Amniotic Fluid - 6 - Polyhydramnios: Causes of Too Much Amniotic Fluid
Friday, May 16, 2008
Kenneth F. Trofatter, Jr., MD, PhD
There are some specific conditions in which polyhydramnios is frequently associated. The easiest to understand are the fetal anomalies that inhibit or prevent fetal swallowing or block the passage of fluid through the fetal bowel. (Recall, much of the amniotic fluid around the baby is urine and the baby must be able to swallow that and move it through the bowel to the colon where it can be reabsorbed). Common structural gastrointestinal abnormalities that are accompanied by polyhydramnios include esophageal atresia (incomplete development of the esophagus), tracheoesophageal fistulas (aberrant connections, sometimes ending in ‘blind pouches’, between the trachea and the esophagus), duodenal atresia with the classic “double bubble” seen by ultrasound in the upper abdomen (and at least 30% of these associated with Down syndrome – trisomy 21), other small bowel atresias and obstructions (the lower in the small bowel the obstruction, the greater the number of fluid-filled loops of bowel), gastroschisis (a condition in which much of the small bowel is outside the abdomen through a small defect adjacent to the fetal umbilical cord insertion site), gastrointestinal ‘malrotations’ and ‘midgut volvulus’.
Other fetal anomalies associated with polyhydramnios probably have different reasons for contributing to the excessive fluid. Large neural tube defects and certain neuromuscular disorders (such as myotonic dystrophy), for example, probably exert their effects by impairing the ability of the baby to actually swallow fluid, even if the esophagus and gastrointestinal tract are patent. Certain cardiac defects and fetal arrhythmias may contribute by virtually putting the baby into congestive heart failure. Heart failure is also likely to be a major contributing factor when the baby has severe anemia secondary to maternal isoimmunization, a fetal hemoglobinopathy, or bone marrow suppression of red blood cell synthesis as is seen with congenital Parvovirus B19 infections.
Other congenital infections (e.g., syphilis, toxoplasmosis, cytomegalovirus) may also result in excessive amniotic fluid although the actual causes of this may be different depending on the organism involved. Indeed, any condition that results in immune or nonimmune fetal hydrops, including chromosomal abnormalities and inborn errors associated with severe metabolic or cardiac dysfunction, may be accompanied by polyhydramnios. One of the more unusual conditions that is associated with polyhydramnios and fetal hydrops is the so-called “mirror syndrome” that occurs in some cases of severe maternal preeclampsia. Lithium toxicity appears to cause polyhydramnios by causing the baby to have a condition called diabetes insipidus which results from inadequate vasopressin (antidiuretic hormone – ADH) secretion by the posterior pituitary gland and, subsequently, massive production of very dilute (unconcentrated) urine.
The most common clinical condition that is often accompanied by polyhydramnios is diabetes, particularly, gestational diabetes and type 2 diabetes. It is much less likely to be found in long-standing diabetics, particularly, if they have significant kidney, cardiac, or vascular disease. In diabetics, polyhydramnios is more common if the diabetes is poorly-controlled and/or the baby is macrosomic. At times, even improving the diabetic control will not reduce the increased amniotic fluid. The etiology of the increased fluid in certain diabetics is unclear, but when present, it increases the risk for a poor fetal outcome.
In the next post, we will continue with a discussion of polyhydramnios – pregnancy complications, evaluation, and management….
Labels: fetal hydrops, fetal macrosomia, isoimmunization, polyhydramnios
54 Comments:
At Tue May 20, 09:19:00 AM 2008,
Lori said…
Hello! I am posting about an unrelated topic - I hope that is ok. Long story short, I have had two early miscarriages in the last year and a half. Since then, I have been diagnosed with Lupus Anticoagulant, MTHFR, and Asherman's syndrome. I had surgery for the Asherman's and am on Lovenox, baby aspirin and Folgard for the LAC and MTHFR - and I just found out I am pregnant. My doc thinks one or more of the above issues are what caused my miscarriages but obviously doesn't know for sure. So now my two questions: 1) He wants to put me on erythromycin for 6 weeks to ensure I don't have and don't get an infection. He said infection *could* have played a part in my miscarriages. First off, are antibiotics ok during the first trimester - I have read varying thoughts on the matter. And if yes, is 6 weeks really necessary just as a preventitive measure? My second question is - my progesterone level on day 28 came back at 79, which is very good from what I have read, but my doc still wants to give me weekly progesterone injections. Is this necessary? Is it ever possible to have your progesterone be too high? Thank you so much for your insight! Lori
At Sun May 25, 05:51:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
Hi Lori: Personally, I would have preferred to treat you with the erythromycin prior to the pregnancy if at all. It sounds like you are in good hands though. At that progesterone level, you will probably get limited benefit from supplemental progesterone, but it should't be "too much" either. Soon the placenta will be making more than we can routinely give you anyway. Good luck and let us know how things turn out. Dr T
At Wed Jun 04, 05:36:00 PM 2008,
Jennifer said…
I have been diagnosed with polyhydramnios and my doctor thinks that our baby may have duodenal atresia. I am waiting to see a specialist but am already 34 weeks pregnant. Is this something that should have been seen earlier in my pregnancy? Also, should I be taking it easy and not exercising? Another article I read on this topic said polyhydramnios puts you at risk for preterm labor. Also, how soon after birth do they do the surgery to correct the atresia? Any answers would be greatly appreciated ad I am extremely worried.
