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Polyhydramnios during pregnancy for how long does it appear? Is polyhydramnios dangerous in chronic form? What is usually prescribed by an obstetrician-gynecologist


The causes of polyhydramnios during pregnancy are diverse.

1. Diseases of the mother. Diabetes mellitus must be mentioned among the most common causes. It was believed that it occurs because there is a lot of sugar in the amniotic fluid, or because the fetus excretes too much urine, but research has not confirmed this. Polyhydramnios in diabetes mellitus develops due to the fact that microcirculation in the vessels of the placenta is impaired. Of all cases of polyhydramnios, a third develops in women with diabetes mellitus.
In addition, polyhydramnios can be in women suffering from cardiovascular diseases, kidney disease.

2. Diseases of the fetus. Polyhydramnios often accompanies congenital malformations, for example, esophageal atresia or malformations of the central nervous system. Often these abnormalities are incompatible with the life of the fetus. They are diagnosed with an ultrasound examination. Another important cause is hemolytic disease of the fetus and newborn. With Rh-conflict, polyhydramnios occurs with a frequency of up to 95%.

3. Twins. Monoamniotic twins often cause polyhydramnios, because in almost 100% of cases there is a discharge of blood through an additional vessel (shunt) of the placenta from one fetus to another. At the same time, polyhydramnios develops, since this fetus secretes more urine, and a difference in weight between the twins is formed. Often this is acute polyhydramnios in the early stages of pregnancy (16-20 weeks).

4. Infections. The role of intrauterine infection with STDs such as chlamydia, ureaplasma and some others has been proven. Please note that we are talking about an infection of the uterine cavity, these infections are found in smears much more often than they cause such a problem.

5. Dysfunction of the membranes themselves with excessive secretion of amniotic fluid. This is the rarest reason, if you exclude all of the above. Based on the foregoing, in each specific case, the answer to the question of why polyhydramnios does not lie on the surface, and requires an in-depth examination.

Polyhydramnios, symptoms

The signs of polyhydramnios are not always obvious, only acute polyhydramnios has obvious symptoms. If it develops slowly, gradually, the woman manages to adapt to it and feels good. The tendency to polyhydramnios can appear very early, as early as 16 weeks, and is often noted for the first time on an ultrasound examination. Often this early polyhydramnios is associated with twins.

However, gynecologists know how to determine polyhydramnios without this examination.

The fundus of the uterus is more than 3 cm higher than it should be with the current gestational age, the uterus seems unusual to the touch (fluctuation, or swelling when examining, as if water was poured into a bag), parts of the fetus are poorly felt, it is too mobile, and the heartbeat is heard from labor.

With acute polyhydramnios, a woman is worried about a feeling of pressure on the perineum, abdominal pain due to the rapid stretching of the uterus, she herself notices that the abdomen is tense and increases too quickly. Shortness of breath and palpitations may bother, many have edema.

Moderate, slowly developing polyhydramnios does not cause much discomfort.

Quite often, a woman hears on an ultrasound the term polyhydramnios with suspension. What does this mean, and is it worth worrying? In fact, suspension in amniotic fluid is not always a pathology. In most cases, this is a desquamated epithelium of the fetus and a high content of protein substances, and does not say anything terrible. Only when this suspension is in large flakes and is combined with other symptoms, there can be a suspicion of its meconium nature, which happens during fetal hypoxia (distress) and requires some action. If the doctor after the ultrasound did not call an ambulance, but let you go home calmly, there is nothing to worry about, everything is not so scary.

Why is polyhydramnios dangerous?

Why is polyhydramnios dangerous during pregnancy? What threatens mother and child?

First of all, polyhydramnios is a threat to the child. His small world in which he lives is disrupted, and this can cause him to lack nutrients and oxygen. Acute polyhydramnios can cause premature placental abruption and death of the child. The baby can get tangled in his own umbilical cord, due to the fact that he is too free, the formation of an incorrect presentation is possible (the most dangerous is the oblique and transverse position of the fetus). This is what is bad about polyhydramnios, and if such a diagnosis is made, treatment is vital.

