Good day, my dear readers! I think many women, having learned about their interesting position begin to read literature related to pregnancy. Unfortunately, information is not always “filtered” and, along with real necessary advice, expectant mothers are read various articles about possible pathologies pregnancy.

The whole collapse lies in the fact that pregnant women are very impressionable and look for various symptoms of a particular pathology. So, for example, many expectant mothers manage to diagnose themselves with polyhydramnios during pregnancy. We will discuss the causes and consequences of such a diagnosis right now so that there are no unnecessary questions and suspicions.

We all know perfectly well that throughout the entire period of pregnancy, the baby "lives" in the water. So, polyhydramnios is an excessive "accumulation" amniotic fluid.

Amniotic fluid (or amniotic fluid) performs important functions:

• protective (both from various injuries and infections);
• heat exchange and maintenance of a constant level of pressure;
• participation in metabolic processes.

Unfortunately, "intrauterine water balance" can be disturbed due to various reasons. Such a pathology can lead to disastrous consequences, so every woman should know what to do in case of such a diagnosis as polyhydramnios.

However, it is important to understand that the accumulation of amniotic fluid is extremely rare - in only 1% of cases. So, it is likely that a woman who has not yet been to a doctor's appointment has thought up a problem for herself.

2. Classification of pathology

As statistics show, polyhydramnios is an extremely rare phenomenon, and in order to determine the presence of this pathology, the help of a specialist is needed. There is a certain table (relatively speaking, “tracking” the amount of amniotic fluid) that helps doctors determine the presence (or absence) of this disease.

It is customary to distinguish the following forms of polyhydramnios:

1. acute form. This pathology is quite easy to identify on early diagnosis. One of the most important features is a sharp increase in "intrauterine" fluid. Acute polyhydramnios develops rapidly, which is dangerous for a pregnant woman. One of the worst consequences: uterine rupture.
2. Chronic form. This pathology is usually detected only on last dates gestation (although this is difficult).
3. moderate form. Fortunately, this form rarely leads to consequences. If a woman in labor has moderate polyhydramnios, it is likely that she will give birth naturally and without surgery.

3. What causes polyhydramnios

As it turned out, science is not always “omnipotent”, therefore, at the moment, the exact reasons for the emergence of this pathology have not been found.

However, there are some preconditions:

• chronic diseases of the mother (including diabetes);
• various infections (for example, herpes, toxoplasmosis);
• deviations in the development of the fetus itself (for example, pathologies associated with the central nervous system);
• multiple pregnancy;
• nutrition of the baby (in the third trimeter, the child can swallow more liquid than before, which provokes an increase in amniotic fluid);
• incompatibility of Rh factors of mother and father;
• other.

If a woman has prerequisites for polyhydramnios, she should visit a doctor more often than usual - this is necessary for control amniotic fluid.

4. Is it possible to recognize polyhydramnios on your own

Moreover, it is polyhydramnios that is extremely difficult to recognize. The fact is that a pregnant woman often takes all the signs of pathology for granted and there is an explanation for this, because the symptoms of this disease are:

• constant loss of strength;
• heavy breathing at physical activity(for example, when climbing stairs);
• pain in the lower abdomen;
• the appearance of stretch marks;
• swelling of the limbs and other parts of the body;
• a sharp jump in the heartbeat;
• other.

There are other symptoms, such as changes in the fundus of the uterus. However, only a doctor on an internal examination can identify such deviations. This means that it is not so easy to self-diagnose.

5. Is polyhydramnios treated?

I will not keep the intrigue - not always. It all depends on the form of the disease and the time when the pathology was detected.

However, do not despair if you conscientiously attend the consultations of a female doctor - an increase in amniotic fluid will be detected at a very early stage.

In this case, we can talk about a possible treatment:

• antibiotics;
• vitamins;
• drugs that affect immune system etc.

At moderate polyhydramnios are often appointed wilprafen. In any case, you need to follow the doctor's recommendations and do not choose drugs on your own.

Again, you need to understand that polyhydramnios itself can arise on the basis of another disease, and here measures will be taken to eliminate the primary source.

6. What are the consequences for mother and child

No disease can be started. Same with polyhydramnios. Lack of treatment can lead to complications.

For a child:

• decreased immune system;
• deviation in the development of the central nervous system and gastrointestinal tract;
• various infections;
• cord entanglement;
• premature birth (with all the ensuing consequences);
• prolapse of the limbs of the child during childbirth;
• chronic diseases (for example, hypoxia).

