Nutrition for polyhydramnios during pregnancy. Treatment of polyhydramnios during pregnancy is a prerequisite for maintaining the health of the fetus

Pregnancy is a wonderful time, but a woman must be vigilant to protect not only her health, but also her unborn baby from pathologies. In fact, there are plenty of potential dangers when carrying a fetus; remember at least polyhydramnios as a serious pathological process.

So, polyhydramnios is an excessive accumulation of amniotic fluid in the uterine cavity. It’s worth clarifying right away that this problem is discovered on the third ultrasound, when the doctor reports that the volume of amniotic fluid exceeds the prescribed norm of 1-1.5 liters. This problem should not be ignored, since it prevents the fetus from staying in the womb and its timely birth. Before starting treatment for polyhydramnios during pregnancy, it is necessary to understand what is the cause of this pathology?

With polyhydramnios, the baby feels an excess of fluid surrounding him, which can lead to serious consequences for his health.

There are several reasons for polyhydramnios, but only a doctor can determine what exactly led to this pathology.

There are several reasons for this pathological process, but doctors present the most frequently diagnosed among them:

• multiple pregnancy;
• the presence of chronic diseases in the female body;
• exacerbation of infectious diseases;
• Rhesus conflict;
• large fruit;
• pathologies at the intrauterine level.

The problem is obvious, but the question arises: how to treat it correctly so as not to harm the baby or provoke complications with his health at birth?

Symptoms of the disease

Polyhydramnios during pregnancy can occur in acute and chronic forms. If in the first case the disease progresses spontaneously and can become the main reason for hospitalization; then the symptoms of chronic polyhydramnios are mild, but getting rid of them is very problematic.

A woman may not be aware of the presence of such a serious problem in the body, but increased swelling of not only the extremities should prompt her to worrying thoughts. In most cases, this pathological condition is clearly noticeable, and the expectant mother compares herself to a filled “barrel of water.”

Signs of polyhydramnios are heaviness in the abdomen, general weakness, shortness of breath, and others.

Among the main symptoms of polyhydramnios are the following:

• heaviness in the stomach;
• discrepancy between the size of the uterus and the ultrasound examination;
• gurgling and rumbling in the stomach;
• frequent shortness of breath;
• increased heart rate;
• decline in performance;
• general malaise.

Of course, such signs can also signal another disease in the pregnant woman, but it still won’t hurt to undergo a detailed diagnosis.

Detailed diagnostics

If the leading gynecologist suspects moderate polyhydramnios during pregnancy, treatment of the patient should begin with a detailed diagnosis, which will determine the problem and its causes, and also help select the most adequate treatment regimen for a specific clinical picture.

A thorough examination for suspected polyhydramnios includes a detailed blood and urine test, ultrasound and some other studies.

The study of pathology should begin with the following laboratory tests:

• general blood analysis;
• blood test for glucose;
• blood test to exclude (confirm) Rh conflict;
• general urine analysis;
• smear to study the vaginal microflora.

Additional results may be required:

• Ultrasound of the pelvic organs;
• Dopplerometry;

When reliable information is received, after carefully studying it, the doctor recommends undergoing a course of conservative treatment, which demonstrates its positive results and beneficial effects on the vital functions of the fetus in all trimesters of pregnancy.

Formal treatment for polyhydramnios

Most likely, a woman diagnosed with Polyhydramnios will have to undergo convalescence.

When diagnosing polyhydramnios, the doctor suggests that the woman be kept in bed, and then, while hospitalized, undergo complex treatment under strict medical supervision. First of all, the expectant mother needs to perform daily fetal cardiotography, measure blood pressure and monitor weight to avoid excessive weight gain. In addition, once a week, an ultrasound scan of the pelvic organs and Doppler sonography are required, which determines the vital signs of the fetus.

These are prerequisites for successful treatment. Even if a pregnant woman refuses to go to the hospital for preservation, she is also under medical supervision, regularly attends antenatal clinics, takes the required tests in a timely manner, and undergoes an examination.

As for drug therapy, it includes taking medications from several pharmacological groups at once, each of which has a positive effect on the fetus and a targeted effect on the problem.

1. Antibacterial therapy in the presence of infectious diseases, as an option - a course of Rovamycin or Erythromycin.
2. Diuretics for removing excess amniotic fluid (Furasemide).
3. Drugs that improve the quality of the placenta and prevent its premature aging.
4. Drugs to enhance placental blood flow.
5. Vitamin therapy (vitamins C, B and E).

Treatment of polyhydramnios is aimed at removing excess fluid from the body using diuretics.