Polyhydramnios, amniotic fluid index

If a pregnant woman polyhydramnios, amniotic fluid index today it is one of the most accurate methods of its assessment. It is calculated during an ultrasound scan of a pregnant woman, evaluating the free space filled with fluid that remains between the child's body and the wall of the uterus. Previously, polyhydramnios was assessed by measuring the pocket of free fluid in the most "free" place for visualization, but this was not very accurate, now the tummy is conventionally divided into 4 squares, and this level is measured in 4 places, then summed up. The resulting figure is IAZH. The assessment is carried out according to the table, in a simplified form it is presented below. You can see the rate for your gestational age and the permissible deviations of the amniotic fluid index in both directions, both with polyhydramnios and oligohydramnios.

Polyhydramnios- This is a pathological condition during pregnancy, when the amount in the amniotic cavity exceeds the normal values ​​characteristic of a given period.

The exact amount of amniotic fluid is determined by ultrasound. For this, the uterine cavity is conventionally divided into four parts and the largest area between the fetus and the wall of the uterus is measured. The result is an indicator called amniotic fluid index... Its excess above normal values ​​indicates the development of polyhydramnios.

Causes

The exact reasons for the development of polyhydramnios have not yet been established. Allocate several risk groups, in which this pathology develops more often:

  1. The presence of chronic diseases in a woman(diabetes mellitus, diseases of the urinary and cardiovascular systems).
  2. Infectious diseases of any location.
  3. Multiple pregnancy(polyhydramnios of one fruit is often combined with oligohydramnios of another).
  4. Large fruit sizes.
  5. Fetal malformations.

Clinical symptoms

Polyhydramnios can occur in acute and chronic forms.

Information Acute polyhydramnios develops extremely quickly (within a few hours), often occurs in the second trimester and is accompanied by well-pronounced symptoms. The acute form is difficult and, as a rule, leads to early termination of pregnancy, the birth of a fetus with malformations or its death.

With chronic oligohydramnios the volume of amniotic fluid increases gradually, the symptoms are moderately expressed or do not appear at all. The prognosis for the chronic form is more favorable, in most cases this pathology responds well to treatment.

The main symptoms of polyhydramnios:

  1. Inconsistency of the size of the uterus with a given gestational age... The abdominal circumference can reach 110-120 cm or more, as a result of which it may appear.
  2. Severity, abdominal pain.
  3. General weakness, malaise.
  4. Shortness of breath due to the high standing of the diaphragm.
  5. Severe edema of the lower extremities.
  6. Distinct fluctuation (gurgling) in the abdomen.
  7. Increased heart rate.

Treatment

When identifying the development of any form of polyhydramnios, a woman should be hospitalized in a hospital... Before starting treatment, the doctor will conduct series of surveys to determine the cause of the increase in amniotic fluid:

  1. General .
  2. General .
  3. Blood test for glucose (sugar).
  4. Cardiography ().
  5. fetus.
  6. A blood test for antibodies in Rh-conflict.

Further treatment tactics depend on the identified cause of polyhydramnios, however, in a third of cases, the exact cause remains unclear. In this case, use a universal treatment regimen, aimed at improving the condition of the child and reducing the amount of amniotic fluid:

  1. Multivitamin complex(necessarily with vitamins of group B, C and E.
  2. Antibacterial therapy with the use of broad-spectrum drugs (Erythromycin, Josamycin).
  3. (Furosemide).
  4. Drugs to improve uteroplacental blood flow ( , ).
  5. Preparations to improve the condition of the placenta.
  6. Therapeutic and diagnostic amniocentesis(slow excretion of up to 200 ml of amniotic fluid).

During treatment, it is necessary constant monitoring of the doctor for the condition of the woman, the fetus and the volume of amniotic fluid:

  1. Daily weight and blood pressure monitoring
  2. Daily fetal cardiography.
  3. Ultrasound, dopplerography every 5-7 days.

With a decrease in amniotic fluid and stabilization of the fetus, pregnancy is prolonged to 37-38 weeks.