For mother:

• blood loss before and after childbirth;
• childbirth that occurred earlier than the expected date;
• change in the position of the child in the womb (for example, to the pelvic or transverse);
• placental abruption;
• weak generic activity;
• severe toxicosis, which is fraught with dehydration of the body.

The worst thing that can happen - miscarriage. Accordingly, a lethal outcome for the baby.

7. Prevention of polyhydramnios

Currently, many young mothers neglect their health while carrying a child.

However, there are those women who, even during pregnancy planning, begin to conduct correct image life.

Unfortunately, there is no “key” that would protect the expectant mother from such a pathology as polyhydramnios. Here, rather, you need to rely on luck, and follow a few golden rules for a pregnant woman:

• eat right;
• breathe fresh air, triple walking;
• attend scheduled medical consultations;
• do not overcool (and vice versa, do not overheat);
• do not be nervous and lead a calm lifestyle;
• rest more often;
• to refuse from bad habits;
• refrain from working with harmful substances.

In other matters, all expectant mothers know about this, and most of them lead the right way of life. But, sometimes this is not enough. Statistics say that in a third of pregnant women who have had polyhydramnios, the cause of the pathology has not been established.

And although an increase in amniotic fluid is a negative factor during pregnancy, this does not mean at all that you will not give birth! If doctors determine that your condition is deteriorating, and excess amniotic fluid can harm the fetus, an emergency is prescribed. C-section(of course, when it comes to recent months pregnancy).

In most cases, childbirth is quite successful, just a little more difficult than in the absence of such a pathology as polyhydramnios. This is where it's important to get it right.

You can watch a video review of polyhydramnios during pregnancy here:

The level of amniotic fluid, which is within the normal range, does not always mean the normal course of pregnancy. In this regard, it is not surprising that many expectant mothers are often concerned about this issue. Sometimes gynecologists diagnose polyhydramnios. There is a lot of conflicting information on the Internet. So let's see: what is actually called polyhydramnios?

To begin with, this statement: the question of the amount of amniotic fluid should be decided by the doctor in every pregnant woman women individually, without resorting to hasty treatment and premature conclusions. Nevertheless, on the territory of our country, the intimidation of pregnant women with such a diagnosis is actively practiced.

The position of the World Health Organization is quite clear: slight and moderate polyhydramnios during pregnancy is not a direct indication for treatment, but an incentive for active monitoring of a pregnant woman.

In the second trimester of pregnancy amniotic index liquids normally is 150 - 350 ml (respectively from 12 to 24 weeks). In the third trimester, the amount of amniotic fluid increases markedly and between 30 and 37 weeks, the amniotic fluid index should not exceed 1700 ml.

Polyhydramnios is diagnosed when the amount of amniotic fluid exceeds 2000 ml under the condition of full-term pregnancy, and clinical manifestations of polyhydramnios are observed at a volume of 3000 ml.

Polyhydramnios is of two types- acute and chronic.

With acute the amount of amniotic fluid rapidly increases in a short period of time (usually from several hours to several days). This state of affairs requires immediate medical attention. In such a situation, premature births very often occur, and, unfortunately, there is a great danger of fetal death due to prematurity. Fortunately, acute polyhydramnios is much less common than chronic.

With chronic polyhydramnios the increase in the amount of amniotic fluid occurs slowly.

Polyhydramnios in pregnant women can be explained as follows reasons:

• atresia of the duodenum or esophagus in the fetus;
• the presence of malformations of the central nervous system in the fetus;
• Availability multiple pregnancy;
• or .

What is the danger of polyhydramnios during pregnancy

Risks and consequences can be viewed from three perspectives:

1. In the fetus: fetal malformations (occurs in 20-30% of cases of polyhydramnios); mortality (occurs in 50% of cases) due to malformations and prematurity.
2. Mother's: weakness or impossibility of labor activity; profuse postpartum bleeding.
3. During childbirth: prolapse of the umbilical cord; dangerous bleeding; violation of the situation and, as a rule, breech presentation fetus.

Causes of polyhydramnios in pregnant women

The main and most often diagnosed cause polyhydramnios - obstruction gastrointestinal tract in the mother, as well as her congenital neuromuscular diseases or cardiovascular defects.

In 20-30% of cases, the causes of polyhydramnios during pregnancy are unknown. Such a phenomenon is called idiopathic polyhydramnios.