As a rule, one course of treatment is enough to stabilize the condition of a pregnant woman and prevent premature birth. If a woman in an “interesting situation” does not trust official medicine, then you can always turn to the real help of traditional treatment. Its main purpose is to remove excess fluid from the body, and for this you need to take diuretic decoctions. As you know, rose hips, hawthorn, chamomile and other herbs that do not interfere with the normal course of pregnancy have a mild diuretic effect.

It is very important to coordinate any treatment with a doctor so as not to harm the baby’s health. With the right approach, the problem can be solved within a week.

Consequences of polyhydramnios

Many women simply do not understand how dangerous polyhydramnios is during pregnancy.

Timely diagnosis and treatment of polyhydramnios will help avoid many complications and preserve the baby’s health.

Its occurrence in a pregnant body can lead to the following pathologies:

• incorrect presentation of the fetus;
• indications for caesarean section;
• early placental abruption;
• acute fetal hypoxia;
• weak labor activity;
• umbilical cord prolapse during childbirth;
• development of late gestosis;
• vomiting in a woman and dehydration;
• swelling of the newborn's brain upon birth.

It is now clear that treatment of polyhydramnios is a prerequisite for the birth of a healthy and strong baby, otherwise problems with his health after birth simply cannot be avoided.

One of the pathologies that can really “fray the nerves” of a pregnant woman is polyhydramnios (an increase in the amount of amniotic fluid). Today the site - a site for expectant and current mothers - will talk about the treatment of polyhydramnios during pregnancy.

Briefly about polyhydramnios: treatment, causes, diagnosis

is a pathological increase in the amount of amniotic fluid, or in other words, amniotic fluid, at a certain stage of pregnancy. This feature occurs for reasons that are not fully understood by specialists, but presumably it could be diabetes in a woman, water infection, kidney disease, Rh conflict, cardiovascular disease in a woman, preeclampsia, multiple pregnancy, as well as pathologies of the fetus itself.

An obstetrician-gynecologist can determine the presence of polyhydramnios at an appointment if the size of the abdomen does not correspond to the due date.

This assumption is confirmed by an ultrasound examination, where it is precisely determined whether there is pathology and what its degree is.

How is polyhydramnios treated in traditional medicine?

Any form of polyhydramnios requires the woman to be admitted to a hospital. Before starting treatment of the patient, a comprehensive examination is carried out, which includes the following tests and studies:

• General blood and urine tests;
• Blood glucose tolerance test;
• Analysis for the presence of antibodies in the blood in case of Rh conflict;
• Smears from the urethra and vagina;
• CTG, ultrasound, Doppler.

When polyhydramnios is detected in pregnant women, treatment is based on test results. But in almost half of the cases the causes of this pathology remain unclear. In this case, a universal treatment regimen and the use of such drugs are used:

1. Diuretics (eg Furosemide, Canephron);
2. Magnesium and potassium preparations;
3. Medicines that improve blood microcirculation, including in the placenta (Actovegin, Curantil);
4. Broad-spectrum antibiotics, except tetracyclines (Rovamycin, Erythromycin);
5. Antiviral drugs and immunomodulators, in the presence of a viral infection;
6. The use of vitamin complexes, vitamins C, E and group B are especially important.

If there is moderate polyhydramnios, treatment may consist only of taking medications. But if there is too much amniotic fluid (acute polyhydramnios), doctors offer the woman therapeutic (or therapeutic-diagnostic) amniocentesis. During this procedure, amniotic fluid is very slowly pumped out through the abdominal cavity using a special catheter (up to 200 ml).

The site advises you to think twice before agreeing to this procedure, as it is quite dangerous and may have some side effects, including premature birth and miscarriage.

Treatment of moderate polyhydramnios during pregnancy: monitoring

Often, polyhydramnios is not “cured” and persists until childbirth (chronic moderate polyhydramnios). Then the woman can be left in the hospital or simply observed when visiting the antenatal clinic.

At the same time, some parameters are constantly monitored:

• Blood pressure, presence/absence, body weight control;
• Very frequent cardiotocography (CTG), if a woman is in the pregnancy pathology department - daily;
• Once a week – ultrasound and Dopplerography.

Polyhydramnios: treatment with folk remedies. Is it possible to?

Polyhydramnios, and pregnancy in general, is not a woman’s condition when one can rely on any folk methods, especially if they are not recognized by official medicine. When a woman develops a small life under her heart, all your decisions should be based on common sense and the recommendations of specialists.