Important If during the treatment of polyhydramnios there is no tendency to improve or the condition, on the contrary, worsens, emergency delivery is indicated, regardless of the timing of pregnancy. In most cases, in the absence of other contraindications, they are conducted through the natural birth canal.

Complications

Polyhydramnios is a serious condition and can cause a number of complications during pregnancy and childbirth.

For the normal development of a child inside the womb, the importance of amniotic fluid is invaluable. They protect the embryo from mechanical stress, participate in metabolism, and provide it with freedom of movement. The amniotic fluid is constantly moving and renewing. However, polyhydramnios during pregnancy is very dangerous, since it is the cause of many diseases in both the woman and the unborn child.

What is polyhydramnios during pregnancy

This is a condition in which the amount of amniotic fluid in a pregnant woman increases dramatically. In medicine, there is a classification of polyhydramnios. It should be noted that an increase in amniotic fluid is not always a pathology. Sometimes the term "moderate polyhydramnios" is characterized only by the approach to the highest rate, but not exceeding the permissible limit. At different times, the rate of amniotic fluid varies. For example, at 10 weeks of pregnancy, the normal volume is 30 ml, at 14 - 100 ml, and by 38 weeks the norm will be 1.5 liters.

When this limit is exceeded, then we are already talking about polyhydramnios in a pregnant woman. There is a certain classification. The increase in amniotic fluid can be moderate, acute, or chronic. The most dangerous condition during pregnancy is acute, when the water level begins to rise very rapidly, over several days or even hours. Chronic polyhydramnios is characterized by a slow increase in fluid volume.

Signs

There are certain signs, the presence of which will tell a woman about the presence of pathology. But not always a pregnant woman can diagnose herself. In the chronic course of polyhydramnios, a woman often learns about the pathology only during the next examination by a doctor. In acute pathology, it is easy to see that the abdomen grows very quickly. Its circumference at the level of the navel sometimes exceeds 120 cm.

A pregnant woman complains of the rapid appearance of stretch marks, rapid fatigue, heaviness when walking, shortness of breath. It is advisable to pay attention to unusual symptoms in order to preserve the pregnancy:

  • gurgling inside the abdomen;
  • decreased child activity;
  • severe swelling of the legs;
  • a feeling of pressure on the perineum;
  • increased heart rate;
  • malaise, weakness.

Spicy

Excessive fluid accumulation can be diagnosed immediately. A sharp increase in the abdomen cannot go unnoticed, because the condition develops within a very short time. A pregnant woman experiences abdominal discomfort, pain in the lumbar region and groin area. The abdominal wall swells noticeably, there is severe shortness of breath. The woman does not hear the movement of the fetus, and listening to its heartbeat is very difficult. The rapid development of pathology can be accompanied by rupture of uterine tissues.

Chronic

In the case of chronic development of the disease, the growth of amniotic fluid occurs slowly. More often, doctors observe such polyhydramnios at the end of pregnancy. Excessive fluid intake of a chronic nature does not have severe symptoms. Pregnant women have time to get used to a certain discomfort, associating it with their position, so the diagnosis of pathology is difficult. For this reason, the chronic form of polyhydramnios is no less dangerous than acute and entails very unpleasant consequences for both the mother and the baby.

Causes

Doctors cannot still point out with 100% certainty the causes of polyhydramnios during pregnancy and name specific prerequisites for the development of pathology. However, there are some tendencies towards the occurrence of this disease. The risk group includes pregnant women diagnosed with diabetes mellitus. Further on the list are chronic diseases of the genitourinary system, infections, vascular diseases, heart defects. A high risk of developing polyhydramnios in a patient with Rh-conflict pregnancy. The reason for the deviation may be too large a fetus or its pathology:

  • deviations in the development of the intestines or stomach;
  • malformations of the heart;
  • defects of the central nervous system;
  • genetic abnormalities.