No less common is polyhydramnios with complications during multiple pregnancy, as well as with anemia of the fetus and damage to its brain. The presence of maternal diseases such as acute viral infections, diabetes mellitus and syphilis also often causes polyhydramnios.

Signs and diagnosis of polyhydramnios

Symptoms of polyhydramnios may be: abdominal pain, a strong increase in the uterus during pregnancy from to.

If polyhydramnios is suspected, consult a doctor immediately and undergo an examination, pass a series of tests to exclude the causes of the disease on the maternal side: diabetes mellitus, syphilis and Rh immunization.

Next, you need to go through a specialist in the field of fetal malformations to confirm or exclude the alleged diagnosis. Also, a pregnant woman is often asked to take no a large number of amniotic fluid to determine the karyotype of the child and identify chromosomal abnormalities.

If intrauterine infection of the fetus is suspected, the amniotic fluid can be tested for TORCH infection. For this, antibodies to infectious pathogens are determined.

Treatment of polyhydramnios during pregnancy

Depending on the severity of polyhydramnios, its causes and the duration of pregnancy, treatment is prescribed. Polyhydramnios of mild and moderate degree, as a rule, do not treat, but actively monitor the condition of the mother and fetus.

Women with pronounced polyhydramnios observance is prescribed bed rest under the strict supervision of doctors. The condition of the fetus is monitored by ultrasound.

With drug therapy mainly prescribe a drug called "Indomethacin". A serious contraindication to its appointment is a gestational age exceeding. The drug works in such a way that it reduces the production of urine in the fetus.

In the normal state of the pregnant woman, treatment is not required, but it is necessary careful outpatient follow-up. If a dangerous condition of the fetus is detected, an unscheduled delivery is required for a period of 35 weeks (possibly earlier with appropriate indications). The morbidity and mortality of such children is higher in comparison with premature babies and babies born at term.

The only consolation is that no more than 17% of high-water pregnancies end in serious complications during childbirth.

When expressed negative symptoms, mothers make a puncture (called an amniocentesis) and gently drain the fluid. But this can lead to premature birth. Also, during the procedure, the risk is significantly increased intrauterine infection fetus.

To prevent polyhydramnios, you should take a responsible attitude to your health even before pregnancy. Long before the intended conception, it is necessary with give the tests recommended by the doctor to identify predisposition to this diagnosis and risk factors associated with it.

During pregnancy, you need to Special attention to your well-being take care of your health.

You should not neglect trips to the antenatal clinic. It is imperative that you follow all the doctor's prescriptions and go through all necessary examinations. Far from the last place is occupied, healthy lifestyle life and moderate physical activity outdoors.

Video about polyhydramnios during pregnancy

We suggest you watch a video about polyhydramnios during pregnancy.

In this article:

Pregnancy is undoubtedly the happiest period in a woman's life, but even he can sometimes be overshadowed. different kind troubles and pathologies. One of these pathological conditions during pregnancy is polyhydramnios, which must be treated.

The composition of amniotic fluid changes throughout pregnancy, so it is important to monitor their amount in each trimester.

Polyhydramnios is the appearance of an excess amount of amniotic fluid, significantly exceeding the norm. The diagnosis of polyhydramnios can put a woman on the most different terms pregnancy. These complications occur in 1 in 100 pregnancies.

At normal course pregnancy, the necessary amount of amniotic fluid is formed for the development of the fetus, approximately 1000-1500 ml. The amniotic fluid consists of 97% water, which contains proteins, calcium, chlorine and sodium salts. Thus, the baby receives the oxygen it needs. nutrients And reliable protection from external environment. Also, the embryo can calmly move and swim in the mother's abdomen, make movements with the limbs.

Amniotic fluid is the environment in which the fetus develops. The water temperature is 37 degrees.

Properties of amniotic fluid:

1. The amniotic fluid protects the embryo from impact and shock. In addition, the noise coming from the outside world is also muffled.
2. Amniotic fluid protects the umbilical cord from being squeezed between the wall of the uterus and the fetus.
3. Amniotic fluid helps reduce pain during labor.
4. They help open the cervix during childbirth.
5. The bubble, in which the fetus and amniotic fluid are located, creates an airtight shell into which nothing can enter from the outside.
6. Amniotic fluid contains immunoglobulins.