Obstetricians and gynecologists emphasize: polyhydramnios cannot be treated with folk remedies!

They can only complement primary therapy, for example as vitamin supplements or diuretics.

Polyhydramnios: treatment and prognosis

Regardless of the period at which it was determined that the amount of amniotic fluid was too large, doctors always do everything possible to ensure that the birth takes place on time. One of the determining factors here is timely seeking medical help. Based on the fact that it is impossible to independently determine this pathology, it is necessary to regularly visit an antenatal clinic.

If the obstetrician-gynecologist leading your pregnancy suspects a problem in time, many of the very serious consequences of polyhydramnios can be avoided. With moderate polyhydramnios, the prognosis is always good, but with acute polyhydramnios, a very difficult birth can occur.

To avoid treating polyhydramnios during pregnancy, you can do everything to avoid this pathology at the stage when planning a baby. Even before conception, treat all chronic infections and diseases, lead a healthy lifestyle, and then the pregnancy will proceed without complications, and the baby will be born healthy and on time!

In the article we discuss polyhydramnios during pregnancy - types, causes, symptoms and consequences. You will learn why polyhydramnios is dangerous for mother and child, how to determine polyhydramnios by the amniotic fluid index, what is included in its treatment regimen and how to prevent its occurrence.

With polyhydramnios, the amount of amniotic fluid exceeds the norm

What is polyhydramnios during pregnancy? This is an excessive accumulation of amniotic fluid in the uterus. Amniotic fluid surrounds the baby and is very important for its development. Amniotic fluid protects the fetus from external influences and infections, ensures normal metabolism and freedom of movement, maintains temperature balance, and prevents compression of the umbilical cord.

When the fluid balance is disturbed and its amount exceeds the norm, polyhydramnios occurs.. Polyhydramnios in pregnant women is diagnosed in 1% of cases.

There are several types of pathology:

• by flow rate - chronic and acute polyhydramnios during pregnancy;
• by the amount of amniotic fluid - borderline, moderate and severe polyhydramnios during pregnancy.

With chronic polyhydramnios, the amount of amniotic fluid increases gradually, and the symptoms of the pathology are less pronounced. In acute polyhydramnios, the amount of amniotic fluid increases over several days or even hours. The size of the abdomen increases sharply, pain appears in the lower back and groin. This pathology threatens uterine rupture and requires artificial termination of pregnancy.

Most often, acute polyhydramnios occurs in the early stages, and chronic polyhydramnios occurs during late pregnancy.

Borderline polyhydramnios or a tendency to polyhydramnios during pregnancy is diagnosed when the amount of amniotic fluid corresponds to the upper limit of the norm, but does not exceed its value. Moderate polyhydramnios during pregnancy is defined if there are slight deviations from normal values, but there are no external manifestations. Severe polyhydramnios is accompanied by obvious symptoms - the stomach grows quickly, the woman feels the baby moving.

Why is polyhydramnios dangerous during pregnancy?

Polyhydramnios causes complications throughout pregnancy and childbirth. It is especially dangerous if polyhydramnios during pregnancy is diagnosed in the last stages of gestation - the consequences for the child and mother can be disastrous.

What are the risks of polyhydramnios during pregnancy for a woman:

• severe dehydration due to continuous vomiting;
• oblique, transverse or breech presentation of the fetus;
• heavy bleeding during pregnancy and after childbirth;
• premature placental abruption;
• development of late gestosis;
• spontaneous miscarriage or premature birth;
• weak labor due to overstretching of the uterus;
• prolapse of the umbilical cord and fetal limbs during childbirth.

Why is polyhydramnios dangerous for a child during pregnancy?

• reduced immunity;
• malformations of the gastrointestinal tract and central nervous system;
• fetoplacental insufficiency;
• prematurity;
• infection;
• fetal death.

Causes of polyhydramnios during pregnancy

Doctors still don’t know exactly why polyhydramnios occurs during pregnancy. However, they identify a risk group in which pathology occurs most often.

This group includes women who have been diagnosed with the following:

• diabetes;
• kidney diseases;
• infectious diseases - rubella, herpes, toxoplasmosis, cytomegalovirus;
• cardiovascular diseases;
• multiple pregnancy;
• Rhesus conflict;
• pathologies of the placenta.

Sometimes in the last stages the baby’s swallowing or excretory function is impaired, which causes polyhydramnios in pregnant women. Polyhydramnios also occurs if the child is too large or has developmental defects.

Symptoms of polyhydramnios during pregnancy

With polyhydramnios, there are a number of symptoms and signs that can tell a woman that something is wrong in her body.

