Polyhydramnios is a condition in which there is an excessive amount of amniotic fluid surrounding the baby in the womb. While this finding does not always indicate a problem, it requires proper evaluation and regular antenatal monitoring to ensure the well-being of both mother and baby.
In this blog, Dr. Mini Salunkhe, Director of Obstetrics and Gynecology at Momstory, explains what polyhydramnios is, why it occurs, its possible risks, and how it is managed during pregnancy.
What Is Amniotic Fluid and Why Is It Important?
Amniotic fluid is the protective fluid that surrounds the baby inside the uterus. It plays several important roles during pregnancy, including:
- Cushioning the baby and protecting it from external impact.
- Supporting the baby’s growth and development.
- Helping the lungs and digestive system mature.
- Providing a suitable environment for the baby’s movement and development.
The amount of amniotic fluid naturally changes as pregnancy progresses. When the fluid level is higher than expected for the stage of pregnancy, the condition is known as polyhydramnios.
What Causes Polyhydramnios During Pregnancy?
Polyhydramnios is often detected during a routine pregnancy ultrasound. Several factors may contribute to an increase in amniotic fluid.
1. Gestational Diabetes
Gestational diabetes is one of the possible causes of polyhydramnios. Elevated maternal blood sugar levels can affect the baby’s urine production, which may lead to an increase in amniotic fluid.
For this reason, your obstetrician may recommend blood sugar testing or further monitoring if polyhydramnios is detected.
2. Fetal Conditions Affecting Swallowing
The baby normally swallows amniotic fluid and processes it through the digestive system. In some cases, certain fetal abnormalities affecting the digestive tract or swallowing mechanism can interfere with this process, causing fluid to accumulate.
Examples include certain oesophageal or gastrointestinal abnormalities. These conditions are uncommon, and further evaluation may be recommended depending on the ultrasound findings.
3. Fetal Infections and Other Conditions
Certain fetal infections and blood-related conditions may also be associated with increased amniotic fluid. Your doctor will assess whether additional investigations are necessary based on your pregnancy history and scan results.
4. Twin Pregnancy
Polyhydramnios can occur in twin pregnancies, sometimes affecting only one baby. These pregnancies may require closer monitoring to assess the health and development of both babies.
5. No Identifiable Cause
In many cases, the exact cause of polyhydramnios cannot be identified, even after appropriate investigations. This does not automatically mean that something is wrong with the mother or baby.
What Are the Risks of Polyhydramnios?
The risks depend on the amount of excess fluid, the underlying cause, and the overall condition of the pregnancy. Some cases are mild and require only monitoring, while more significant cases may need additional medical care.
Possible complications include:
- Maternal breathlessness: Excessive fluid can cause the uterus to become significantly enlarged, putting pressure on surrounding organs and making breathing uncomfortable.
- Preterm labour: Increased uterine distension may raise the risk of labour beginning before the due date.
- Premature rupture of membranes: The amniotic sac may rupture before labour begins.
- Labour and delivery complications: Excessive amniotic fluid may increase the risk of certain complications during labour and delivery.
These complications do not occur in every pregnancy with polyhydramnios. Regular assessment helps your obstetrician identify potential concerns and plan appropriate care.
How Is Polyhydramnios Managed During Pregnancy?
There is no single treatment plan for every case of polyhydramnios. Management depends on the severity of the condition, the suspected cause, the mother’s symptoms, and the baby’s well-being.
1. Regular Antenatal Check-ups
Consistent antenatal visits help your obstetrician assess your health, review symptoms, and monitor the progress of your pregnancy.
2. Follow-up Ultrasound Scans
Your doctor may recommend repeat ultrasound scans to assess amniotic fluid levels, monitor the baby’s growth, and check for any abnormalities that require further evaluation.
3. Blood Sugar Monitoring
If gestational diabetes is suspected or diagnosed, blood sugar testing and appropriate treatment are important. Managing blood glucose levels helps reduce risks associated with uncontrolled gestational diabetes.
4. Monitoring for Preterm Labour
Your obstetrician may advise you about symptoms that require immediate attention, including fluid leakage, regular contractions, or other signs of early labour. The frequency of monitoring will depend on your individual condition.
5. Individualised Treatment
Treatment is tailored to each pregnancy. Some women may need only regular monitoring, while others may require additional investigations or specialist care. Any treatment or activity-related advice should be based on your obstetrician’s assessment rather than a general recommendation to restrict activity.
When Should You Contact Your Obstetrician?
If your ultrasound report mentions polyhydramnios, discuss the findings with your obstetrician to understand the severity and the next steps.
Seek prompt medical assessment if you experience:
- Leakage or a sudden gush of fluid from the vagina.
- Regular contractions or persistent abdominal tightening before your due date.
- Significant or worsening breathlessness.
- Any other concerning symptoms during pregnancy.
Do not wait for your next routine appointment if you suspect your waters have broken or you are experiencing signs of preterm labour.
Polyhydramnios in Pregnancy: Why Regular Monitoring Matters
A diagnosis of polyhydramnios can be worrying, but increased amniotic fluid does not necessarily mean that something is wrong with your baby. The condition can have several causes, and in some cases, no specific cause is identified.
The most important steps are to attend regular antenatal appointments, follow your obstetrician’s advice, complete recommended scans and blood sugar tests, and seek medical attention if concerning symptoms develop.
At Momstory, our obstetrics and gynecology team supports expectant mothers with pregnancy monitoring, evaluation, and personalised care to help them make informed decisions throughout their pregnancy.