The amount of amniotic fluid changes every week. Therefore, for each trimester of pregnancy, there are rules. At the very beginning of pregnancy, the amount of amniotic fluid is approximately 30 ml. At 23 weeks, the amount of amniotic fluid is about 600-700 ml. By 30, 32, 33 and 34 weeks, this figure is approximately 600-900 ml. By week 36, the amount of water already increases to 1000. At 37 and 38 weeks of pregnancy, the amount of amniotic fluid becomes maximum. At 39 weeks and closer to the birth itself, there is a decrease in amniotic fluid to 800 ml.

In the presence of some predisposing factors, the amount of water may decrease or increase. When amniotic fluid is less than normal, then this condition is called oligohydramnios. Oligohydramnios is also a pathology and affects the development of the fetus and the condition of the pregnant woman.

Causes of polyhydramnios

Although the causes of polyhydramnios are not yet fully understood, there are some factors that contribute to the occurrence of this pathology.

Polyhydramnios during pregnancy can occur due to such reasons:

• pathology of fetal development;
• infectious diseases of a pregnant woman;
• bacterial infection;
• diseases of the cardiovascular system;
• Rhesus conflict between mother and fetus;
• metabolic disease;
• diabetes;
• pyelonephritis;
• multiple pregnancy;
• large fruit.

Types of polyhydramnios

This condition in a pregnant woman can proceed in different ways: in an acute form or a chronic form. There may be severe or moderate polyhydramnios.

The acute form is characterized by a violation of the general condition of the pregnant woman and the fetus. Such childbirth, as a rule, ends in miscarriage, stillbirth, or such a child will have developmental defects. Polyhydramnios appears in an acute form, usually starting from the 16th to the 24th week. Sometimes the amount of amniotic fluid can increase even within a few hours. In this case, immediate health care, in a dangerous state.

Moderate polyhydramnios during pregnancy is characterized by a gradual increase in symptoms and signs. Moderate polyhydramnios can lead to the birth of a child with developmental anomalies. This is due to the constant lack of oxygen. Very often, moderate polyhydramnios occurs in a chronic asymptomatic form, and therefore can go unnoticed for a long time.

Signs of polyhydramnios

Sometimes a pregnant woman herself may suspect polyhydramnios, by the presence of some signs characteristic of this condition.

1. The belly of a pregnant woman with an excess amount of amniotic fluid reaches a circumference of more than 100 cm. It has a slightly rounded shape. There is a feeling of heaviness in the abdomen and back. The uterus increases in size and begins to squeeze the internal neighboring organs. Therefore, as a consequence, a pregnant woman often has shortness of breath and other ailments.
2. Lower limbs may swell. In some cases it may even happen early effusion amniotic fluid.
3. A fluctuation appears: in a pregnant woman, gurgling in the abdomen is quite clearly audible. There are pains in the perineum.
4. A large number of stretch marks appear on the abdomen.
5. The pregnant woman's pulse quickens. The fetal heartbeat is weakly audible.
6. Since there is more free space, the fetus takes the wrong position in the uterus (pelvic, oblique). This is directly reflected in the childbirth itself: the stretched uterus contracts incorrectly and childbirth with polyhydramnios will be characterized by weak labor activity.

Polyhydramnios is also dangerous because the child can wrap around the umbilical cord. Hypoxia may develop, the fetus will receive less oxygen. Even if the birth takes place on time, the fetus may have intrauterine pathology, such a child may be born with a developmental disorder internal organs or systems.

It should be remembered that the earlier polyhydramnios appears in a woman, the more amniotic fluid accumulates and the risk of complications increases.

Moderate polyhydramnios

The diagnosis of moderate polyhydramnios is made when the amount of amniotic fluid is approximately 1.5 or 2 liters. And although such a diagnosis is made even in the first trimester of pregnancy, it is possible to seriously talk about the presence of pathology only starting after the 16th week. The cause of this condition is often the Rh-conflict of the mother and fetus or the presence of infections.

A woman with moderate polyhydramnios feels tension in the abdomen. It becomes more elastic. When you feel the fetus, you will notice that it often changes its position. You can hear the rolling of water in the stomach. The uterus increases in size and becomes edematous.

You can determine moderate polyhydramnios at a scheduled ultrasound examination or at an examination. Moderate polyhydramnios is characterized by early labor and placental abruption.

A pregnant woman with moderate polyhydramnios should be constantly monitored by specialists, as it sometimes happens that this diagnosis wrong or temporary.

In the absence of a serious pathology, the doctor tries to keep the pregnancy and that the birth takes place naturally without artificial intervention. Conservative treatment is prescribed: vitamins, hypothiazide. If necessary, antibiotic therapy is carried out.