What are the symptoms of polyhydramnios during pregnancy:

• chronic weakness and malaise;
• pain and heaviness in the abdomen;
• shortness of breath due to the high position of the diaphragm;
• swelling of the lower extremities;
• increased heart rate;
• abdominal volume 100-120 cm or more;
• a large number of rough stretch marks;
• the sound of gurgling inside the stomach.

Signs of polyhydramnios during late pregnancy:

• constant tension of the uterus;
• excessively high fetal activity;
• reduction in urine production.

The sooner you detect these signs, the more effective treatment will be.

Some women are interested in how to determine polyhydramnios during pregnancy on their own. The answer to this question is unequivocal - no way. You cannot diagnose yourself. You can only pay attention to external signs, for example, stretch marks that are too rough, and consult a doctor for an accurate diagnosis.

How to determine polyhydramnios in pregnant women

Polyhydramnios can only be detected through ultrasound

To diagnose polyhydramnios, a woman undergoes an ultrasound examination, during which the amniotic index is calculated - the volume of amniotic fluid. In addition to ultrasound, the gynecologist measures the abdominal circumference and the height of the uterine fundus to find out whether they exceed normal values. The doctor also palpates the uterus and reveals its tension and high mobility of the embryo.

Amniotic fluid index table

To determine the exact amount of amniotic fluid, the uterine cavity is divided into four squares, the largest area between the uterine wall and the fetus is measured in each of them, the indicators are summed up and the amniotic fluid index (AFI) is obtained.

The IAF is compared with a table of the normal amount of amniotic fluid, which shows indicators for different stages of pregnancy. According to this table, polyhydramnios during pregnancy occurs when the index goes beyond the limits of probable fluctuations. If you are 37 weeks pregnant and the indicator is at the upper limits of normal, that is, you have borderline polyhydramnios in the last stages of pregnancy, do not refuse hospitalization. You better be under the supervision of doctors.

Gestation period, weeks	Average normal value, mm	Probable fluctuations, mm
16	121	73-201
17	127	77-211
18	133	80-220
19	137	83-225
20	141	86-230
21	143	88-233
22	145	89-235
23	146	90-237
24	147	90-238
25	147	89-240
26	147	89-242
27	156	85-245
28	146	86-249
29	145	84-254
30	145	82-258
31	144	79-263
32	144	77-269
33	143	74-274
34	142	72-278
35	140	70-279
36	138	68-279
37	135	66-275
38	132	65-269
39	127	64-255
40	123	63-240
41	116	63-216
42	110	63-192

How to treat polyhydramnios during pregnancy

The first thing to do when the first signs of polyhydramnios appear is to forget about self-medication. Do not use pharmaceutical drugs or traditional medicine without consulting your doctor. They can be dangerous for your condition and will make you feel even worse. If you have symptoms of acute polyhydramnios, call an ambulance immediately. This is about your child's life.

Before treating polyhydramnios during pregnancy, its degree is determined:

• for mild polyhydramnios, therapy is not needed; the doctor prescribes more frequent examinations of the pregnant woman to monitor her condition;
• moderate to severe cases require hospitalization.

Since the development of polyhydramnios provokes chronic oxygen starvation of the fetus, it is necessary to quickly establish the cause of the pathology and cure it.

You will undergo additional examinations:

• general blood and urine analysis;
• blood sugar test;
• blood test for Rh conflict;
• flora smear;
• Dopplerometry;
• cardiotocography;
• Ultrasound of the fetus.

In some cases, the doctor performs an abdominal amniocentesis. During this procedure, a sample of amniotic fluid is removed from the uterus and fetal cells and waste products are examined to assess the health of the fetus.

Having found out the cause of polyhydramnios, the specialist will prescribe appropriate treatment.

Universal treatment of polyhydramnios during pregnancy includes several areas that gradually reduce the amount of amniotic fluid:

1. therapy of the underlying disease;
2. relief of painful symptoms - pain is effectively relieved by antispasmodics, such as No-shpa or Magnesia for polyhydramnios in pregnant women;
3. vitamin therapy - taking vitamin C, E and B vitamins is mandatory;
4. improvement of uteroplacental blood circulation and metabolism - tocolytics Ginipral and Partusisten dilate the uterine vessels, reduce the tone of the uterus; antiplatelet agents Curantil and Trental normalize the “fluidity” of the blood;
5. diuretics - for example, Furosemide;
6. therapeutic and diagnostic amniocentesis - in severe cases of polyhydramnios, up to 200 ml of amniotic fluid is slowly removed from the uterus;
7. a strict diet - fights thirst and excess fluid in the body well.