At Sat Jun 07, 07:26:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Jennifer: As I am sure you have read by now, about half of babies with duodenal atresia have trisomy 21 (Down syndrome). I have been involved in many cases where this was found late in pregnancy only after polyhydramnios developed. If you had not had an ultrasound since earlier in midtrimester it could have beeen easily missed. The repair is usually done shortly after birth if the baby is stable from other respects, but ask your doctor to arrange a consultation with a neonatalogist and a pediatric surgeon to give you the full idea of the evaluation and management options following delivery. Best of luck to you and please let us know how things turn out! Dr T
At Tue Jul 01, 08:15:00 AM 2008,
Monica said…
I miscarried at 22 wks in June 06, all test revealed nothing. The only issues was that I had excess amniotic fluid. I am now 20 wks pg and have been diagnosed with Polyhydramnios again, volume of liquor is 26cm. I am really worried, they have referred me to UCH for a more detailed scan on Friday
At Tue Jul 01, 06:39:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Monica: Idiopathic polyhydramnios recurs about 50% of the time, we are just too stupid to figure out why! I hope they look at your cervix while they are evaluating the baby and the fluid. You could have cervical incompetence as well. Best of luck and let us know what you find out! Dr T
At Mon Jul 14, 09:30:00 AM 2008,
Anonymous said…
I am 32 weeks pregnant and my doctor told me that my overall fluid is 21.8 but that a pocket was 6.3 (I guess a pocket should not exceed a 5). I have had genetic testing/trisomy testing etc. and everything has come back normal on the baby. Because of a bicornuate uterus, I have had ultrasounds every four weeks since 20 weeks. A specialist came to review my last three ultrasounds and said he doesn't see anything wrong with the baby..i.e. kidneys, heart etc. My doc said they will now give me weekly ultrasounds to monitor the pocket/fluid but anticipates all will be OK. Thoughts?
At Mon Jul 14, 07:09:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous July 14: You have 'generous' fluid, but I am not sure I would call that hydramnios at this point. Your doctors might consider rescreening you for diabetes since 10-15% of women who develop diabetes in pregnancy will not do so until 32-36 weeks. That is always a possible cause of excessive fluid! Good luck and you will probably do just fine! Dr T
At Sat Jul 19, 07:32:00 AM 2008,
Anonymous said…
I will be 34 weeks on sunday. I was put in the hospital last friday due to i was 2-3 cm dialated and having contractions. I have have the two shots of cortisteriod to improve her lungs. I was also put on procardia. When i was put in they said i was borderline polyhydramnio. By the time i was discharged on monday they said i had to much fluid around her. I not long found out i was gestational diabetic. What problems could my baby have at birth? I have had one other pregnancy with gestational diabetes and he is fine and never had any problems.
At Mon Jul 21, 04:25:00 PM 2008,
Anonymous said…
On an ultrasound done @ 22 1/2 weeks, a "shadow" was found on my baby's heart.It was speculated that this was a calcium deposit.They also found that my amniotic fluid level was @ 23. Since I'm 35yr's I had the genetic screening done for down's, etc. w/ chances of DS being about 1/5000.I was told to disregard the office results since I already had gen. testing, but have been referred to a perinatologist in 2 days for a closer look.I have also been having mild contractions, pelvic pressure, and low abdominal pain, all sporadic. I've been to hospital 2x for monitoring w/ no conclusion other than increase fluid intake.I've had 3 perfect pregnancies resulting in 3 healthy, normal children.Any suggestions?I'm trying not to stress but after my online research, it's not working!Kristi
At Wed Jul 23, 11:30:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous July 19: The major complications of uncontrolled diabetes late in pregnancy are polyhydramnios (too much fluid), macrosomia (big babies), preterm delivery secondary to uterine overdistention (from polyhydramnios and macrosomia), neonatal HYPOglycemia (low blood sugars), respiratory distress syndrome (diabetes can cause delay in lung maturation), hyperbilirubinenia (secondary to delay in the baby's liver maturation), and pulmonary hypertension. Just because a baby is big, does NOT mean it is ready to survivie in the world outside the womb! Good luck. Dr T
At Wed Jul 23, 01:26:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Kristi Jult 21: There are many possibilities at this point based on what you have told me. Tell you what, after you have seen the perinatologist and he/she does a good ultrasound on you, write back and let us know what they find and are thinking. Best wishes. Dr T
At Wed Jul 30, 09:05:00 PM 2008,
Anonymous said…
Sat with Doctor after ultrasound that resulted in having a level of 23 for amniotic fluid. I am 33 weeks pregnant, not sure of my last menstrual as this was a big surprise for me at 44 years old. Have taken all test for the exception of the needle going into my tummy and everything came out great, knowing nothing is 100%. Have had a much earlier pregnancy and my daughter weighed 8lbs.15 oz. and it was an uncomplicated birth. However, 25 years ago did not have all the test they have today. Is my level considered extremely high and how common is it to carry larger due to excess fluid. thank you
At Thu Jul 31, 04:15:00 PM 2008,
Aaron said…