Forms, types and degrees

As already noted, polyhydramnios in a pregnant woman can be chronic or acute. Pass in moderation or develop rapidly. According to the severity, obstetric pathology is divided into:

  • lung, when the amount of water does not exceed 3000 ml;
  • moderate, in which the amniotic fluid has volumes from 3000 to 5000 ml;
  • severe if the amniotic fluid exceeds 5000 ml.

There are several more basic gradations of polyhydramnios: relative, borderline, idiopathic and pronounced. The first is not dangerous for the woman and the fetus. Borderline polyhydramnios is also considered normal, but it already requires constant medical supervision. Idiopathic excess of water has no characteristic signs and causes, develops at any time.

What is dangerous

The main danger of polyhydramnios in pregnant women is the threat of miscarriage. This is how the pathology ends in 35% of women. In most cases, pregnant women have severe toxicosis at any time, which often turns into vomiting, which threatens dehydration. A large amount of water interferes with the correct presentation of the fetus, therefore, an incorrect position of the child is often observed: pelvic or transverse. The risk of fetoplacental insufficiency is not excluded, when the work of the placenta is disrupted. The fetus develops oxygen starvation, which harms its full development.

Diagnostics

In addition to studying the complaints of a pregnant woman, the antenatal clinic doctor examines her for the presence of relevant signs. There are several types of diagnostics of polyhydramnios. The most reliable is ultrasound, in which a woman is assigned to determine the amniotic fluid index (AFI). An additional method of examination is a triple test to determine the concentration in serum (16-18 weeks of pregnancy) of free estriol, chorionic gonadotropin and α-fetoprotein. Analyzes show possible fetal defects, often found in polyhydramnios.

Today there are two methods for measuring amniotic fluid. The first is called the "gold standard". For this, the uterine cavity is divided into 4 quadrants, in each of which the doctor determines the depth of the largest pocket of amniotic fluid, free of all parts of the embryo. AFI is the sum of all four values. If the result is below 5%, then a diagnosis of oligohydramnios is made. When the values ​​exceed 97.5%, then this is characterized by polyhydramnios.

IAZh

The second option is to determine the largest pocket of fluid, which is free from the umbilical cord loops and small parts of the fetus, measured in 2 perpendicular planes. The norm is a value from 2 to 8 centimeters. If the result shows 1-2 cm, then this is considered a borderline condition. Polyhydramnios is defined when the largest pocket of fluid is larger than 8 cm.

Treatment

When a disease such as polyhydramnios occurs during pregnancy, the gynecologist, if possible, should establish its cause and, based on this, prescribe appropriate therapy. A pregnant woman receives classical treatment in a hospital under the strict supervision of doctors. They try to preserve the pregnancy to the last. Prescribed, as a rule, are antibiotics, B vitamins, drugs that restore uteroplacental blood flow and improve metabolic processes, as well as drugs that improve blood microcirculation and diuretics.

If polyhydramnios occurs early in pregnancy, then it is treated without consequences for the fetus and mother. With a sudden and acute course of the disease, doctors often resort to the procedure for opening the fetal bladder (amniotomy) in order to drain the excess amniotic fluid. Otherwise, there is a threat not only of complications of pregnancy, but also the life of the mother and / or child.

Antibiotics

Since the etiology of the disease is very difficult to identify, the gynecologist with polyhydramnios must be very careful in choosing antibiotics. In acute pathology, the doctor often prescribes treatment with Rovamycin or analogues. There is evidence of therapy with Indomethacin (every 6 hours at 25 mg), but it should be remembered that there is a high probability of premature closure of the ductus arteriosus in the fetus.

Consequences

Polyhydramnios negatively affects the health of the mother and the development of the fetus. If the problem is not eliminated in time, an increase in the amount of amniotic fluid threatens the following consequences:

  • the uterus enlarged due to an excess of fluid for a long period squeezes large and small blood vessels, which provokes an increase in blood pressure and edema in the mother;
  • the uterus with polyhydramnios is strongly stretched, which can provoke massive bleeding and detachment of the placenta;
  • childbirth against the background of polyhydramnios in 30% of cases occurs earlier than the due date, because due to the large accumulation of fluid, the uterus increases to the size of a full-term pregnancy;
  • leaving the uterus prematurely, the amniotic fluid can pull out a handle, leg or umbilical cord;
  • early outpouring of amniotic fluid weakens labor, sometimes to a complete cessation.

