Complications of pregnancy Excessive water

Amniotic fluid volume continues to increase steadily around 34 th week of pregnancy if the amount tends to level off. In polyhydramnios, the “water sac” does not have a normal size, but rather exceeds the ideal during pregnancy.

Normal or average fluid volume is around 500-1000 ml (1 liter). When the volume exceeds two liters, it becomes noticeable to the mother, especially as her discomfort increases. Polyhydramnios occurs in about 1% of pregnancies.

In most cases, polyhydramnios is not a problem. Normal fluid production soon stabilizes outside of synchronization, and the extra fluid is reabsorbed by the mother’s body.

Where does amniotic fluid come from?

Amniotic fluid is produced by the baby’s kidneys. There is a constant circulation and processing of fluid in the baby’s lungs and stomach. When the fluid is digested, it is then excreted through the baby’s kidneys for processing. If the amount of amniotic fluid remains high and does not correct itself, the problem with the baby is suspected.

Mothers who develop polyhydramnios closely monitor the complications. Sometimes baby-related developmental problems, especially their ability to swallow or absorb fluids, are impaired. All cases involving the small intestine, esophagus, stomach, and diaphragm can lead to the development of polyhydramnios. Another reason for its development is if the baby has neurological problems or complications in the central nervous system.

Other risk factors for the development of polyhydramnios

• Mothers carrying several babies. This is because of the size of the placenta and the amount of space in its abdomen.

• Mothers with gestational diabetes are not being treated effectively for this.

• When the same twins were present and they developed a twin-twin transfusion. This is a condition that can occur when one baby receives more blood flow than the other.

• In most cases, the cause of polyhydramnios is unknown.

Risks of polyhydramnios

The earlier polyhydramnios is detected during pregnancy and the higher the amount of amniotic fluid, the higher the risk of developing complications.

• Premature birth (due to premature rupture of membranes)

• Placental abruption

• Cord prolapse

• The need for complications by cesarean section and these are additional complications compared to births with a normal vagina

• Postpartum hemorrhage is more likely, i.e. postpartum hemorrhage, because the uterus does not have muscle tone and cannot contract as much as it should.

• Having a child older than normal

• Birth

In most cases of polyhydramnios, there are no complications. As soon as the baby is born, the excess fluid comes out and the mother immediately feels comfortable.

Signs and symptoms of polyhydramnios

• Excessive and rapid weight gain (normal weight gain during pregnancy is around 12-16 kg)

• Rapid increase in maternal abdominal volume and increased discomfort

• Swelling of the legs and general swelling of the body

• Shortness of breath is only in the upright position

• A hard, tight abdomen makes it difficult for the baby to palpate and feel individual limbs

Polyhydramnios Hydrops (severe condition of the fetus) can also occur during an existing pregnancy. The child develops severe anemia and an abnormal combination of fluid, which leads to their heart failure.

How is polyhydramnios diagnosed?

Through clinical signs, for example, if the size of the mother's abdomen does not correspond to her gestational age. A measurement called amniotic fluid index (AFI) measures the pockets and depth of amniotic fluid that surrounds the baby. Ultrasound provides a clear window and picture of fluid volume and, if available, helps diagnose polyhydramnios. Normal AFI ranges from 7-18, and an AFI greater than 18 indicates polyhydramnios.

Treatment of polyhydramnios

There is no specific treatment other than careful observation of the mother. If the amount of fluid is excessive and the risk of preterm birth is high, then amniocentesis can be performed to shed some of the excess fluid. An obstetrician trained in the procedure should be involved. Ultrasound examination is usually performed at the same time so that there is no risk to the baby, umbilical cord or placenta.

Another method of treatment is a drug that reduces fluid production. However, this is not determined by the problems that can occur after 31 weeks of pregnancy, as it is important for mothers with polyhydramnios to get as much rest as possible. Excess fluid intake can lead to pregnancy fatigue, leg pain, and general discomfort.

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