Polyhydramnios at the end of pregnancy

Polyhydramnios at the end of pregnancy is approximately 0.6% of all other pathologies. Its appearance may be due to late toxicosis. This threatens with serious complications during childbirth:

• prolapse of the umbilical cord;
• oxygen starvation of the fetus;
• weakness of labor activity.

Therefore, such a diagnosis is an indicator for carrying out. Treatment of such polyhydramnios is carried out depending on the cause.

Diagnosis of polyhydramnios

You can diagnose polyhydramnios during an examination by a gynecologist at an appointment in antenatal clinic. To do this, the doctor examines the pregnant woman for the presence of relevant signs. The most reliable method for diagnosing polyhydramnios is an ultrasound examination. Doplerometry is also prescribed. Thus, it is possible to identify a more accurate amount of amniotic fluid, check the blood flow in the umbilical cord and placenta.

Careful examination of the fetus reveals possible anomalies in its development.

Polyhydramnios can be diagnosed using the "amniotic index". There is a special table that allows you to determine the amount of amniotic fluid is normal in a certain trimester of pregnancy.

If the diagnosis is confirmed, then the woman is sent for an additional examination of the fetus.

Consequences

With polyhydramnios, the following consequences are possible:

• or termination of pregnancy;
• fetal death or developmental defects;
• if an infection becomes the cause of polyhydramnios, then there is a possibility of infection of the fetus;
• prolapse of the umbilical cord or handle (leg) of the fetus during childbirth;
• the presenting part of the fetus does not fall during childbirth or is not fixed;
• malposition.
• bleeding;
• various gestoses.

Treatment

The main treatment for the diagnosis of polyhydramnios is aimed at eliminating the cause that caused this pathology. At first future mom surrenders everything necessary tests confirming the presence of polyhydramnios: fetal cardiotocography, ultrasound examination, blood test for the Rh factor, dopplerography and others.

As a rule, complex treatment is carried out. In case of moderate severity or unexpressed pathology, the pregnant woman is prescribed drug therapy. Depending on the condition of the woman, treatment can take place in a hospital or at home (outpatient). This condition does not require termination of pregnancy or delivery.

Diuretics (diuretics), vitamins and antibiotics are prescribed. Antibiotics are necessary to fight microorganisms, since the main cause of polyhydramnios often lies in the infectious process. Also, starting from 24 weeks and up to 38, indomethacin is prescribed.

If the prescribed treatment does not help or polyhydramnios takes a severe form, then the doctor prescribes early delivery. use medical preparations that help artificially induce labor.

During artificial delivery, it is necessary to carefully open membranes, and gradually release amniotic fluid so as not to cause fetal asphyxia. This procedure is carried out using a thin catheter. Measures are taken to prevent prolapse of the umbilical cord or limbs of the fetus.

Medicines to stimulate labor should be used no earlier than 2 hours after the outflow of amniotic fluid.

On early dates when it is impossible to carry out delivery, amniotic fluid is released. Amniotic fluid helps the baby move through the birth canal, regardless of the artificial or natural opening of the fetal bladder. But this should be done carefully so that the umbilical cord does not fall out.

If the fetus has malformations that are incompatible with life, then for up to 28 weeks, an abortion is performed.

childbirth

If polyhydramnios does not affect the condition of a pregnant woman or her fetus, then in this case, childbirth is carried out naturally. Mandatory procedure in this case: artificial opening of the fetal bladder. In this case, the volume of the uterus decreases, and this helps to make contractions more productive. Often such childbirth is delayed, and then there is a need for rhodostimulation. Rhodostimulation is carried out by the introduction of labor-accelerating drugs. And already as the most extreme remedy, a caesarean section is performed.

The postpartum period may be complicated by bleeding due to poor uterine contractility. Therefore, the woman is prescribed the introduction of reducing drugs, such as oxytocin and methylergometrine.

Prevention of polyhydramnios

Since polyhydramnios is a pathology, this condition can be avoided if precautions are taken.

It is very important to immediately exclude the presence of an Rhesus conflict. During pregnancy, a woman should move as much as possible. It is necessary to calculate the amount of fluid taken. It also does not hurt to adjust the diet a little.

To prevent polyhydramnios, the expectant mother should take vitamin complexes or medicines prescribed by a doctor.

It is necessary to undergo all examinations and analyzes on time, as they will help to identify a pathology or deviation in the development of the fetus even at the earliest stages.