Hello!! I have several questions I was hospitalized at 23 weeks due to preterm labor caused by an infection, during that time they also found that I have an accessory lobe of my placenta and I had a amniotic fluid level of 25. Thank God I was sent home on bed rest and given nifedipine for my contractions which never went away after they got rid of the infection. My fluid has increased from 25 to 32 my question are all the abnormalities that cause hydramnios detectable by ultrasound or blood work. We have seen her face and know she does not have malformation of her mouth, her kidneys look good, her stomach looks good, my blood work has been good and no diabetes. So should I assume that she is going to be fine, or are there causes that only show up after birth? My second question is having this extra fluid is making it hard to breath, and I am lightheaded a lot of the time, my doctor has mentioned a medication to stop or slow down the production of urine the baby makes, is this a safe alternative to amniocentesis to drain the fluid? I would rather not give something to the baby if I don't have to, but will amnio be more dangerous? It is awful hard to breathe or I would opt out of both options. Thank you
At Thu Aug 07, 06:03:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous July 30: If you do not have diabetes and the baby has no structural abnormalities, a normal stomach, and moves normally, this may well just be 'idiopathic polyhydramnios' - that means we don't know why there is a little extra fluid. Your fluid is at or just above the upper limits of normal, so chances are everything is fine. But, since that and the baby are filling up your uterus, you will measure 'larger than normal'. Good luck and let us know how things turn out! Dr T
At Thu Aug 07, 06:12:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To aaron: What sort of "infection" did they think you had? It could not have been intrauterine or you would have delivered by now! Your preterm contractions are more likely related to the extra fluid. Any time there is that degree of polyhydramnios this early in pregnancy, I always worry that something else is going on with the baby. By the way, did they happen to to do Doppler studies on the baby's umbilical and middle cerebral arteries? Abnormal resistance in the umbilical artery in the presence of polhydramnios increase the chance that the baby has a chromosomal abnormality; increased peak systolic velocity in the middle cerebral artery increasest the likelihood of fetal anemia - both can be accompanied by hydramnios. There is also a possibility the baby ha a neuromuscular or swallowing disorder. I will be very curious to hear what you find out either before or following delivery and pry for your sake his is simply 'idiopathic polyhydramnios'. By the way, amniocentesis is generally not a very good way to manage this so early in the pregnancy. The fluid usually reaccumulates in less than 72 hours. If your doctors choose to use indomethacin, it usually does not have any serious long-tern effects on the baby. Good luck! Dr T
At Thu Sep 11, 09:07:00 AM 2008,
Brittany said…
Hi, I too was diagnosed with Polyhydramnios Last week at 31.5 weeks.. My level is at 31!!! I went to a specialist, who didn't explain anything to me. I know that he said there was a cystic growth on the umbilical cord, but he told me to ask my doctor. I feel like everyone is giving me the run around:( i truly do. I saw her kidneys, bladder, full stomach etc....she is measuring 3 weeks ahead, and i just want someone to tell me whats going on. Also, it's soo hard to breathe, it sucks!!!! I just want answers, can someone help me!???!!!!?? is my baby going to be okay?
At Thu Sep 11, 09:07:00 AM 2008,
Brittany said…
Hi, I too was diagnosed with Polyhydramnios Last week at 31.5 weeks.. My level is at 31!!! I went to a specialist, who didn't explain anything to me. I know that he said there was a cystic growth on the umbilical cord, but he told me to ask my doctor. I feel like everyone is giving me the run around:( i truly do. I saw her kidneys, bladder, full stomach etc....she is measuring 3 weeks ahead, and i just want someone to tell me whats going on. Also, it's soo hard to breathe, it sucks!!!! I just want answers, can someone help me!???!!!!?? is my baby going to be okay?
At Mon Sep 15, 11:33:00 AM 2008,
Stu said…
Hi my names is stu. just back from a 32 week scan with the wife and they say our baby girl is a wee bit bigger than she should be and that she has too much fluid. My wife is 38. The results today are ""BPD 85.0mm - HC 319.00mm - AC 300.0mm - FL 67.0mm . Heart action present. Presentation CEPHALIC. Amniotic fluid: normal. Amniotic fluid index : 25.0cm"" They've booked her in for her 3rd glucoze test and her last two results were low. I'm soo worried, this is my first kid, my family has no luck, we have huntingtons disease on my side of he family and to be honest i'm actually so worried by unborn girl will be downs. What do you guys think?
regards, stu
At Tue Sep 16, 07:41:00 AM 2008,
Anonymous said…
I had Poly with my last pregnancy- a pretty good case of it too. I was taken out of work early.I was the size I should have been full term at 7 months. They never found a reason for it. My daughter is now almost 2 and perfect. I am now 24 weeks pregnant. Last week I went in due to a kidney infection and they happened to messure me and at 23 weeks I was messuring 27cm. They have me scheduled for an Ultra sounds. But am already concerned. I didnt think it would happened again. With my first daughter Everything was normal! What would cause it to happen twice?
