This video shows a Pregnancy of 32 weeks with Polyhydromnios, fetal ascites, slow heart rate, and sluggish fetal movements.
If the initial ultrasound shows evidence of polyhydramnios, sonologist will be requested to do a more detailed ultrasound. Measurement of the amniotic fluid volume (AFV) by measuring the single largest and deepest pocket of fluid around the baby. An AFV value of 8 centimeters or more suggests polyhydramnios.
Common causes of polyhydramnios include gestational diabetes, fetal anomalies with disturbed fetal swallowing of amniotic fluid, fetal infections, and other, rarer causes. The diagnosis is obtained by ultrasound.
Ultrasound diagnosis:
• The vertical measurement of the deepest pocket of amniotic fluid free of fetal parts is used to classify polyhydramnios into mild (8-11 cm), moderate (12-15 cm), and severe (equal to or more than 16 cm).
• In about 80% of cases, the polyhydramnios is mild, in 15% moderate, and in 5% severe.
• Most cases of mild polyhydramnios are idiopathic, but most cases with moderate or severe polyhydramnios are due to maternal or fetal disorders.
• In most cases, polyhydramnios develops late in the second or in the third trimester of pregnancy. Acute polyhydramnios at 16-22 weeks is mainly seen in association with twin-to-twin transfusion syndrome.
Impact of Polyhydramnios on pregnancy
Most women with polyhydramnios will deliver healthy babies with no problems. If polyhydramnios is severe, it may make your uterus contract. You may also find it difficult to get comfortable in a chair or lying down.
With polyhydramnios, the risk of the following complications is increased:
Preterm contractions and possibly preterm labor.
Premature rupture of membranes.
Fetal malposition.
Maternal respiratory compromise.
Umbilical cord prolapse.
Uterine atony.
Abruptio placentae.
Moderate to Severe Polyhydramnios may cause the following symptoms:
Difficulty breathing.
Swelling in the lower extremities.
Swelling of the vulva.
Decreased urine production.
Constipation.
Heartburn.
Feeling huge or tightness in the belly.
Birth defects associated with Polyhydramnios
Persistent polyhydramnios has been associated with fetal aneuploidy, and polyhydramnios at birth has been associated with preterm delivery, unstable lie, malpresentation, cord prolapse, and placental abruption.
The AFI is normally 7 to 25 cm. In addition, each individual pocket of fluid should be 2 to 8 cm. Fluctuations outside of this range define oligohydramnios (too little amniotic fluid) or polyhydramnios (too much amniotic fluid).
In cases with multiple gestations, a range of 3-8 cm is defined as normal. With this method, polyhydramnios is classified as mild, moderate, or severe. Mild polyhydramnios is characterized by a value of 8-11 cm, moderate polyhydramnios by a value between 12-15 cm, and severe polyhydramnios by values above 16 cm.
Polyhydramnios is the term used to describe an excess accumulation of amniotic fluid. This clinical condition is associated with a high risk of poor pregnancy outcomes. The reported prevalence of polyhydramnios ranges from 0.2 to 1.6 % of all pregnancies.
It is wrongly believed that drinking a lot of water during pregnancy can cause swelling of the genitals of the woman and lead to abnormal development of the fetus. When the genitals swell, it is often attributed to an infection or too much fluid surrounding the baby, a condition called polyhydramnios.
Mild cases of polyhydramnios usually do not require any treatment. Your doctor will probably ask you to come in for extra checkups to make sure the condition does not become severe. In some severe cases, your doctor may decide that the best course of action is to induce labor early, at 37 weeks, or even sooner.
To treat polyhydramnios, doctors try to reduce the amount of amniotic fluid in the womb. This can prolong pregnancy and improve the woman's well-being. A doctor may use one of the following methods to reduce the volume of fluid: Reduction amniocentesis also called amnioreduction.
Gestational age Mean Standard deviation 5th percentile 10th percentile 50th percentile 90th percentile 95th percentile
34 weeks 14.59 1.79 11.7 12.0 14.6 17.0 17.3
35 weeks 14.25 1.57 11.1 11.8 14.2 16.2 16.4
36 weeks 13.17 1.56 10.6 11.0 13.2 15.3 15.7
37 weeks 12.48 1.52 10.1 10.2 12.6 14.7 15.1
38 weeks 12.20 1.70 9.8 10.0 12.1 14.4 14.7
39 weeks 11.37 1.71 8.8 9.1 11.4 14.0 14.4
40 weeks 10.99 1.55 8.7 8.8 10.8 13.5 13.7