What you need to know about polyhydramnios during pregnancy

If you are a mother-to-be, you must have heard about the water that surrounds your baby in your womb. In medical terms, we call this ' amniotic fluid '. This fluid is like a protective cushion for your baby. This fluid is essential to protect, nourish, and allow your baby to move around. But sometimes, the amount of this fluid can be more than normal. That is the condition we call Polyhydramnios. Don't be scared when you hear this name. Let's talk about it clearly and simply today.

First, let's see, what is this amniotic fluid?

Simply put, your baby is in a fluid-filled sac inside your uterus. We call this sac the amniotic sac. The clear fluid inside is called amniotic fluid. This is essential for your baby's growth. The baby swallows this fluid and adds it back to the fluid as urine. This is how the fluid levels are always balanced.

The amount of this fluid changes throughout pregnancy. On average, there is about 800 milliliters of fluid at about 34 weeks. However, as labor approaches, at about 40 weeks, this amount decreases to about 600 milliliters. Sometimes, this amount of fluid can be less than normal (Oligohydramnios) or more than normal (Polyhydramnios) .

So what is Polyhydramnios?

Polyhydramnios, as mentioned earlier, is when there is too much amniotic fluid in the uterus. This can cause your uterus to become larger than normal. This is most often seen in the latter part of pregnancy. However, it can sometimes occur as early as 16 weeks.

What are the causes of this increase in water in the womb?

It's often difficult to pinpoint the exact cause, but there are a few common causes that doctors have identified.

What symptoms might you experience if you have Polyhydramnios?

If your belly feels like it's getting a lot bigger in a short period of time, it could be a sign of polyhydramnios, a condition that occurs when the fluid builds up and puts pressure on the uterus and surrounding organs.

• If the amount of fluid is only slightly excessive (mild polyhydramnios): You may not have any symptoms.
• If the amount of fluid is too much (Severe polyhydramnios): You may experience one or more of the following symptoms:
• The stomach is very hard.
• Difficulty breathing.
• Digestive problems and chest inflammation.
• Constipation .
• Swelling of the thighs, legs, and feet.
• Uterine discomfort or contractions.
• Fetal malposition.
• Decreased feeling of baby's movements.

What complications can occur due to this condition?

If the amount of fluid increases too much in the early weeks of pregnancy (severe polyhydramnios), there is a risk of complications. It is important to be aware of these, but remember that these do not occur in everyone.

• Premature birth: Birth before 37 weeks.
• Premature rupture of membranes: The rupture of the amniotic sac (water bag) before delivery.
• Placental abruption: The placenta detaches from the uterine wall before the baby is born.
• Umbilical cord prolapse: The umbilical cord enters the vagina before the baby is born.
• Baby growth spurt: Baby getting bigger.
• Need for a cesarean section (C-section).
• Stillbirth: This is a very rare occurrence.
• Heavy bleeding after childbirth.

Don't be afraid to hear these things. Your doctor is well aware of these risks. That's why he will regularly check you and your baby and provide the best care possible.

How does the doctor diagnose this condition?

If you have the above symptoms, your doctor will first perform an ultrasound scan . This will measure the amount of fluid in your abdomen. There are two methods used for this:

1. AFI (Amniotic Fluid Index): Imagine dividing your uterus into four sections, measuring the deepest point of the fluid in each section, and adding them all together. If the sum is more than 24-25 centimeters, it is considered Polyhydramnios.

2. MPV (Maximum Vertical Pocket): This measures the depth of the deepest fluid pocket inside the uterus. If this value is equal to or greater than 8 centimeters, it is also diagnosed as Polyhydramnios.

In addition, other tests can be done to find the cause:

• Blood tests: To check if the mother has any infections or conditions such as diabetes.
• Amniocentesis: This involves using a very fine needle to take a small amount of fluid from the uterus and testing it. This can provide information about things like genetic problems in the baby.

Once this condition is diagnosed, your doctor will monitor you and your baby regularly, using tests such as a nonstress test (checking your baby's heart rate) and a biophysical profile (a scan that regularly checks your baby's movement, breathing, and fluid levels).

What are the treatments for polyhydramnios?

The good news is that most cases of mild fluid retention do not require any treatment . The condition will resolve on its own over time. It can also improve when an underlying cause, such as diabetes, is treated.

However, if the fluid is too high (severe) and you have difficulty breathing, abdominal pain, or signs of preterm labor, you may need treatment. You may even need to be hospitalized.

As treatment methods:

• Fluid removal: Similar to amniocentesis, a needle is used to remove excess fluid from the uterus. However, because this procedure carries a small risk of premature rupture of the membranes, your doctor will only do this if absolutely necessary.
• Medication: Medications such as Indomethacin may be prescribed. These reduce the amount of urine the baby produces and reduce fluid levels. However, these medications are given before 31 weeks of pregnancy. Since these medications can have some effects on the baby's heart, the doctor will regularly check the baby's heart.

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