At Fri Sep 19, 03:47:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Brttany: If the baby is measuring "3 weeks ahead" the first thing your doctors should do is rescreen you for diabetes. What kind of "cyst" did they see on the umbilical cord? Dr T
At Fri Sep 19, 03:50:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Stu: Babies with chromosomal abnormalities are not usually large for gestational age. Let's see what the repeat screening for diabetes shows. By the way, do you know if you are a carrier for Huntiington's yourself? Dr T
At Fri Sep 19, 03:51:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous Sept 16: One of the most important dictums in high risk obstetrics is that "history tends to repeat itself" even if we are not smart enough to figure out why! Let us know what your ultrasound shows and good luck! Dr T
At Wed Oct 22, 08:31:00 PM 2008,
Shannan said…
Well, I went in for an ultrasound at 26 weeks (two weeks ago) and they said my baby had a larger than normal kidney, and I had a lot of amniotic fluid, but they sent me to a maternal fetal ultrasound clinic last friday and the doctor there said baby's tummy was the biggest part of his body and I had too much fluid. Didnt give me an amount though. The kidneys were normal. He also said it looked liked undiagnosed gestational diabetes.
I took the one hour glucose test on Monday and got my results back today. They were normal. Now I can't find anything that lists excessive amniotic fluid and a fetus with a oversized belly as symptoms.
I am 28 years old, and my 8 year old son was 10 lbs at birth with no problems, and the father of this baby was 11 lbs 1 oz at birth. Could this all be just that I am having a big baby?
At Fri Oct 31, 05:34:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Shannan: Yes the baby is "macrosomic" (i.e., has a BIG BODY) and even though that is more common in diabetics, since it does not appear you have diabetes, this is most likely 'constitutional.' Big Daddy, big previous child, and now another big baby! Sometimes we just don't have answers for these things, but in your case, I worry a lot less than in others! Best wishes for the rest of the pregnancy and plese let us know how things turn out! Dr T
At Sun Nov 02, 01:24:00 AM 2008,
Stu said…
Hi its stu again from this post http://www.healthline.com/blogs/pregnancy_childbirth/2008/05/amniotic-fluid-6-polyhydramnios-causes.html#c5589817792841012439
our daughter was born healthy and though they said she'd be 9 to 9.5 lbs, she was only 7lb 10 oz
so much worry about nothing
At Wed Nov 05, 11:00:00 AM 2008,
Anonymous said…
my wife is currently 28 wks, and were referred to a university clinic about 3 wks ago because her OB noted a megaureter on one of her prenatal ultrasounds. she just had her f/u appt with them and now they tell us there may now be polyhydramnios. they recommend we see them again in 6 weeks, and only offered TORCH blood screening today. any ideas? should we possibly seek a second opinion?
At Mon Nov 10, 01:00:00 PM 2008,
Worried Sick said…
Hello Doctor, I am about 22 weeks pregnant and in my 18 weeks ultrasound nothing was detcted except an EIF, I am an asian so didnt worry too much about it. I had another ultrasound done at 21 weeks which showed the doubble bubble, the doctor said the bay has duodenal atresia and also pylectasis. I did get my amnio done and the FISH results are negative and I also have a fetal ultrasound set up soon....The doctor says everything else looks fine...I wanted to know that if a baby has duodenal atresia but not down syndrom and possible has a fine heart too what are the other problems that the baby could have even after surgery??
At Thu Nov 13, 08:20:00 PM 2008,
Anonymous said…
I am 34 weeks along and have been seeing a specialist evry 4 weeks from the beginning due to a few miscarriages. I had a perfect boy 15 months ago and with this child was given the option of going to the specialist now that I had a normal pregnancy. I have had what seems like a million ultrasounds already but after my 32 week one they started to watch my fluid because it was at 22. Now at 34 weeks it is 28 and I have started fetal monitoring. My diabetes test was negative and the specialists just keeps telling me the baby looks perfect. Do I need to be worried about these abnormalities you speak of? Wouldn't they have seen them since I have had so many ultrasounds?