For a child

In addition to the complications listed above, polyhydramnios also negatively affects the unborn baby in the mother's womb. The development of placental insufficiency at an early stage leads to poor development of the embryo, and at a later stage - to fetal growth retardation. Doctors call the following negative consequences for the child:

  • intrauterine infectious process;
  • malformations of the gastrointestinal tract;
  • insufficient formation of the nervous system;
  • chronic fetal hypoxia;
  • decreased immunity;
  • premature birth.

These pathologies can be latent, and appear only some time after birth. For example, polyhydramnios in the last stages of pregnancy in an infant can cause mental and mental retardation, which pediatricians determine after 1-1.5 years. The birth of a baby ahead of time threatens with a low level of body defenses and is fraught with the development of respiratory and infection with infectious diseases.

Childbirth

As already mentioned, labor occurs ahead of schedule with polyhydramnios. In the last stage of pregnancy, a dense bladder can burst suddenly, after which the amniotic fluid pours out abundantly and abruptly. At this moment, the limb of the fetus or the umbilical cord may fall out, and the woman's labor activity will be weakened. Sometimes a pregnant woman does not feel any contractions at all. With polyhydramnios, childbirth is associated with other complications:

  • unsuccessful position of the child inside the womb (for example, down the buttocks);
  • severe bleeding after childbirth;
  • placental abruption.

Prevention

Can polyhydramnios be avoided? Prevention of pathology consists in regular examination of a woman during pregnancy. This will allow you to identify and quickly eliminate pathology in time. Particularly acute in need of additional examination are pregnant women who are at risk, that is, women with a diagnosis of diabetes mellitus, the presence of a negative blood Rh factor and with chronic diseases of the genital organs.

Video

The amniotic fluid has many important functions. First of all, they provide nutrition for the child, create the necessary conditions for his full development and protect against various kinds of diseases. The amount of amniotic fluid increases with the course of pregnancy. Under a certain set of circumstances, their volume may exceed the permissible limits. In such a situation, polyhydramnios is diagnosed.

The concept of the norm of the amount of amniotic fluid

It is impossible to establish the norm of the amount of intrauterine fluid with an accuracy of a milliliter. On average, it ranges from 0.6 to 1.5 liters.

You can give the average values ​​of the norm on a weekly basis. It will look like this:

1. After the 10th week - 30 ml.

2. After the 13th week - about 100 ml.

3. After 18 weeks - about 400 ml.

4. Closer to the end of the term - up to 1.5 liters.

As a rule, in the last weeks of pregnancy, the amount of water decreases to an average of 800-100 0 ml.

Polyhydramnios: description and classification of the disease

The amount of fluid around the fetus gradually decreases starting at 35-37 weeks. The child regularly swallows water, and then it is excreted from his body along with urine. This is how the level of intrauterine fluid is monitored.

If this balance is disturbed, the volume of water increases and this becomes the cause of the development of polyhydramnios. In especially severe cases, the liquid can be up to 5 liters, which exceeds the permissible rate by 5 times.

Depending on the intensity of the severity, polyhydramnios can be:

  • easy - the amount of intrauterine fluid reaches almost 3 liters;
  • medium - up to 5 liters;
  • heavy - over 5 liters.

In accordance with the characteristics of the clinical disease, it is classified into acute and chronic.

Acute form of polyhydramnios

In the acute form, polyhydramnios is diagnosed earlier. It is characterized by a sharp rapid increase in the volume of intrauterine fluid. This condition is very dangerous. This form of polyhydramnios develops in a few days, and sometimes even hours. Outwardly, it is manifested by a too strong increase in the girth of the abdomen.

The woman begins to experience uncomfortable, and more often very painful sensations in the groin and lower back. There is a strong swelling of the abdominal wall. Shortness of breath appears. Listening to a baby's heartbeat becomes more difficult. Because of this rapid increase in amniotic fluid volume, uterine tissue can rupture.

