Having a child is a god given gift to couples and a safe pregnancy without complications can prove to be a blessing in disguise. Mother Nature has designed the human body to carry a child in its womb for 9 months.
But what is it that ensures that the child lies safe inside its mother’s womb. Besides good health, a healthy diet, exercise and regular prenatal check-ups the amniotic fluid in the mother’s body plays a very important role in producing a healthy baby. Amniotic fluid is a fluid enveloping the baby as it comfortably floats in the mother’s womb. The water is inside a casing called as the amniotic membrane. The fluid amounts vary but most women carry around 500 ml of the amniotic fluid. Hydramnios in itself is rare and very transient
The amniotic fluid has several roles to play. It helps maintain the body temperature of the developing baby. It cushions the baby against any kind of injuries or trauma and makes sure that the umbilical cord which provides the baby oxygen and food does not get pressed. The fluid plays a very crucial role in helping the developing foetus hone his most primary skill of respiration. It allows the foetus to swallow and inhale/exhale from its lungs. The amniotic fluid allows the baby easy mobility thus helping strengthen the baby’s muscles and bones and also protects the baby from infections.
The amniotic fluid gets manufactured from the mother’s circulatory system into the gestational sac. The fluid keeps increasing in the third trimester and peaks around week 34. A normal amount of amniotic fluid ensures the all round development of the foetus but there are cases where excessive amniotic fluid causes a condition called as Hydramnios. The incidence of Hydramnios or Polyhydramnios is seen in 2% of pregnancies. It is diagnosed when the amniotic fluid index is greater than 20.
The Amniotic Fluid Index
Amniotic fluid is measured with the help of an ultrasound to measure the depth of the fluid accumulated in the various cavities of the womb. The depth in four different areas is added up and gives the amniotic fluid index. A depth of less than 5 cms means you are carrying very less fluid which is called as Oligohydramniosis. Anything greater than 25 means you have Polyhydramnios.
Symptoms of Polyhydramnios
Symptomatic fall out of Hydramnios is a sudden increase in the size of the abdomen, discomfort and uterine contractions. There may be swelling in the legs due to excess fluid, water retention and indigestion as the abdomen expands. Since the abdomen expands the mother may be prone to severe bouts of acidity, nausea and vomiting as the digestive system gets compressed. At times mothers remain symptom free till they are examined.
A little amount of excess fluid is said to be normal and should not cause concern as the body and the foetus tend to absorb it. The severity of the problem however indicates more worrying causes. Acute Hydramnios where the amniotic fluid build up is very sudden is extremely rare. It is ominous as the mother’s urine output decreases very rapidly
Causes Of Hydramnios
The causes of Hydramnios or Polyhydramnios vary. An incidence of hyperglycaemia or high blood sugar in the mother’s body typically causes a condition called as gestational diabetes.
This predisposes the foetus to develop a condition called as poly urea or excessive foetal urine which generally increases the amount of fluid in the gestational sac. Some foetuses maybe anaemic which may predispose them to Hydramnios .
There may be an incompatibility in the mother’s and baby’s blood which may have been over looked in the initial stages of pregnancy. Still other foetal anomalies typically point to an increase in the amount of amniotic fluid. Foetal anomalies like facial clefts and gastrointestinal defects prevent the foetus from swallowing normally. Since the foetus swallows quite a bit of the amniotic fluid, such anomalies allow excessive fluid to build up.
Renal and kidney disorders also increase the foetal urine output. Chromosomal disorders like Down’s syndrome, Encaphaly and Edward’s syndrome are all associated with gastric disturbances thus preventing the foetus from developing a good swallowing reflex. Sometimes an intra uterine infection in the mother’s body causes excessive pus formation thus increasing the amount of fluid in the sac. Such infections can prove to be fatal for the mother as well as the child. Mothers carrying multiples or very large babies also show signs of Hydramnios.
Diagnosis Of Hydramnios
The condition can be easily diagnosed through regular prenatal check-ups and keeping a strict watch over the mother’s blood sugar levels. Certain clinical signs like sudden weight gain and a disproportionate increase in the abdominal girth may suggest an incidence of Polyhydramnios. Stretched out skin and breathing difficulties in the mother as well as chest heaviness are some other signs.
Babies exposed to excessive amniotic fluid are at risk for premature births, cord prolapse, placental abruption and still births. Often foetal distress is seen in such babies. There may also be an incidence of premature rupture of the water bag thus forcing doctors to operate on the mother. It prevents the mother from having a normal delivery. At birth it is imperative that a thorough examination of the baby been done checking his respiratory functions as well as detecting any signs of congenital deformities.
Treatment Of Hydramnios
The treatment plan can be chalked out after considering the expectations from the course of the condition. The mother’s medical history, age and general health also needs to be factored in. The doctor will consider the pros and cons of putting the mother on any kind of therapeutic procedures or medicines. Treatment modalities for Hydramnios are very straightforward. A simple procedure of amniocentesis is done which drains out excess amniotic fluid from the pregnancy sac. Blood sugar levels in case of diabetes are strictly monitored and kept under control.
The mother alternately may also be advised to restrict her salt and fluid intake till the condition normalizes. Prostglandin inhibitors which reduce the baby’s urine output may also be prescribed. Sometimes treatment becomes much more complicated as the cause of Hydramnios remains unknown. Emergency Caesarean Sections are very common in mothers having Hydramnios. Despite it being a complicated condition, Hydramnios generally has good prognosis, if diagnosed and treated in time