On the way to motherhood, a woman can face many dangers. Fortunately, modern medicine today has stepped far forward and has the ability to diagnose and treat many pathologies in the initial stages. What is polyhydramnios during pregnancy? What are the causes and consequences for the child?
Definition
Polyhydramnios is called pathological accumulation of a large amount of amniotic fluid in the last trimester of pregnancy. The main function of amniotic fluid is to protect the fetus from external influences, to prevent crushing of the umbilical cord, as well as providing space for movement.
At different stages of pregnancy, different norms of the amount of amniotic fluid are noted. At 10 weeks, the norm is about 30 ml of water, at 14 weeks - 100 ml, at 37-38 weeks - 1.5 liters of liquid. If there is a greater amount of fluid than is accepted by the norm, we can talk about polyhydramnios.
Symptoms of pathology
The causes of polyhydramnios during pregnancy in the later stages can be a large number, however, despite the reason for the occurrence, they have the same manifestations. Only the acute and chronic forms of the course of the pathological condition differ. In the acute form, symptoms develop much faster than in chronic. So, for example, they can appear within a few hours. Polyhydramnios can be suspected if such manifestations are observed:
- Stretch marks on the abdomen, which indicate a large uterus. In this case, the volume of the abdomen of a pregnant woman may exceed 115-120 cm.
- Abdominal pains that are aching.
- Feeling of heaviness.
- Malaise, weakness, as in the onset of a cold.
- Severe swelling of the lower extremities.
- Increased heart rate.
- When changing position, walking you can hear gurgling in the stomach.
- The appearance of shortness of breath even with minor physical exertion, for example, when climbing stairs.
With the rapid development of polyhydramnios, a pregnant woman needs hospitalization. In serious cases, termination of pregnancy or artificial birth may be necessary, otherwise there is a chance of having a baby with developmental pathologies.
Reasons for polyhydramnios
To date, it is not known exactly what causes the disease. However, there are reasons for polyhydramnios during pregnancy, because of which a woman is at risk:
- Diseases of the genitourinary system, impaired renal function.
- Chronic cardiovascular disease.
- Infectious diseases or inflammatory processes in the body.
- The Rhesus conflict of the mother and the fetus, as a result of which the woman’s body begins to perceive the child as a foreign body, and make attempts to get rid of him.
- With multiple pregnancies with different amniotic sacs, polyhydramnios may develop in one baby and oligohydramnios in another.
- Decreased excretory function of the fetus.
- Large size and weight of the child.
- The presence in the history of a pregnant woman with type 1 or type 2 diabetes.
- Malformations in a child.
- Violation of the swallowing function of the fetus. Normally, amniotic fluid is constantly updated, as the baby swallows about 500 ml of fluid in 24 hours.
One or a combination of several causes of polyhydramnios during pregnancy can cause pathology.
Types of disease
A variety of causes of polyhydramnios during pregnancy lead to these types of pathological conditions:
- Pronounced - noticeable upon examination (large abdomen, increased activity of the child, complaints of a woman about pain in the lumbar spine).
- Idiopathic - polyhydramnios during pregnancy with good tests. the reasons for which could not be determined.
- A mild form in a full-term pregnancy, when the volume of amniotic fluid is increased, but does not exceed 3 liters.
- The average is characterized by an increase in amniotic fluid to 5 liters.
- Severe - diagnosed in the case of a pathological increase in fluid volume over 5 liters.
- A chronic form of the development of pathology is noted in the case of a gradual increase in the amount of amniotic fluid.
- Acute - when the water level rises rapidly.
The greatest danger to the woman and the fetus is the acute form of the development of pathology, as well as an increase in the amount of fluid to a critical mark - above 5 liters. In this case, emergency hospitalization, artificial birth or cesarean section is indicated.
Moderate polyhydramnios
There are several degrees of severity of the pathology. The causes of moderate polyhydramnios during pregnancy can be as follows:
- Increased blood sugar.
- Toxicosis in late pregnancy (preeclampsia).
- Genetic diseases.
- Problems in the functioning of the placenta.
Moderate polyhydramnios does not pose a particular danger to the mother and child, since an increase in the volume of fluid is insignificant. However, if the doctor does not control this process, there may be the following complications:
- fetal freezing;
- premature birth;
- anomalies in the development of the child;
- pregnancy overtaking.
In some cases of moderate polyhydramnios, a pregnant woman is recommended to be in a hospital.
Chronic polyhydramnios
This form of pathology is characterized by the gradual filling of the amniotic fluid with an increase in the amount of fluid. In addition to the standard symptoms of pathology, with chronic polyhydramnios, such manifestations are noted:
- deviations in the height of the uterus;
- an unnaturally large and convex navel;
- a tight and tense stomach;
- pain during fetal movement;
- varicose veins (spider veins, bulging veins, swelling and tired legs);
- increased urge to urinate, while the amount of outgoing urine is minimal (this occurs with increased pressure of the uterus on the bladder);
- reduction in the number of fetal movements.
Despite the fact that polyhydramnios is manifested in a small percentage of pregnant women, no one is safe from it. That is why you need to regularly visit a gynecologist in order to recognize the pathology in time and minimize risks.