Chronic polyhydramnios

You need to consult a doctor in a timely manner and follow the recommendations received.

In the chronic form of deviation, intrauterine water increases in volume more moderately. Usually, this disease begins to develop towards the end of pregnancy and does not have particularly pronounced symptoms. Women most often get used to the uncomfortable sensations of pregnancy. Because of this, timely diagnosis is very often omitted.

It is important to understand that even a chronic form of the disease can lead to very serious consequences.

Regardless of its form, polyhydramnios indicates the presence of deviations. The development of a chronic type of the disease is usually caused by genitourinary infections, viral ailments, inflammation in the appendages, problems in the work of the kidneys and cardiovascular systems, diabetes mellitus.

In case of a chronic disorder, there are good chances of carrying out and natural childbirth. You just need to consult a doctor in a timely manner and follow the recommendations received. In the absence of a reaction to the problem, the baby can suffer significantly.

The concept of moderate and pronounced polyhydramnios

In accordance with the intensity of the process, it is classified into moderate and pronounced.

At moderate polyhydramnios the deviation of the volume of intrauterine fluid from the norm is insignificant. Symptoms increase gradually. Outward signs are absent in most situations.

For expressed the same type of polyhydramnios is characterized by a rapid increase in the size of the abdomen. The patient begins to feel the child's movements more pronounced. Painful sensations appear in the perineum, abdomen and lower back.

It is important to understand that even in the absence of severe symptoms, polyhydramnios can lead to adverse consequences, both for the fetus and for the expectant mother.

Polyhydramnios: why is it dangerous?

  • The main danger of the pathology under consideration is the threat of premature miscarriage. This ends about 30-35% of cases.

In more than 35% of clinical cases, there is a very strong toxicosis, often turning into regular uncontrollable vomiting. For a mother, this situation is dangerous due to dehydration.

  • In some situations, the disease becomes the cause of the transverse or breech presentation of the baby.

The risk of developing placental insufficiency is not excluded (occurs in about 30% of cases). The condition is extremely dangerous. If it is present, the normal work of the placenta is disrupted, from which the fetus inevitably suffers. Oxygen starvation develops, and this already leads to harm to the whole organism.

  • In the early stages of pregnancy, oxygen deficiency slows down the baby's development. In the later, because of it, growth retardation, pathologies of the nervous system, and deterioration of immunity may be noted.

Polyhydramnios can lead to violations of labor, up to the death of a child. Also, the disease is fraught with severe bleeding during childbirth.

  • Due to polyhydramnios, childbirth may begin earlier than expected. Often, the amniotic sac ruptures on its own, which leads to a profuse and sharp outpouring of fluid. Because of this, loss of the umbilical cord or limbs can occur.

The uterus undergoes too much stretching, up to exfoliation of the placenta, severe bleeding after childbirth, and other extremely dangerous situations.

To prevent such phenomena, patients are often punctured by the amniotic sac. After the procedure, the amniotic fluid is poured out in a very thin stream, the uterus begins to contract, as a result of which the contractions intensify. Even more often, the only option is a caesarean section.

The reasons for the development of polyhydramnios

There is still no 100% reliable list of reasons for the appearance of polyhydramnios. In about 30-35% of cases, it is impossible to establish specific prerequisites. However, the general trend can still be traced. Doctors identify a kind of risk group for women who have polyhydramnios more often than other pregnant women.

  • First of all, you need to be careful pregnant women with diabetes.

It is he who most often leads to the development of polyhydramnios. For details on gestational diabetes mellitus in pregnant women, read

The next most common causes are diseases cardiovascular system and kidneys, as well as various kinds infections... No less often, polyhydramnios causes the child and the mother.

  • The situation develops differently in the case of multiple pregnancies: one fetus may have polyhydramnios, while the second will suffer from oligohydramnios.

Lead to polyhydramnios pathology of the excretory function, as well as developmental disorders of the child, including:

  • genetic deviations;
  • malformations of the nervous system, heart and blood vessels;
  • structural disturbances gastrointestinal path.