In this case, you can avoid severe consequences during childbirth and postpartum period. It is important to remember that regular examinations by an obstetrician-gynecologist are not just a formality, but a vital necessity on which the condition of the baby depends.

Useful video

Polyhydramnios during pregnancy later dates- what is dangerous, causes and consequences for the child

The increase in amniotic fluid depends on the gestational age. Its relative volume increases by 45% from gestation, by 25% from . Starting from, amniotic fluid increases by 10% per week, and from 33 its growth stops.

If delivery did not occur on, then there is a weekly decrease in the volume of water by 8%.

If production exceeds resorption, then polyhydramnios develops. For each week of gestation, its own amount of water is determined. Polyhydramnios during pregnancy is considered to be an excess of more than 1500 ml by the end of pregnancy. Abroad, the number 2000 ml is accepted.

An increase in the volume of fluid is reflected in the position of the child (still the fetus). Even in the last stages of pregnancy, his unstable position remains. A large room for movement leads to a change in presentation from head to breech or transverse. This poses a risk during childbirth.

Polyhydramnios during pregnancy may be evidence of various pathologies of the fetus, which are not always amenable to correction or subsequent treatment.

Polyhydramnios during late pregnancy: causes

In 60% of cases, it is not possible to establish why polyhydramnios developed. Amniotic fluid is constantly in a state of exchange. It is absorbed by the amniotic membrane, swallowed by the fetus. So there is a decrease in its volume. The secretion of new portions occurs directly from the placenta, due to the urine of the fetus and lung fluid. A complete exchange cycle takes 3 hours.

The defeat of one of the links of the exchange leads to polyhydramnios. The causes of polyhydramnios may be:

• maternal diseases: diabetes mellitus, infections, inflammatory diseases;
• multiple pregnancy with feto-fetal blood transfusion syndrome;
• congenital malformations: acardia-acephaly, malformations of the nervous or urinary system, digestive tract, lungs, heart, skeleton;
• hereditary diseases and chromosomal abnormalities: Down syndrome, trisomy 13.18 chromosomes;
• neoplastic processes (congenital tumors);
• blood diseases,
• intrauterine infections;
• hemolytic disease of the fetus;
• non-immune dropsy of the fetus;
• pathology of the placenta: chorionangioma, placenta surrounded by a roller.

Polyhydramnios that occurs during pregnancy with twins can be called physiological if it is not associated with other pathological conditions. Two fruits release the amount of liquid required for each, so the total volume will be increased.

Symptoms and clinical signs of polyhydramnios

You can suspect polyhydramnios with rapid weight gain. With the obligatory measurement of the volume of the abdomen and the height of the fundus of the uterus during a visit to the doctor, there is an advance in terms of pregnancy.

With development modern technologies doctors have the opportunity to identify and treat various diseases. This is especially true for women who aspire to become mothers. Before the rapid development of technological progress, childbirth, like pregnancy itself, was something like Russian roulette: lucky - no luck.

Therefore, a large number of women in labor and babies died. One of the most common diseases during pregnancy is polyhydramnios. Today, this syndrome threatens a quarter of expectant mothers. Therefore, constant monitoring by a gynecologist is highly desirable.

What is it? The wording of the diagnosis of polyhydramnios sounds like: "an extreme pathological condition against the background of excessive accumulation of amniotic fluid." The amniotic fluid is in constant motion and is periodically updated.

At normal development pregnancy, its volume by the end of the period should not exceed 1500 ml. However, already in the early stages, a significant excess of the volume of amniotic fluid may appear.

To calculate the rate of amniotic fluid, it is customary to use the table:

Pregnancy period, weeks	Average normal rate, mm	Probable fluctuations, mm
16	121	73-201
17	127	77-211
18	133	80-220
19	137	83-225
20	141	86-230
21	143	88-233
22	145	89-235
23	146	90-237
24	147	90-238
25	147	89-240
26	147	89-242
27	156	85-245
28	146	26-249
29	145	84-254
30	145	82-258
31	144	79-263
32	144	77-269
33	143	74-274
34	142	72-274
35	140	70-279
36	138	68-279
37	135	66-275
38	132	65-269
39	127	64-255
40	123	63-240
41	116	63-216
42	110	63-192

Types and danger of polyhydramnios during pregnancy

Polyhydramnios during pregnancy can lead to infection of the birth canal, developmental abnormalities. Excessive accumulation of fluid leads to constant tension of the uterus, which can provoke. Also, polyhydramnios in pregnant women interferes with the correct location of the fetus.