Regardless of whether an infection has been identified, a course of anti-inflammatory drugs and antibiotics is prescribed for polyhydramnios during pregnancy. In the case of urogenital infections, Vilprafen is often used for polyhydramnios in pregnant women. A stronger antibiotic is Ceftriaxone for polyhydramnios in pregnant women. It is useful not only in the treatment of infections of the genitourinary system, but infections of the skin, digestive and respiratory tract.

During the treatment process, the woman is under constant medical supervision. Every day, weight and blood pressure are measured, and fetal cardiotocography is performed. Every 5-7 days an ultrasound with Doppler ultrasound is performed. If the child’s condition stabilizes, pregnancy is maintained until 37-38 weeks. If there is no improvement or the amount of amniotic fluid increases, emergency delivery is performed.

Nutrition for polyhydramnios in pregnant women

Basic rules of diet for polyhydramnios in pregnant women:

• eat foods that contain animal and plant protein;
• exclude dairy products and fatty meats and fish from your diet;
• increase the amount of fruits and vegetables in the menu;
• drink plenty of water and fresh juice.

Prevention

Since the causes and consequences of polyhydramnios during pregnancy have not yet been clearly established, doctors have not developed specific preventive measures.

1. Plan your pregnancy. Before conceiving a child, undergo examinations, get tested for hidden sexually transmitted infections, cure caries, tonsillitis and other foci of chronic infection.
2. Register during pregnancy in a timely manner and do not miss routine gynecological examinations until 39-41 weeks.
3. Follow a proper diet and daily routine, avoid places with large crowds of people and other sources of infection.

The best prevention of polyhydramnios during pregnancy is regular ultrasound examinations. Only an ultrasound examination will detect the complication at an early stage, and after treatment you will be able to carry and give birth to a healthy child.

For more information about amniotic fluid, watch the video:

What to remember

1. What does polyhydramnios mean during pregnancy - excess amniotic fluid that surrounds the baby in the amniotic sac.
2. The diagnosis of polyhydramnios is made if the amniotic fluid index is greater than the upper limit of probable normal fluctuations.
3. Symptoms of polyhydramnios are weakness and shortness of breath, swelling of the lower extremities, an increase in abdominal volume, the appearance of rough stretch marks, gurgling sounds.
4. The causes of polyhydramnios are chronic and infectious diseases of the woman, fetal malformations, Rh conflict, multiple pregnancies.
5. Polyhydramnios can cause miscarriage or premature birth, complications during labor, birth defects, and death.
6. Treatment includes therapy for the underlying disease, vitamin therapy, normalization of uteroplacental blood flow and antibiotics.

Whenever, while carrying a baby, it comes to some kind of treatment, any pregnant woman, well, as a rule, always perceives such a prospect without enthusiasm and admiration. And many of us generally prefer to always do without the use of any serious medications, or at least during the period when we are carrying a child. However, unfortunately, such behavior is not always really possible. So, for example, if a pregnant woman has developed a condition such as polyhydramnios, then the expectant mother cannot do without adequate and urgent help from doctors.

Why does polyhydramnios during pregnancy need urgent treatment?

As we all know, amniotic fluid constantly surrounds the child and so on throughout the entire period while the baby develops in utero. This liquid, or as we are more accustomed to calling it, water, not only serves as a habitat for the unborn baby, but it also provides him with absolute freedom of movement in the tummy. In addition, water also has a protective function; it perfectly protects the baby from quite likely mechanical damage that may appear from the outside, and in general, water maintains a small and constantly growing organism in a normal state. Modern scientists claim that, as a rule, amniotic fluid even smells almost like mother's milk. Actually, this is why the little angel literally just born into this world, being still very small and helpless, always knows exactly where exactly his mother’s warm breast is right now.

But throughout the entire pregnancy, the total amount of amniotic fluid changes almost constantly. So, at the beginning of pregnancy, they constantly and very rapidly increase in volume, and then, on the contrary, the amniotic fluid should become less and less in relation to the growing child. However, as you understand, constantly, throughout the entire period of pregnancy, there is a certain norm, which doctors necessarily focus on when examining every pregnant woman.

A deviation downward from this norm determined by doctors is the so-called oligohydramnios, but a deviation upward from this norm is polyhydramnios. Moreover, the latter does not occur very often, but at the same time it can be fraught with many real dangers. So, the baby, which is in too much of that same amniotic fluid, is more active precisely in the later stages of pregnancy, when normally its movements should already be really constrained by the constant decrease in the space surrounding it. And believe me, there is nothing good in such a state, because, tumbling freely like this, your baby may well be wrapped in his own umbilical cord, sometimes even more than once.

