What Is Polyhydramnios?
I've never been what you could call a small pregnant woman.
But when I started to look like I was about to deliver a baby at any second while still in my second trimester, I thought perhaps something may be up.
And as it turns out, that “something” was my amniotic fluid. It was way, way up.
At 29 weeks pregnant, I was diagnosed with polyhydramnios, and for a woman who has had three pregnancies with nary a complication in sight, I admit I was a bit skeptical.
Just what is polyhydramnios, and what did I need to know about it?
What is polyhydramnios?
Polyhydramnios is a condition of having too much amniotic fluid present in the uterus. Amniotic fluid is produced by the mother until about 4 months of pregnancy when the baby's kidneys kick into gear and help production through urine. Fluid is made up of mostly water and some a small percentage of salts and other cells from the body. Normal fluid levels should be between 5 and 25 centimeters—anything over that warrants a diagnosis of polyhydramnios.
What is it caused by?
In the majority of polyhydramnios cases, the cause is simply unknown. It's just “one of those things,” meaning doctors are still perplexed by the mystery that is pregnancy. But your care provider will rule out the more serious causes of polyhydramnios, which are:
- Gestational diabetes
- Birth defects (especially affecting the nervous system or digestive tract that could affect the baby's swallowing)
- Fetal anemia
- Twin-to-twin transfusion syndrome
- Blood incompatibilities between mom and baby
What are the risks?
Polyhydramnios isn't generally too risky in and of itself, but it can put you at increased risk of some complications during your pregnancy such as:
- Cord prolapse
- Premature labor or premature rupture of the membranes (due to the extra fluid causing more pressure on your cervix)
- Cord issues (with all the extra fluid, your baby has more room to move and possibly get entangled in the cord)
- Larger babies (waves hand over here!)
- Placental abruption
- Bleeding after pregnancy
- High blood pressure
- Breech babies
What you can expect
Now living the life of a woman with “poly,” as it is often dubbed in OB circles, I'll tell you that it's no picnic. I started measuring a full-term, 38-week-along belly at only 32 weeks, so I've basically felt like I've been about to give birth for an entire month. I'm incredibly uncomfortable, way too big for any of my normal maternity clothes, and more than familiar with a whole host of rude comments anytime I'm out in public. But aside from the physical fun of polydramnios, here's what you can expect during your pregnancy:
- Additional sugar testing. In addition to your fasting one-hour glucose, your care provider may make you go through a three-hour blood sugar test just to make sure you don't have gestational diabetes. It's a fun morning of no food and multiple blood draws. Ugh.
- Extra ultrasounds. Depending on how high your fluid level is and if your baby is breech, your care provider may schedule several ultrasounds to keep track of your fluid and your baby.
- Weekly NSTs. Especially during the end of your pregnancy, you will more than likely have weekly, or even twice-weekly non-stress tests (NSTs) that monitor your baby's heart rate, activity, and your contraction pattern. They are a test of your baby's well-being.
- More Braxton-Hicks. Although the risk of preterm labor is higher with polyhydramnios and you will need to be on the lookout for actual contractions, you may also notice an increase in Braxton-Hicks from the increased fluid and pressure in your uterus. I have contractions every time I sit down, and I've noticed they are a lot more painful than any of my other Braxton-Hicks with previous pregnancies.
- Possible induction or C-section. Your care provider may recommend an early induction or C-section based on your fluid levels, the size of the baby, and potential risks for cord complications. Many babies whose mothers have poly have the potential to turn breech or get tangled in the cord, so an early delivery may be less risky than waiting for labor to begin on its own. I have my own first-time induction scheduled for 38 weeks, a decision that both my OB and my midwife fully support. Baby time, here I come!
Did you have polyhydramnios? How early did you deliver?