Subject to early diagnosis acute form diseases. This is a sharp increase in amniotic fluid, which is considered extremely dangerous. The development of this form of polyhydramnios occurs within a few days or even hours. external sign pathology is a sudden excessive increase in the volume of the abdomen.

Also, a pregnant woman begins to experience pain or discomfort in the lumbar and inguinal region. The abdominal wall is visibly swollen. The expectant mother has severe shortness of breath. Listening to the fetal heartbeat is difficult. Such a rapid development of the disease may be accompanied by rupture of the tissues of the uterus.

Another form of polyhydramnios in pregnant women is called chronic. With it, the increase in the volume of amniotic fluid is more moderate. Basically, this form appears at a later date and has less pronounced signs. Often, pregnant women are already used to the feeling of discomfort associated with their position. Therefore, the diagnosis of chronic polyhydramnios can be difficult. And yet this form of the disease can also lead to negative consequences.

First of all, this disease indicates deviations from the norm in the body. The chronic form of polyhydramnios usually develops against the background of viral diseases, genital infections, inflammatory processes in the kidneys or appendages, cardiovascular diseases, and diabetes mellitus.

Sometimes this form can be diagnosed moderate polyhydramnios. Usually it is put in the absence of any tangible changes and complaints. Also, this may mean that the deviation in the amount of amniotic fluid is insignificant and the fluid arrives gradually. Often, with moderate polyhydramnios, there are great chances for full-fledged gestation and independent childbirth. But this disease will certainly affect the fetus.

The nervous system of the baby is most at risk. This is due to a change in blood circulation in the placenta. As a result, the circulation of oxygen in the child's brain is disturbed. In order to minimize the consequences and the possibility of developing polyhydramnios during pregnancy, you need to listen carefully to the slightest deviations in your general condition. Edema, pain and heaviness in the abdomen are already good reason to visit a doctor.

Symptoms of polyhydramnios in pregnant women

Many signs that women are accustomed to consider as an acceptable norm can actually signal this pathology.

Indeed, the range of symptoms of polyhydramnios is quite wide:

• the presence of severity, discomfort and frequent pain in the abdominal cavity;
• almost continuous bouts of weakness;
• shortness of breath with minimal physical effort. May be due to too high standing of the diaphragm;
• sudden increase in heart rate;
• constant profuse swelling of the legs;
• a condition in which the abdomen at the level of the navel in girth becomes more than 100 cm;
• the appearance of many coarse stretch marks;
• frequent distinct squelching in the abdomen (fluctuation);
• an increase in the uterus disproportionate to the period.

Polyhydramnios in the last stages of pregnancy is usually accompanied by constant tension in the uterus, excessive deviation of its size from the norm, increased anxiety of the fetus. There is also an increase in the height of the fundus of the uterus above the womb.

Due to the excessive freedom of the fetus inside the mother's womb, there is a risk of entanglement with the umbilical cord.

If you have all or more of these symptoms, you should contact your gynecologist as soon as possible. Most likely, an ultrasound will be ordered. For the diagnosis of polyhydramnios in pregnant women, there is the concept of "amniotic index". And if you have found polyhydramnios - you can not pull with treatment.

Polyhydramnios: causes

So, we found out that this disease is not so difficult to diagnose. Now it will not be superfluous to determine the causes of polyhydramnios during pregnancy. Unfortunately, doctors cannot name the specific prerequisites for polyhydramnios with absolute certainty. By the way, about a third of cases remain without finding out the reasons. And yet there is a certain category of women with an increased tendency to polyhydramnios. This is the so-called risk group, in which this pathology observed more frequently than others.

First of all, patients with diabetes. It is his doctors who put him first on the list of risks of polyhydramnios. Next come infections, diseases kidney disease, heart disease, any vascular disease. Also, most cases of polyhydramnios are detected when rhesus conflict pregnancy.

An interesting picture can be observed when multiple pregnancy: polyhydramnios in one fetus is often combined with a sharp oligohydramnios in the second. Too large fruit can also cause this deviation. The list of causes of polyhydramnios includes violations excretory function and real pathology of the fetus.

The latter include:

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

The threat of polyhydramnios is also relevant when infected with classic infections:, rubella, (abbreviated TORCH infections). During pregnancy, a meeting with a virus to which immunity has not yet been developed is especially dangerous. Such an infection is characterized by an increased circulation of microbes in the blood that can penetrate the child's body.