At Fri Nov 28, 08:35:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Worried Sick: If the baby is chromosomally nornal, does not have a syndromic (genetic) problem, only has duodenal atresia and no other abnormalities of the gastrointestinal tract, heart, or other organs, then the prognosis is very good. The overall early mortality rate now stands at about 3% in most series with most deaths occurring as the result of the presence of associated anomalies such as complex congenital heart defects. The babies can have complications related to electrolyte imbalances and respiratory difficulties, usually the consequence of premature delivery resulting from polyhydramnios (excessive amniotic fluid). Survival rates are generally good because of the advances in neonatal care such as high-frequency ventilation, surfactant supplementation, and nutritional support. Pediatric anesthesia and advaces in neonatal heart surgery also contribute to improved outcomes. Long-term survival is excellent at rates reported between 86% and 90% with the primary factors that contribute to mortality again being associated abnormalities, chromosomal, and genetic problems. Best wishes for the rest of your pregnancy and please let us know how things turn out. Dr T
At Fri Nov 28, 08:41:00 AM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous Nov 13: Most likely you have what causes 50% or more of polyhydramnios - idiopathic polyhydramnios - which means we are too stupid to figure out why there is extra amniotic fluid (and, hopefully, it does not matter anyway). You could have late onset gestational diabetes, as occurs with as many as 10-15% of cases of gestational diabetes, if you have not been tested since the extra fluid has been noted. It is highly unlikely that your doctors have missed a birth defect since the fluid is still only modestly elevated. If it was very high, I would worry about conditions that are more difficult to detect by ultrasound, such as esophageal atresia with a trachoesophageal fistula, or a fetal swallowing problem secondary to a neuromuscular condition, but the latter is quite rare and if the baby is moving well, it is also very unlikely. Chances are you and the baby will do just fine. Best wishes and please let us know how things turn out! Dr T
At Sun Dec 07, 05:53:00 PM 2008,
Anonymous said…
My son and his wife are expecting. She is a tiny girl of Asian descent. Although he is lean and lanky now, he weighed 9lbs. 6 oz at birth. His father, my husband, weighed 12 lbs. 1 and 1/2 oz at birth.
They thought the baby had a mega-urator and now say that there is too much amniotic fluid. They gave my daughter in law a test for diabetes and she doesn't test positive for it. The baby isn't due until the end of January, but the baby is 2 to 3 weeks ahead in size. They are giving her steroid shots for lung development of the baby. This is all taking place in Germany. I don't know what to think.
At Tue Dec 09, 10:44:00 PM 2008,
Anonymous said…
Hi, I have just had my baby on 28th November 08, 3 weeks premature. I was diagnosed with high sugar levels during my third trimester and my waters broke at 35 weeks so had an emergency c section. The doctor who performed my c section only informed me that i had polyhydraminos. All the scans i had before, nobody told me anything about excess amniotic fluid.My baby was large, weighed 3.45kg at birth. She doesn't have any external impairments, but I am worried that she could have internal problems. Any answers will be highly appreciated. Thanks, Shaa
At Sat Dec 27, 01:13:00 PM 2008,
Paige said…
Hello, according to my doctors, I am 30-31 weeks but I went in for my checkup yesterday and they said I am measuring 33-34 weeks. I told him how tight my belly felt and how hard it has been recently to get up, reach for something, etc. because my belly feels so big and tight. I have a healty 5 yr old and I don't remember feeling this way before. Feels like a bowling ball most of the time. I feel a great amount of fetal movement so I am wondering too if he has a decreased amount of room. The doctor mentioned I could have high fluid levels and that if I measured ahead on my next visit, 2 weeks, they would do an ultrasound. Now after doing some research myself, should we wait that long for an ultrasound since I am measuring almost 3 weeks ahead? I am really concerned. I also find it hard to breath and my heart rate seems really strong altough my blood pressure always checks out around 100/60. My blood sugar was tested last month and that came back ok. Should I call on Monday and ask for an ultrasound sooner? Thoughts?
At Mon Dec 29, 10:15:00 AM 2008,
Anonymous said…
At 36 weeks I measured large and was found to have what the Dr. said was slight polyhydramnios. They also found during the sonogram that my baby had mild ventriculomegaly. I am going in for diabetes testing in a few days, and a non stress test today. The doctor seems to not be too concerned and has said I can continue to see my midwife. She seems to think that since everything was normal before 36 weeks that the outcome should be good. I am however more concerned than the doctor! What do you think?
At Mon Jan 19, 11:20:00 PM 2009,
Marina said…
Hi, I am 31 weeks pregnant and just two weeks ago I found out that my amniotic fluids were above normal. I was told my level is at 33. I am very worried that there could be something wrong with my baby. I have been having ultrasounds every 4 weeks since I was 20 weeks, firt because of an echogenic focus found on my babys heart and also one of the kidneys was a bit enlarged. I have been told the kidney is normal size, but I can't stop thinking that my baby could have down syndrome or another birth defect. I did not do the amnioscentisis. I would appreciate it if you could give me some insight or tell me what questions I can ask my doctor . I feel very worried and do not know if I should stop working to prevent premature labor. I am 32 years old. Thank you. Mary
At Thu Jan 22, 07:12:00 AM 2009,
Anonymous said…
Hi There,
I've been told I have higher than normal amniotic fluid levels following at growth scan at 28+3. My AFI if 25.4 so slighly over the 97th percentile and I have had a GTT several days before the scan that came back 'ok' though I'm not sure what that means as I do not have the figures. I was told the baby was 'a good size' but again I'm not sure what that means.