In addition, a female amniotic sac overflowing with water really runs the risk of rupturing prematurely, which, of course, is fraught with the onset of the entire labor activity much earlier than the due date. Childbirth during a polyhydramnios pregnancy is usually extremely difficult, and labor is usually weak, sometimes it can stretch itself excessively, and because of this, excessive bleeding may occur during childbirth. There is definitely also a risk of developing premature aging or even placental abruption. In addition, polyhydramnios is also dangerous due to the development of so-called fetoplacental insufficiency, and as a rule, the postpartum period with polyhydramnios also always occurs with dangerous complications.

With polyhydramnios, the unborn baby usually suffers as well. Real complications during childbirth usually prevent the baby from being born normally and easily. And in particular, there is a huge risk of developing such a condition as infant asphyxiation, as well as depression of the children’s central nervous system and possibly the gastrointestinal tract system. Let us recall that even during the period of intrauterine development of the baby, polyhydramnios may well become a real cause of the development of some of the most dangerous pathologies in the baby, this is exactly what modern doctors believe.

How should polyhydramnios usually be treated during pregnancy?

The main ones have not been studied well enough to date, however, among the available probable causes, modern doctors identify diseases such as diabetes mellitus, nephritis, a condition such as Rh conflict, some diseases in the cardiovascular system, as well as intrauterine infections and many others.

And of course, before you begin treatment for polyhydramnios that occurs during pregnancy, which is mainly carried out in an inpatient setting, your doctor will have to establish the real reason why this condition developed in the first place. But for this, any pregnant woman will have to be sent for a number of specific examinations (this includes ultrasound with Doppler, CTG, and a general blood test and, of course, a smear for possible infections, and in case of Rh conflict, an analysis for existing antibodies).

Actually, your further tactics will depend on the real cause of this condition. So, if there is a Rh conflict between mother and child, it is quite possible that urgent administration of immunoglobulin will be necessary, but, for example, intrauterine infections are definitely treated only with antibiotics. It should, however, be recognized that in almost a third of all existing cases, the causes of such pathology remain incompletely clarified. That is why, over the years, our doctors have already developed a completely “universal” standard regimen for the treatment of polyhydramnios during pregnancy. Most often, the complex of mandatory prescriptions for the occurrence of polyhydramnios includes multivitamins (and vitamins of groups B, E and, of course, C), necessarily magnesium preparations, fairly strong diuretics, and some kind of antibiotic that has a wide spectrum of action, no less Special dietary nutrition is also important.

But in general, treatment of such a condition as polyhydramnios pregnancy is aimed directly at a sharp decrease in the amount of the same amniotic fluid. Also, the maximum improvement and even stabilization of the general condition of the baby is expected from the treatment. Of course, during this treatment, the condition of the woman herself and her child will have to be monitored almost constantly by experienced specialists.

And almost always, doctors try to both maintain and prolong the existing polyhydramnios pregnancy as close as possible to the initially expected, correct date of birth. But if, despite observing all the necessary measures, a real tendency to improve the condition is not observed, then, as a rule, a decision is made to carry out an early delivery. In cases where this is not at all possible (for example, in the very early stages of pregnancy), doctors can resort to removing a certain strictly defined amount of amniotic fluid. And this is usually done by simply puncturing the amniotic sac (or amniocentesis). But believe me, it really rarely comes to this.

But timely seeking qualified help from doctors will be of decisive importance when prescribing treatment for polyhydramnios that occurs during pregnancy. Therefore, never delay your visit to the doctor if you think that you are experiencing any possible signs of such a condition as. Usually, we can talk about polyhydramnios when, against the background of general severe malaise, constant weakness, shortness of breath, and even a sharp increase in heart rate, a pregnant woman begins to notice that the total number of stretch marks is rapidly increasing directly in the abdominal area.

Also, a real symptom of polyhydramnios is considered to be the sensation when, at the slightest change in the position of the body, or rather the abdomen, a woman feels some gurgling and even rolling of water. In addition, with polyhydramnios, there is a sharp swelling of the legs, and even pain or heaviness is felt directly in the abdomen. If you notice that the volume of your abdomen is increasing too rapidly, as they say, right before your eyes (meaning within one day or hours), your uterus is sharply tense, and the anterior abdominal wall itself is constantly swelling, then we are definitely talking about about the acute condition. Moreover, in such a condition, you should go to the nearest hospital, simply immediately, without even wasting time on the arrival, usually of an ambulance. We hasten to reassure you, in real life, such dangerous cases occur quite rarely. However, still be as vigilant as possible! And may everything work out well for you and your future baby!