Polyhydramnios can develop against the background of a number infectious diseases(herpes, rubella, toxoplasmosis, etc.). Particularly dangerous are viruses to which the patient does not yet have immunity. In case of infection, microbes will begin to circulate through the blood at a high intensity, which may be enough to penetrate the fetus.

An additional danger of the listed viral diseases is their insufficient severity, which often makes timely diagnosis impossible. For example, patients with moderate polyhydramnios often leave their problem unattended, because there is no pronounced symptomatology.

  • The appearance of polyhydramnios at the end of the term often leads swallowing dysfunction at the fetus. A developed child is able to absorb up to 3-4 liters of intrauterine fluid per day. Water is renewed every three hours. That is, the baby may simply not have time to drink enough liquid.

Each of the above violations can lead to the development of polyhydramnios in a chronic or acute form. However, even if there are no prerequisites, pregnant women are still strongly recommended to be constantly monitored by a gynecologist, and when the first alarming symptoms appear, consult a doctor.

The earlier the problem is diagnosed, the higher the likelihood of full bearing of the fetus and its natural birth.

Symptoms and main signs of polyhydramnios in pregnant women

The presence of pathology can be indicated by many different signs. Among the most common symptoms are:

  • uncomfortable sensations, a feeling of heaviness, too frequent painful sensations in the abdomen;
  • attacks of weakness and general malaise;
  • severe shortness of breath even with minor physical exertion;
  • sudden increase in heart rate;
  • frequent appearance of swelling of the legs;
  • an increase in the size of the uterus above the norm for the current period;
  • an increase in the girth of the abdomen at the level of the navel over 1 m;
  • multiple rough stretch marks on the skin;
  • frequent and distinctly audible squelching in the abdomen.

In the presence of the problem under consideration in the last stages, deviations of the size of the uterus from normal values, tension in its area, and excessive anxiety of the child are often noted. Among the additional signs, an excessive increase in the height of the fundus of the uterus is often noted.

The presence of any of the listed symptoms should force the pregnant woman to immediately turn to to a gynecologist.

The doctor will prescribe the necessary diagnostic measures, during which the amniotic index and, if possible, the reasons for the development of pathology will be determined, followed by the appointment of a course of treatment.

Diagnostics of polyhydramnios

The specialist carefully examines the patient's complaints, conducts an external obstetric examination and prescribes an ultrasound scan.

Today, 2 methods are most often used to determine the volume of intrauterine fluid during an ultrasound examination:

1. Establishing an index of amniotic fluid.

For each term of pregnancy, it is different. This index characterizes the permissible volume of intrauterine water. Diagnostics is performed as follows.

The uterine cavity is conventionally divided into 4 quadrants. In each of these quadrants, the greatest depth of amniotic fluid free from the child is established. The resulting values ​​are summed up. The result is an index of amniotic fluid. We are talking about polyhydramnios when the index increases over 97.5%.

In general, you can study the normal indicators of amniotic fluid and permissible deviations from the norm at each stage of pregnancy in the following table:

It is important to understand that these fluctuations are quite significant, so that even if you have it far from the established norm, this is not necessarily a cause for concern and anxiety.

2. The size of the largest pocket is determined intrauterine fluid, free from umbilical cord loops and parts of the fetus.

The size of the pocket is determined by two mutually perpendicular planes. Polyhydramnios is diagnosed when a value exceeding 80 mm is obtained. During an ultrasound scan, the child's condition is carefully examined in order to establish the presence of characteristic developmental abnormalities.

3. Additionally, the test can be applied., according to which the patient's blood serum is studied for the content of free estriol, chorionic gonadotropin, and alpha-fetoprotein... Material for analysis is taken mainly at 16-18 weeks. This test allows you to timely diagnose pathologies of the development of the placenta and the baby.

Also, the presence of a problem may be indicated by a decrease in the concentration of prolactin below the permissible values ​​for the current period.

The main methods of treatment

The optimal order of treatment is established by a specialist after carrying out diagnostic measures.