At my anomoly scan at 21 weeks no abnormalitys were detected and my baby is active with a good heartbeat (140 - 156 seems to be the figures when monitored for 40 mins due to bleeding, now explained as an ectropion)
I'm overweigh too begin with (BMI of 41 at the 12 weeks, which I know is high but I had lost 2.5st at this point so was lower than it had been) I have been given Asprin 75mg daily since 4weeks (the reason for the growth scans) as I have had a previous early miscarriage and have been told to continue this to 36 weeks. I have another growth scan booked for 34 weeks and am not seeing the consultant again until then. They did give me a blood test for viral infections but beside that I'm very worried that I need things investigating. My doctor said he would likley repeat the GTT test at 34 weeks. Am I over reacting or should I push to try and get things looked at. Thanks for any advice you can give me. Nikki
At Sat Jan 24, 01:22:00 PM 2009,
Anonymous said…
hi im keesh and im 30 yrs old my aniotic fluid is high and my baby is big. i see a specalist every two weeks they say everything is fine. i even take a n.s.t test which is a stress test and they say that fine.i cry everyday cause this is my third child and it's my boy and i pray for him to be healty my question?....they can not drain out the fluid or some of it. please pray for me i cant think or focus at all cause im so sacred.....what to do?
At Wed Feb 11, 02:01:00 PM 2009,
HIPPIEGURL said…
Hi. I am 21 weeks pregnant and I found out that my 20 week ultrasound revealed mild polyhydramnios. My doctor told me not to worry, but after doing research, I am. How much do i have to worry?
At Thu Feb 19, 12:28:00 PM 2009,
Amanda said…
I stumbled across this blog today and thought I'd ask a question. It has been a few months since any post so I hope it is still active.
I am almost 26 weeks and diagnosed with polyhydramnios. They have found that she has a double collection system in her left kidney.
I had severe poly with my first child. My uterus measured 47 cm at 35 weeks. There was no prenatal diagnosis that could explain the extra fluid. My son was born with CHARGE syndrome and had, among many other medical conditions, a TEF/EA, Choanal atresia, and complex heart defects. All of these things led to the extra fluid.
He was born via emergency c-section at 35 weeks due to unexplained loss of heartbeat.
Now that we are experiencing the same fluid issues and we have issues with her kidneys I am incredibly nervous that she also has CHARGE despite the low risk.
We have seen her stomach on the ultrasound but were told she could still have an TEF/EA just with a connection that would allow the stomach to fill.
My question is, could a double collection system as an isolated issue cause polyhydramnios? I can't seem to get a straight answer from my perinatologist and there is not much information on the internet. I had issues with chronic UTI's as a child but never had any imaging done of my kidneys. Is there any way to test if I have a double collection system? I know that if I have it she has an increased risk of having it and I may be able to relax a little more about CHARGE. Thank you for any advice!
At Tue Feb 24, 01:13:00 PM 2009,
Heather said…
Hi, I am writing to ask if my highly unusual experience with polyhydramnios might be something I should investigate further for other health issues. I have 5 and 7 year old sons. I had SEVERE polyhydramnios with both pregnancies - the volume being quoted as happening in 1 in 1,000 pregnancies for my first child, 1 in one million pregnancies for the subsequent pregnancy. Both children were delivered slightly early.
My oldest son has a cleft lip and palate, diagnosed (the lip, anyway) in utero. We blamed the cleft for the polyhydramnios and moved on. I delivered at 37 weeks with 4 quarts of fluid drained during the c-section.
The 2nd pregnancy presented problems at the same time at 20-22 weeks gestation. I could feel the change before my appointment and knew where I was headed. We went into labor at 27 weeks and they were able to stop it. At 29 weeks, they performed a therapeutic amnio for reduction of fluid (not fun!!!) and reduced by 2 liters. I was put on moderate bed rest as I had a toddler and they were quite nervous about us making it closer to term. This enabled us to make it to 36 weeks, when my son's lungs were "good enough." This time, of course, they monitored us closely and determined no birth defects were detectable. He later presented metopic craniosynistosis, but we cannot see evidence of it from birth (pictorally). I have made our craniofacial team rich - but they are worth it!!!
The doctors were completely baffled by this seemingly ideopathic severe case of P.H. following my first pregnancy. I showed not even a hint of gestational diabetes ever. The second pregnancy especially, was very painful. I hurt a lot!!! Also, my uterus was so enormous that if I reclined straight back even 45 degrees, I would faint from it pressing on my vena cava. This made amnios and c-sections particularly wonderful. My OB's told me I was crazy if I wanted to do this again and we had a tubal ligation.
I read somewhere that other maternal causes could be kidney related. My sister is currently being tested for a rare adrenal disorder that has genetic tendencies. Have you ever heard of P.H. associated to anything of that nature? Also, I have some lupus-like, fibromyalgia-like symptoms with muscle and joint issues. Could there be a connection to other diseases? Just curious if I should present this pondering to an internist. Thanks in advance for any insight you can provide.