Polyhydramnios is a pathological pregnancy caused by excess amniotic fluid.

The fetus is surrounded by a bioactive liquid substance, which gives it the opportunity to move freely and train vital skills (swallowing and breathing). In addition, amniotic fluid takes an important part in labor.

Thanks to this “living water”, ideal conditions are created for the child: a stable temperature is maintained - 37 ° C, loud sounds are dampened, and any shock impacts are softened. The volume of amniotic fluid increases in accordance with the size of the child, for example:

• at week 10 it is 30 ml;
• on the 14th - 100 ml;
• on the 20th - 500 ml;
• from the 38th to childbirth - 1-1.5 liters.

It would seem that an increase in the useful water environment beyond the norm cannot cause harm. But medical practice proves the opposite. It is considered unfavorable when by the end of pregnancy the volume of water exceeds one and a half liters (according to some foreign experts - two liters). Clinical consequences occur when the volume of fetal fluid reaches 3 liters or more.

In such cases, this pathology is dangerous both for the child and the pregnancy itself. Why it occurs, what it threatens and how to prevent the negative complications of polyhydramnios, read our article.

Causes of occurrence

To endure this condition with minimal consequences or to avoid them completely, you need to understand what it is. All links of the unified system “woman - placenta - fetus” participate in the formation of amniotic fluid.

As the baby grows, it swallows fetal fluid, receiving nutrients from it. After processing, it is excreted into the amniotic sac in the form of urine. In this case, every three hours the fetal fluid is completely renewed.

Due to various negative reasons, the optimal balance may be disrupted. When the production of fetal fluid prevails over excretion from a woman’s body, its amount increases disproportionately.

To control, doctors use the amniotic fluid indicator, which is calculated during an ultrasound. If its index exceeds the table limits, then polyhydramnios is diagnosed.

Types of polyhydramnios in pregnant women

Given the variety of reasons, while expecting a baby, pathology occurs individually in women. Depending on the speed of the process, two forms are distinguished. The worst consequences are fraught with acute polyhydramnios in the early stages: from the 16th to the 20th week. It is characterized by a hurricane increase in the amount of amniotic fluid. The acute process occurs at lightning speed: within a few days, in rare cases even hours.

At the same time, the pregnant woman’s condition worsens sharply: she feels increasing pain in the lower back and perineum. Swelling of the abdominal wall is likely, which is noticeable visually. Increasing stress on the walls of the uterus can lead to uterine rupture and premature birth. A threatening condition for the fetus requires active treatment and emergency care.

Chronic polyhydramnios is more common during pregnancy. It occurs mainly at a later stage. It differs from acute symptoms by a gradual increase in the amount of water and more subdued symptoms. Despite the fact that childbirth occurs on time, it also has a bad effect on the child’s well-being.

Diagnosing chronic polyhydramnios can be more difficult, so a woman should be aware of certain symptoms of trouble. In case of suspicion, you need to promptly report them to the obstetrician leading the pregnancy.

Characteristic signs of polyhydramnios

• feeling of heaviness and pain in the abdomen;
• tachycardia;
• swelling;
• an increase in the size of the abdomen to 100 centimeters or more;
• severe stretch marks on the abdomen.

We should not forget that most symptoms are relative in nature and are characteristic not only of polyhydramnios, but also of other pathologies of pregnancy. Therefore, you should not take any measures based solely on them. It is enough to inform the doctor about the causes of concern, who will prescribe the necessary tests and examinations.

On an ultrasound, the diagnostician can see an increase in the height of the uterine fundus, as well as fetal activation. During a routine examination, a doctor may be alerted by the high density of the uterus during palpation and a dull fetal heartbeat.

Why does polyhydramnios develop?

The reasons for the imbalance in the volume of amniotic fluid have not been fully established. In approximately a third of cases, modern medicine is not yet able to accurately determine the specific provoking factor. However, in most situations it is still possible to trace the relationship. The red list includes the following negative reasons:

• diabetes;
• infections during pregnancy, mainly in the genital area;
• inflammatory urological diseases;
• Rh conflict between mother and fetus;
• fetal malformations.

Another possible cause of polyhydramnios is the child’s active swallowing of amniotic fluid. In turn, this disrupts the update process.

