Polyhydramnios: excess amniotic fluid

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Amniotic fluid is an essential substance during pregnancy. It is a fluid where the fetus that the woman generates is developed throughout the pregnancy, being in week 34 when it is in greater quantity.

The amount of amniotic fluid must be correct: values ??below cause oligohydramnios, while an excess of fluid generates polyhydramnios, which can produce complications in pregnancy.

Below you have an index with all the points that we will discuss in this article.

Index

Polyhydramnios: excess amniotic fluid

Measurement of amniotic fluid

During ultrasound controls, obstetricians, in addition to controlling fetal development, perform amniotic fluid measurements. There are two ways to measure amniotic fluid:

  • Maximum vertical column (MCV): the maximum vertical column of free fluid is measured, that is, without fetus or cord. They are normal values ??of 2 to 8 cm.
  • Amniotic fluid index (ILA): the same dynamic is followed as in the previous one but by adding the four quadrants in which the belly of the pregnant woman is divided. The normal levels of ILA range from 5 to 25 cm and it is done from the 24th week of gestation.

The MCV method is routinely used and, if any anomaly is detected, the ILA is already used. Polyhydramnios is detected in 2% of pregnancies and, depending on the degree, a distinction is made between:

  • Mild polyhydramnios: amniotic fluid index of 25-29.
  • Moderate polyhydramnios: amniotic fluid index of 30-34.
  • Severe polyhydramnios: amniotic fluid index greater than or equal to 35.


Causes

It is not always possible to find out what is causing the increase in amniotic fluid; in fact, in half of the cases, the reason for polyhydramnios is not known. In general, there are three possible causes: fetal, maternal and placental.

Amount of amniotic fluid

If the origin is in the fetus, it may be due to abnormalities in its development. Especially relative are the gastrointestinal alterations, but there are other causes such as alterations in the central nervous system, renal, infectious, neuromuscular alterations and some syndromes associated with genetic alterations.

When the cause is found in the mother, it is usually related to gestational diabetes. In this way, a metabolic alteration in the pregnant woman can cause this excess of liquid.

On the other hand, some alterations in the placenta, such as a chorioangioma (benign tumor of the placenta), can cause polyhydramnios.

Depending on the severity of the polyhydramnios and the etiology, the obstetrician will perform the follow-up and the appropriate controls.

Treatment

In many cases, there is no specific way to treat fetal glomerular filtration, especially if its cause is unknown.

In those more severe cases, there being a high porbability of premature delivery, an amniodrainage can be performed to eliminate excess fluid. This drainage is never done after week 35 and only with moderate or severe polyhydramnios, with ILA greater than 30.

Amniodrenaje

Starting at week 32, prostaglandin inhibitors can also be used. These are drugs that cause less filtration by the fetus, decreasing the amount of fetal urine. They also increase the pulmonary reabsorption and the passage of amniotic fluid through the membranes. This treatment can have serious side effects in the fetus, so it is only used in very specific cases.

With polyhydramnios it is very likely that the delivery is premature, so, depending on the degree and development of the fetus, the time of delivery can be advanced.


childbirth cesareo in Madrid(Spain)

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