At Wed Feb 25, 02:54:00 PM 2009,
Anonymous said…
my wife has been diagnosed with polyhydramniossince about 20 weeks. they have since done a glucose test and that was negative, they have taken blood samples and tested the amniotic fluid. they have not given us the results yet. they last ultrasound scan showed there was nothing physically wrong with the baby. they have prescribed a drug called sulindac to reduce the fluid. is there any risk to the baby with this drug. the amount of fluid was measured at a depth of 17cm, do these drugs work in reducing the fluid or just stop its production.
At Wed Mar 04, 05:53:00 AM 2009,
Anonymous said…
Hello. I was pregnant with twins and I had severe Polyhydramnios. My doctor found this out very early in my pregnancy. He told me that he was going to do an amnioreduction but he did not want to do it very many times b/c it would send me into labor. At that time he also told me of another solution that we could try. It was a laser surgery of some time but could only be done in Flordia (I think that is correct). I cannot remember exactly what it was. Anyway, he never mentioned it again. When I was about 22-24 weeks along I started premature labor. They gave me medicine to stop it and put me in hospital. They did another reduction of 2 liters then the very next day done it again taking 2 1/2 liters. I told them something felt wrong but no one listened. As soon as the needle came out I went into labor. As a result my babies did not survive. Did the doctor take too much fluid off? What went wrong. I felt that they done something wrong or there was something they could have done differently.
At Tue Mar 17, 05:49:00 PM 2009,
Anonymous said…
I am 27 weeks pregnant with Boy/Girl Twins. My dr called today to let me know that Baby A has excessive fluid and that i will have to see a specialist. She did not tell me anymore than this. I have had 4 ultrasounds done this pregnancy and the excessive fluid didnt show up until this last one at 26 weeks. I had the quad screening done and it came back normal. I have had one other pregnancy and everything was normal.
At Wed Mar 25, 03:08:00 PM 2009,
Anonymous said…
hello dr my wife is 34 weeks pregnant and her fluid is measuring 39. we have been seeing a neonatoligist since the beginning of this pregnancy because we lost a child to turners syndrome two years ago. The doctors can not find anyhing wrong and have been doing full body ultrasounds, checking the heart kidneys stomach everything and still cant find anything. What im wondering is since the fluid is so high does it mean they are missing something or could theyre really be nothing wrong. obviously we are really worried and we feel like they are not telling us everything because the fluid is so high. Does this number usually go higher when theyre are abnormalities or could a level of 39 be idiopathic, it has been a gradual increase. She also has pregnancy induced hypertension so she has been on bedrest since 30 weeks. Please help us get some answers because alll weve been told is that it is high but nothing else is apperntly wrong
At Mon Mar 30, 07:55:00 PM 2009,
tracey said…
hi evryone i am looking for some answers. long story short i am type one diebetic, i went for a c section at 37 weeks on the 4th march 2009, my baby was delivered dead. at the time i heard the medical staff say "oh my god look how much fluid". the day before i went to my obstrtrician he listened to the heart beat and the baby was alive, he gave me a steroid injection and one to take home to do myself which i did. i have many questions my overall hbia1c throughout the whole pregnecy were between 6 and 7. the blood test from the morning i visited him said i had little c anti virus. i had not had a scan since 24 weeks. please help with any information in regards to fetal death that may be relative.
thanks tracey. f
At Mon Mar 30, 08:19:00 PM 2009,
Anonymous said…
Hello. I am based in Australia where I think practices are a little less interventionist. I am now 32.5 weeks. I had a 20 week scan which was normal except for finding a single umbilical artery, and a 31 week scan which confirmed polyhydramnios measuring 27. I had the 31 week scan because I got large very quickly and was feeling very uncomfortable. This is my second pregnancy. First was uncomplicated with natural birth at 38.5 weeks - 7 pound baby. The 31 week scan showed that this baby is average size and no anomalies were found. Similar to a previous posting, I am wondering, what are the risks with this level of polyhydramnios that there is a fetal problem which has not been detected by ultrasound? Does the single umbilical artery raise any additional alarm bells? Finally, I am concerned about going into preterm labour as I have been having very very frequent braxton hicks contractions and occasional period cramp like pains. A cervical examination yesterday revealed my cervix was "soft" but closed. As a result I have been put on Nifedipine 10mg 3 times a day until I reach 34 weeks - then they will let labour occur. I have been told to "take it easy" but not put on strict bedrest. I am having another scan again at 33 weeks to reassess. I want to do whatever it takes to prevent preterm labour. Is 34 weeks a safe time to "let things happen"? Will bedrest help? Is there anything else I can do? I have read about drinking lots of water. What are the risks of preterm labour with this history?
At Tue Mar 31, 11:20:00 AM 2009,
Alokenanda said…
Hi!I got diagnosed with Gestational Diabetes at 26 weeks and have been watching my diet closely ever since. My blood sugar levels are controlled.During my 31 week scan amniotic fluid was seen to be 23.Now the diabetes clinic wants me to come in for weekly tests. I did do NTS and scan for downs and trisomy in the 13th and 16th weeks and the probabilities were very low.Do I have a case of polyhydramnios?If so, what are risks and preventive measures I can adopt (dietary,lifestyle etc) to minimize the risks?