Polyhydramnios at an early stage
As a rule, a pregnant woman suffers from the problem of excessive amniotic water in the late stages. However, idiopathic polyhydramnios occurs during pregnancy up to 28 weeks, the causes of which are not fully known. In most cases, it does not carry a danger and eventually passes by itself.
Possible risks
Dangers in pathology lie in wait for a number of reasons. The consequences of polyhydramnios during pregnancy can be as follows:
- There is a strong stretching of the walls of the uterus, because of which there is a risk of detachment of the placenta.
- Premature birth.
- Too much space in which the baby is located can prevent him from taking the correct position before childbirth (head presentation).
- Heavy bleeding during and after childbirth.
- The occurrence of toxicosis in late pregnancy.
- Frequent and unreasonable vomiting, which can lead to dehydration.
- The development in a child of pathologies from the gastrointestinal tract and nervous system.
- Decreased fetal immunity and the risks of infectious diseases.
Often, in case of polyhydramnios, a cesarean section is recommended, since natural childbirth can be complicated by the following points:
- weakness of labor;
- prolapse of the umbilical cord or limbs of the child;
- amniotic rupture;
- transverse or gluteal presentation of the child.
This condition should be under medical supervision. Only in this case can a lot of unpleasant consequences be avoided.
Diagnosis of the disease
Clarification of the causes of polyhydramnios during pregnancy and treatment of the consequences is impossible without modern diagnostic methods. Feeling the first symptoms, the woman turns to the gynecologist, who, on the basis of the patient's complaints, prescribes the necessary studies:
- Ultrasound diagnostics is the most accessible and informative way to determine polyhydramnios. An image is displayed on the monitor of the device, analyzing which, you can diagnose the problem.
- Cardiotocography, which is necessary to assess the condition of the fetus.
- Dopplerography of blood vessels for the study of the uterus and baby.
- General blood analysis.
- Laboratory studies of a smear to examine for vaginal infections.
It is important not to ignore the need for tests and studies, as they are the key to prescribing the right treatment for polyhydramnios.
Pathology treatment
Depending on the causes of polyhydramnios during pregnancy, adequate therapy is prescribed at 33 weeks. First of all, it is necessary to exclude the factor that provoked an increase in the amount of amniotic fluid. Therapy consists of the following points:
- After diagnosing the problem, you must deal with the root cause. For example, when a water infection is detected, drugs may be injected into the amniotic membrane. If polyhydramnios is triggered by diabetes, the expectant mother is prescribed drugs to maintain normal blood sugar and stabilize carbohydrate metabolism.
- Fighting fetal hypoxia, which may occur due to an increase in amniotic fluid levels. Drugs are used to improve blood flow in the vessels: Curantil, Trental.
- With an increased tone of the uterus, medications are needed to reduce it. Often used tocolytics such as Ginipral, Partusisten, Indomethacin, and antispasmodics: No-Shpa, Spazmalgon, Papaverin.
- The drug "Actovegin" to normalize glucose-oxygen metabolism in the placenta.
- Vitamin complexes to increase the level of immunity in a pregnant woman.
- Diuretics to lower amniotic fluid. In rare cases, mechanical withdrawal of excess fluid by amniocentesis is necessary.
In the acute course of pathology, medications may not give the expected result. In such cases, premature birth or termination of pregnancy is indicated, depending on the duration of the pregnancy.
Childbirth with pathology
The causes and consequences of polyhydramnios during pregnancy are diverse. Most often, a woman is contraindicated in natural childbirth. Therefore, the following techniques are used to preserve the fetus and normal delivery:
- Puncture of the bladder is necessary for the outflow of excess amniotic fluid. At the same time, it is carried out carefully so as not to catch a part of the child’s body with the tool.
- When the amniotic bladder ruptures, the doctor should place his hand in the vagina in order to prevent the loss of the baby's umbilical cord or limb.
- If it is necessary to stimulate labor by oxytocin or other drugs, it is necessary to avoid premature placental abruption. For this, the drug is administered no earlier than 2 hours after the outflow of water.
- With weak labor, drugs are used that stimulate contractions.
Depending on the reasons, the consequences for a child with polyhydramnios during pregnancy can be different. In most cases, the baby requires being in intensive care during the first days of life.
Disease prevention
To prevent pregnancy complications, the expectant mother must adhere to the following recommendations:
- A history of chronic diseases must be brought into remission. This is especially true of diabetes, hypertension.
- Check with a gynecologist for the presence of urogenital diseases and treat them in a timely manner.
- At the beginning of pregnancy, take vitamin complexes.
- Regularly visit a gynecologist, as well as carry out his appointment.
In preparing the body for conception, it is necessary to lead a healthy lifestyle. In this case, the likelihood of carrying a child without problems increases significantly.
Finally
The causes of polyhydramnios during pregnancy at 32 weeks and other periods are varied, and in most cases it is impossible to establish exactly what served as an impetus for the development of pathology. In addition to the discomfort and pain experienced by a woman with such a diagnosis, complications can also be from the respiratory system, since an enlarged uterus presses on the diaphragm, making it difficult for air to enter. In addition, polyhydramnios can cause early detachment of the placenta, weak labor, excessive bleeding during childbirth. It is important not to allow pregnancy with a pathology to gravity, since the consequences can be disastrous.