Viruses of the TORCH group are characterized by mild symptoms. Therefore, they are difficult to diagnose. With moderate polyhydramnios, the causes of its occurrence may not be identified and the development of pathology occurs without a pronounced factor.

On last trimester polyhydramnios in pregnant women can be caused by swallowing dysfunction at the baby. The fact is that a grown child absorbs up to four liters of amniotic fluid per day, the renewal of which occurs at intervals of three hours.

In the presence of one of the described disorders, there is a real risk of developing acute or chronic polyhydramnios. And although there is a chance that you will not get sick, constant monitoring by a gynecologist is necessary. Do not forget that this disease can and should be treated. And the sooner the diagnosis is made, the higher the chances of a full-fledged gestation and safe delivery.

Possible consequences

The main threat in polyhydramnios is premature spontaneous interruption pregnancy. About a third of all cases end in this way. Second side effect polyhydramnios in 36% of cases is the strongest toxicosis, turning into frequent uncontrollable vomiting.

This is very dangerous and threatens the expectant mother with dehydration. Sometimes this disease leads to pelvic or transverse presentation fetus. In some cases, fetoplacental insufficiency may develop. This problem relevant for 30% of pregnant women. This dangerous state, in which all functions of the placenta are violated. As a result, the fetus suffers from. First of all oxygen starvation strikes at metabolic processes.

In early pregnancy, hypoxia slows down the development of the fetus. In the later stages, it leads to growth retardation, affects the nervous system and reduces the infant's immunity. Also, fetoplacental insufficiency can cause anomalies in labor, which often leads to fetal death.

Polyhydramnios during pregnancy has dangerous consequences for the central nervous system and gastrointestinal tract of the unborn baby. Also, the disease is fraught with heavy bleeding. Polyhydramnios sometimes leads to very dangerous late gestosis.

Classical treatment of polyhydramnios

Since the diagnosis of polyhydramnios future mother should be aware of its danger. As a rule, women are assigned to a hospital for constant monitoring by health workers. With light and medium degree polyhydramnios, if there is no increased disturbance of blood circulation and respiration, doctors will do everything possible to maintain and safely resolve the pregnancy.

In extreme cases, with an acute form of the disease, an artificial interruption may be necessary, since often such a situation poses a significant threat to the life of a woman.

Accurate determination of the etiology of polyhydramnios facilitates the recovery process. Since, only after knowing the source of the primary origin of the disease, the doctor can prescribe the optimal treatment.

classic general treatment polyhydramnios is based on antibiotic therapy. At the advanced stage of polyhydramnios - broad-spectrum antibiotics, except for tetracycline. The main task of treatment is to establish microcirculation, uteroplacental blood flow and, if possible, metabolic processes. With a viral etiology of the disease, immunomodulators can be prescribed.

Mandatory accompanying agents are vitamins and diuretics. Sometimes, for additional diagnosis, a puncture of the amniotic membrane may be used. This procedure is considered quite dangerous and is prescribed only as a last resort. If polyhydramnios was provoked by any disease, doctors will first of all try to completely eliminate it.

Polyhydramnios during childbirth

With polyhydramnios, childbirth, as a rule, occurs ahead of time. The rupture of the fetal bladder can occur suddenly, because of which the amniotic fluid pours out abruptly and abundantly. Against this background, prolapse of the handle, leg or umbilical cord may occur. Also, an early outpouring provokes a significant weakening of labor activity, sometimes there are no contractions at all.

In addition, there is an excessive stretching of the uterus, which is fraught with placental abruption, heavy postpartum bleeding and other extremely dangerous consequences. In addition, due to the suddenly increased space, the baby may take the wrong position - gluteal or transverse.

To prevent such a situation and stop the outpouring of amniotic fluid, an early amniotomy is performed - a puncture of the fetal bladder. Thanks to this procedure, amniotic fluid is poured out in a thin stream, the uterus contracts and the contractions become stronger. However, in most cases, doctors insist on a caesarean section.

To avoid polyhydramnios during pregnancy and childbirth, it is necessary to undergo an examination and, if necessary, treatment of infectious and inflammatory diseases at the stage of pregnancy planning. It is also necessary to maintain a healthy lifestyle in order to prevent endocrine pathologies- Diabetes or obesity. Regularly visit the gynecologist throughout the entire period of pregnancy.

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