At Wed Apr 08, 11:15:00 AM 2009,
chloe's clan said…
Hi there,
I am 31 weeks pregnant and have an unltrasound ordered for next week. I am measuring 7 weeks larger than I should be and my Dr. suspects excess fluid. At 20 weeks I was 23cm, 24 weeks was 28cm, 28 weeks was 33 cm, and 30 weeks was 37cm. I grew 4 cm in 2 weeks! I am worrying and perhaps jumping the gun since I haven't had my ultrasound yet, but considering these measurements, does this sound like polyhydramnios to you? I am negative for diabetes and my previous 2 babies were 4lbs 15 oz born 5 weeks early and 7 lbs 10oz born at 39 weeks. Are there questions I should ask my Dr. at the appointment? Thanks!
At Thu May 14, 11:12:00 AM 2009,
Anonymous said…
What about having too much fluid early in the pregnancy? I am eight weeks, had my second ultrasound today. The baby measured eight weeks, four days but the sac measured ten weeks. What does that mean?
At Wed May 27, 02:03:00 PM 2009,
Shannan said…
I left a post late last year about having a huge baby and too much fluid. I had my baby boy on January 16th via emergency C-section. Turns out I had gestational diabetes and I got a false negative my first test. I just want to say to those people reading this if you have a large baby and too much fluid and they can;t figure out why and your Glucose test comes out negative, do what I did and ask them to take it again. I just knew something didnt feel right. I didnt find out I was GD until I was 36 weeks after all of this so my son ended up being 9 lbs 3 oz and I had so much fluid that when they broke my bag of waters I gushed for hours and hours! This all caused a chain reaction, because I had to get my water broken, and there was so much, the umbillical cord got wrapped around my sons neck, Twice. This in turn caused him from being able to descend enough to make me dilate which made him go into distress and made me have to undergo a C-section which I was adament about not wanting. I also have a small hernia which i am sure is because of how far my stomach stretched. I know there are plenty of other reasons for polyhydramnios, but if they can't find one, and you're blood sugar is fine, you should still eat like you have diabetes.
At Sun May 31, 09:24:00 PM 2009,
taniah said…
Hello.
Whilst I was 30 weeks pregnant my 2 year old contracted Hand, Foot and Mouth (Coxsackie virus) several days after attending a playgroup. My obstetrician initially said that I most likely would have been previously exposed to the virus, however I insisted that I would prefer to be cautious. I was then notified to have an initial blood test and ultrasound.
Following this I was then instructed to wait 2 weeks before having the follow up blood tests and ultrasounds to determine whether I actually contracted the virus and whether any congenital defects have affected the fetus.
I noticed a previous comment about someone contracting an infection which caused the amniotic fluid levels to increase. My initial ultrasound showed a amniotic fluid level of 23 which is quite high however under the 25 threshold. The first ultrasound however showed that heart and brain seem to be ok.
Just waiting on the second wave of tests and results before knowing. And maybe then I won't probably fully know whether the baby is 100% ok until he is born.
Has anyone else encountered a similar issue?
At Sun May 31, 09:26:00 PM 2009,
taniah said…
oh I forgot to mention that during my first pregnancy I had gestational diabetes but the 2nd pregnancy has come back ok.
therefore i am not sure whether my high levels of amniotic fluid are a result of a wrongly diagnosed gestational diabetes test, or whether the baby has been affected by the Coxsackie virus. Or other?
At Mon Jun 01, 04:20:00 PM 2009,
Jessica said…
Hello,
I am 33 wks pregnant and have extra fluid in my uterus (in the 30's). I also have sizeable fibroids, I measure big, and my son is over 5 pounds in the 80th percentile. My first pregnancy had the same traits, i had preterm labor then but manage to carry my first son full term and delivered three days after his due date. When my first son was born, the doctor that performed the emergency csection commented that one of my fibroids was as big as the baby's head and he was over 9lbs and 22.5 inches. I am not diabetic this time nor the first time. My mother delivered big babies and she is smaller than me at just five feet. I'm confident that I make big babies and carry pretty big. My gyno is very concerned with the size of the my son and wants to monitor me now every week for amniotic fluid levels and size of the baby in the event that he has to schedule my delivery sooner. As far as I know the biology of my son is 100%, the many ultrasounds have not picked up anything unusual. His heartbeat is great and movement is terrific. Since I had these symptoms the first time, I tend not to be to concern since I think its my particular make up (furthermore the fibroids I have can almost account for a twin!!!) and I don't want to believe the worst. But my doctor's penchant on delivering early or thinking the worst makes me uneasy. After much probing today, he finally told me that the reason he wanted to monitor me so closely via ultrasounds was because high fluid can cause death to the baby....that was actually the first and only cause he gave me as an answer. Nor my husband or I have any genetic diseases in our families. I am 35 yrs old. What are your thoughts on my case.... I would love a very comprehensive explanation since its so difficult to get one for my doctor!! Thanks in advance for all you help!!
Jessica
Post a Comment
<< Home