When the diagnosis is confirmed, patients are usually admitted to the hospital for regular monitoring by medical staff.

In the case of diagnosing a mild or moderate degree of deviation, in the absence of too strong violations of respiratory function and blood circulation, doctors will try to maintain the pregnancy. In the presence of an acute form of the disease, it may be necessary to terminate the pregnancy, because this condition is very dangerous for the life of the mother and baby.

Determining the causes of the development of pathology greatly facilitates the treatment process. As soon as the main source of the problem is identified, the doctor has the opportunity to prescribe the optimal and most effective therapy.

Traditionally, polyhydramnios is treated with antibiotics. The main goal of therapy is to normalize uteroplacental blood flow and metabolic processes.

If the disease is of a viral origin, immunomodulators are usually prescribed.

Without fail, the doctor prescribes a complex of diuretics and vitamin preparations.

For the rest, the optimal procedure for treatment is established by a specialist after carrying out the necessary diagnostic measures.

Regardless of the form and intensity of severity, polyhydramnios is a very insidious and rather dangerous disease.

Under any circumstances, such a condition indicates the presence of pathologies in the woman's body and, as a result, the fetus. Therefore, women should try to do everything possible to prevent the development of more serious disorders.

Expectant mothers should pass all examinations in a timely manner that can confirm or deny the presence of any kind of diseases and disorders. A specific list of tests will be given by the supervising physician.

It is equally important to stick to and drink the correct amount of fluids. For prevention purposes, you need to be outdoors more often and, if possible, walk on foot.

It is equally important to avoid excessive physical exertion, stress and generally bad emotions.

The most effective preventive measure is full compliance with the recommendations of the doctor in charge of pregnancy.

Follow the advice of a specialist, get tested in a timely manner, take the medicines and vitamins recommended by the doctor, and everything will be fine.

Health to you and your baby!

Amniotic fluid is the first living environment of every person. The well-being of the woman and the development of the fetus, the peculiarities of labor activity, depend on their number and composition.

The volume of amniotic fluid increases every week as the baby grows. For some women, the amount of water does not correspond to the norm.

Both polyhydramnios and oligohydramnios during pregnancy can bring various unpleasant surprises to the expectant mother, so such deviations cannot be ignored.

Polyhydramnios during pregnancy: what does it mean

Polyhydramnios during pregnancy is an excess of amniotic fluid in the amniotic fluid. The role of amniotic fluid in the development of a child is enormous: maintaining the body in space, ensuring freedom of movement, a source of nutrients, protection from damage and infections. But their number must always correspond to the norm.

When examining with ultrasound, the doctor determines the amniotic fluid index (AFI) - an indicator of the amount of amniotic fluid, and compares it with the table.

When determining the AFI, the sonologist visually divides the cavity of the amniotic fluid into 4 equal parts and in each determines the space that is filled with water and does not contain parts of the baby's body (vertical pocket). If the largest pocket has a depth of 2 cm or less, a diagnosis of oligohydramnios is made, with a depth of more than 8 cm - polyhydramnios.

Gynecologists distinguish between different forms of polyhydramnios:

1 Relative polyhydramnios- a slight deviation from the norm at this time, usually associated with the bearing of a large fetus, and in the absence of other pathologies, it can be safe for the woman and the fetus.

2 Borderline state, or a tendency to polyhydramnios during pregnancy is a case when the amount of water reaches the upper limit of the norm, and it is possible that an excess of them may appear in the future.

Due to polyhydramnios, a woman may not develop labor, therefore, in the last weeks she should be under the supervision of doctors, and if necessary, they do it.

Polyhydramnios during pregnancy: treatment

How to treat polyhydramnios during pregnancy depends on the cause of the disorder. If amniotic fluid accumulates due to a woman's illness, appropriate therapy is needed.

In severe cases, with a sharp deterioration in the mother's condition, it is necessary to terminate the pregnancy in order to save the woman's life. If the situation is not so critical, the pregnant woman will simply have to spend some time in the hospital and undergo a course of treatment to save the baby.