usually diagnosed when amniotic fluid volume is more than two litres. It could be as high as 3 litres in severe cases. 
If you notice that your tummy is getting unusually large and feeling more tight than usual, and that your skin is stretched and shiny , associated with being uncomfortable to breath, please kindly get a review. 
Polyhydramnios could build up gradually, or very rapidly in twin / higher order pregnancies. 
Symptoms of Polyhydramnios:

indigestion,heartburn,constipation,swollen legs,varicose veins, stretch marks
How is polyhydramnios diagnosed?

Ultrasound scans would provide a more qualitative assessment of the volume of amniotic fluid and can confirm a diagnosis of polyhydramnios. 
The sonographer will measure the amount of fluid in four areas around your baby to work out your amniotic fluid index (AFI) or use the deepest vertical single pocket measurement. 
Polyhydramnios is diagnosed when the AFI is more than 24 centimetres or if there is a single pocket of fluid that is more than 8cm deep . 
The higher the AFI, the more severe the clinical problem is. 
Sometimes the scan may also reveal a reason for the condition, such as a pregnancy complication.
What causes polyhydramnios and how is it treated?

The treatment you will receive will depend on the cause , severity of your condition and how far you are in to your pregnancy / how close you are to delivery. 
In milder cases it could resolve gradually , but close monitoring would be essential. 
If a specific cause for the Polyhydramnios is found in your case additional specialist care may be advised ; if so pls adhere to it. 
Cause of Polyhydramnios 
1. Uncontrolled Diabetes: This increases the volume of amniotic fluid your unborn baby produces; and you’re not already being treated for diabetes In pregnancy I would advice your seek a diabetes specialist; because when you diabetes is well controller this would reduce the amount of fluid. 
2. Infection : severe viral infections like could lead to increased am amniotic fluid. 
3. Twin-to-twin transfusion syndrome (TTTS) : Twin pregnancy with identical twins whereby they share a placenta are at risk of a complication called twin-to-twin transfusion syndrome which could lead to polyhydramnios. 
TTTS happens when one twin receives too much blood from the placenta and becomes overloaded with fluid. 
This leads to the twin receiving the excess blood producing more amount of urine, which results in too much amniotic fluid. 
Treatment could be to drain some of the fluid from around this twin to ease the pressure; and in severe cases laser treatment could be used to seal some of the placental vessels to the well-connected twin which could to even out the blood flow. 
4. Developmental malformations like blockage in his food pipe (oesophagus) or a problem with his muscle control leading to impairment In the passage of swallowed fluid or inability to swallow amniotic fluid. 
5. Chromosomal abnormality
A chromosomal abnormality, such as Down’s syndrome or Edwards’ syndrome, can sometimes be a cause of polyhydramnios. 
Treatment of Polyhydramnios 

Draining excess fluid In severe cases, treating any obvious cause like infections, diabetes, laser treatment in TTTS cases and considering c- section if closer to term. 
♨️Try to remember that most women with polyhydramnios go on to have healthy babies, particularly if the condition is mild.
♨️Symptomatic relieve of heartburn due to Polyhydramnios are : Eat small amounts more frequently, not lying down straight after eating food, don’t eat just before going to bed, Don’t eat or drink anything that makes your heartburn worse, such as spicy food, some may find relief if they sleep propped up in bed, and you get antacid prescription from you doctor. 
Edited by Dr. Babajide Alalade
©BabyCentre UK. 
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Dr Babajide Alalade

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