Adverse effects of polyhydramnios

In the early stages, pathology can cause toxicosis and placental insufficiency. In the most severe case - spontaneous abortion.

In the later stages, in the absence of medical assistance, the negative consequences become even more numerous. A child is at risk of polyhydramnios:

• entanglement of the umbilical cord due to active movement;
• hypoxia;
• developmental delay;
• intrauterine infection;
• death due to placental abruption.

After birth, children may have reduced immune defenses. For this reason, they grow weak and painful.

Consequences for a woman:

• dehydration due to frequent vomiting during toxicosis;
• massive bleeding;
• late gestosis;
• more complex postpartum rehabilitation.

Childbirth with polyhydramnios

In addition to pregnancy complications, excess amniotic fluid negatively affects the process of delivery. A spacious intrauterine space provokes malpresentation of the fetus, which is fraught with complications during childbirth. If childbirth is independent, then the following negative aspects cannot be ruled out:

• absence or missed contractions due to decreased tone;
• entanglement of the baby's umbilical cord;
• weakness of labor;
• profuse bleeding.

Treatment and diagnosis of polyhydramnios

The earlier this condition is detected, the higher the likelihood of a full pregnancy and successful childbirth. The diagnosis of polyhydramnios is made after a visual examination and an ultrasound diagnosis. If confirmed, fetal CTG is recommended. To exclude adverse consequences of pregnancy, blood is taken for intrauterine infections.

From the moment the pathology is discovered, the expectant mother requires close medical supervision. If there are no serious signs of circulatory and respiratory problems, they strive to bring the pregnancy to physiological resolution. With mild polyhydramnios, the woman stays at home and is treated on an outpatient basis.

Moderate pathology may require hospitalization, where the pregnant woman is under medical supervision around the clock. The classic treatment regimen for the consequences of polyhydramnios includes:

• antibiotic therapy;
• drugs to stimulate blood flow;
• immunocorrectors;
• diuretics;
• vitamins.

If a specific cause of the pathology is found, then the main efforts will be aimed at eliminating it. For example, with polyhydramnios caused by an infectious or inflammatory disease, specific therapy is required to suppress the pathogen.

As a rule, doctors are able to maintain a pregnancy until its natural completion without inducing labor. In case of complicated polyhydramnios, if there is an obvious threat to women's health, the decision to give birth early is justified. If timing allows, a caesarean section is performed.

In emergency situations, when the period is still quite short, they resort to releasing amniotic fluid. Since this procedure has a high risk of negative consequences, it should be carried out with extreme caution.

Doctors warn that if you have polyhydramnios, it is categorically not acceptable to be treated with folk remedies, or to follow the advice of “experienced” friends. This is fraught with harmful consequences for the fetus and the pregnant woman.

Prevention

Expectant mothers rightly ask the question: “What to do in advance to avoid the occurrence of polyhydramnios?” Considering the severity of the possible consequences, women's anxiety is completely justified. Having remembered the causes of the pathology, we must try to eliminate those negative factors whose connection with polyhydramnios has been proven.

We are talking about identifying and treating infections at the planning stage of conception and preventing infection during pregnancy. It is necessary to undergo diagnostics for the presence of diseases and Rh incompatibility, which can lead to polyhydramnios. Banal prevention will help eliminate many medical problems during this joyful period of a woman’s life. Don't forget about simple things:

• strictly follow medical instructions;
• undergo routine ultrasounds and other mandatory examinations during pregnancy in a timely manner;
• eat well and drink enough fluids;
• do not get too cold;
• avoid public places during ARVI epidemics;
• eliminate stress and overexertion;
• If you experience any alarming symptoms, consult your doctor immediately.

How to feel better with polyhydramnios?

Frequent companions of polyhydramnios are shortness of breath, swelling, and rapid heartbeat. To make it easier to bear these unpleasant symptoms, doctors advise limiting physical activity associated with carrying heavy bags and doing household chores. Avoid strenuous climbs up stairs and escalators and try to move more slowly.

An enlarged uterus puts pressure on the stomach, often causing heartburn. To avoid this, nutritionists advise eating frequently and in small portions, giving up smoked, fatty, spicy, fast food and coffee. A special pillow for pregnant women is ideal for relaxation and sleep. For painkillers, the doctor may recommend noshpa, which is harmless during pregnancy.

If a woman experiences obsessive anxiety, she needs to try to distract herself: visit a pregnancy club, look for new sources of positive emotions.

The professionalism of the medical staff helped many mothers to bear and give birth to a strong baby, despite the presence of such a pathology. A positive attitude and friendly support from the environment play an important role.