Why is there more amniotic fluid in late pregnancy

Amniotic fluid is an important protective barrier for the baby before it leaves the mother's body, because amniotic fluid can not only provide enough nutrition for the baby's growth, but also allow the baby to move better in the mother's belly. However, does this mean that the more amniotic fluid the mother has, the healthier the baby is?

Excessive amniotic fluid causes abnormal enlargement of the uterus. Increased pressure in the uterine cavity and increased uterine tension; at the same time, the enlarged uterus compresses adjacent organs, which are the main clinical manifestations of polyhydramnios.

1. Acute polyhydramnios often occurs between 20 and 28 weeks of pregnancy. Due to the rapid enlargement of the uterus within a few days, a series of compression symptoms occur. The abdominal organs are pushed upward, the diaphragm rises, and respiratory movements are restricted, manifesting as difficulty breathing, chest tightness and shortness of breath; the tension of the abdominal wall increases, causing distension and pain: the skin of the abdominal wall becomes thinner, and the subcutaneous veins are clearly visible. The huge uterus presses the bilateral ureters backwards, and at the same time a large amount of fluid accumulates in the amniotic cavity, causing the pregnant woman to have oliguria. The uterus compresses the inferior vena cava, blood return is obstructed, and the lower abdomen, vulva, and lower limbs are severely edematous. Abdominal examination revealed that the size of the uterus was inconsistent with the gestational age, the uterine tension was increased, the fetus could not be felt during four-step palpation, and the fetal heart rate was distant during auscultation. Some pregnant women cannot lie flat.

2. Chronic polyhydramnios often occurs in the late pregnancy. The rate of increase in amniotic fluid is slow, and the amount of amniotic fluid is slightly or moderately increased. Pregnant women can tolerate the gradually enlarged uterus, and the compression symptoms are mild, and pregnant women often do not feel anything. The only symptoms are that the uterus is larger than the gestational age, the fetus is difficult to palpate, and the fetal heart rate is far away.

Medication

The treatment of polyhydramnios should mainly depend on whether the fetus is malformed, the gestational age and the degree of polyhydramnios. For those with fetal malformations, the decision to terminate the pregnancy is based on the degree of the malformation. When the fetus develops normally, mild and moderate polyhydramnios do not require treatment, while severe polyhydramnios can be treated. Indomethacin is a very effective drug for treating polyhydramnios, but it has obvious side effects. Amniocentesis may be performed when excessive amniotic fluid causes abdominal pain or difficulty breathing.

Polyhydramnios combined with fetal malformation should generally lead to termination of pregnancy, and the method of termination of pregnancy should be chosen according to the specific circumstances. Artificial rupture of membranes, intravenous infusion of oxytocin, or application of prostaglandins. The membranes should be ruptured with a high-position membrane rupture device, or a small hole can be punctured with a needle to allow the amniotic fluid to flow out slowly, thereby gradually reducing the pressure in the uterine cavity, so as to avoid a sudden drop in intrauterine pressure causing placental abruption. If the rupture of membranes occurs carelessly, the rupture of membranes is too large, and a large amount of amniotic fluid gushes out, you should block the cervix with your hands or raise your hips to slow down the flow. For patients with severe polyhydramnios, for safety reasons, amniotic fluid can be released through abdominal puncture first, and then induced labor can be performed after the uterine cavity pressure decreases. If the cervix is ​​in good condition and fully receptive, the fetus can generally be delivered in a short time. If the cervix is ​​immature, oxytocin or prostaglandins are often needed to prepare the cervix and induce labor after 24 to 48 hours. After the amniotic fluid flows out, a sandbag is added to the fundus of the uterus to increase intrauterine pressure and prevent complications caused by a sudden decrease in abdominal pressure. During labor, pay attention to the pregnant woman's vital signs such as heart rate and blood pressure, and observe whether there is vaginal bleeding. Pay close attention to the early signs of placental abruption and treat them promptly if they occur.

The situation of excessive amniotic fluid in the late pregnancy is also common for some pregnant women. If you find that your excessive amniotic fluid causes physical discomfort, you should go to the hospital for some examinations, because the health of pregnant women is very important. If you ignore this situation, the consequences will be very serious.