What are the symptoms of excessive amniotic fluid at 32 weeks?

Sufficient amniotic fluid can ensure that the baby can grow healthily in the mother's belly, but it does not mean that as long as there is enough amniotic fluid, the baby will be healthy and disease-free. Why do some people have more amniotic fluid per week? If a pregnant woman finds that she has more amniotic fluid per week, what should she do?

There are no specific changes in the placenta, amniotic membrane and amniotic fluid composition in patients with polyhydramnios. The onset of the disease may be related to pathophysiological changes in pregnant women and fetuses. Any factors that can cause amniotic fluid production and metabolic disorders in pregnant women, as well as factors in the placenta and fetus can cause polyhydramnios, such as pregnancy complicated with diabetes, maternal-fetal blood type incompatibility, fetal malformations, etc. However, there are still quite a few patients with unknown cause, which is called idiopathic polyhydramnios. The pathogenesis of polyhydramnios is still not fully understood. According to Hill et al., about 2/3 of polyhydramnios are idiopathic.

1. Fetal malformation is the main factor causing polyhydramnios, especially congenital nervous system malformations and digestive tract abnormalities. 18% to 40% of polyhydramnios are accompanied by fetal malformations. When polyhydramnios is accompanied by the following high-risk factors, the incidence of fetal malformations increases significantly: ① fetal growth retardation; ② premature birth. The incidence of fetal malformations in polyhydramnios accompanied by spontaneous premature birth is 24%, which is significantly higher than that in full-term births (the incidence rate is 11%); ③ early onset. Polyhydramnios often occurs before 32 weeks of pregnancy; ④ cannot be explained by other high-risk factors.

(1) Neurological malformations: The most common, such as anencephaly, meningocele, etc., accounting for about 50% of polyhydramnios malformations. Because the meninges are exposed in the amniotic cavity, a large amount of body fluid seeps out through the cerebrospinal fluid, leading to polyhydramnios; secondly, the brain and spinal cord are directly stimulated by the amniotic fluid, resulting in increased urination; thirdly, fetal vasopressin deficiency is also a factor leading to polyhydramnios.

(2) Digestive and respiratory system malformations: mainly digestive tract atresia, such as esophageal atresia, duodenal atresia or stenosis.

(3) Abdominal malformation: During fetal development, various factors cause incomplete development of the fetal abdominal cavity.

(4) Hereditary pseudohypoaldosteronism (PHA): This is a congenital hyponatremia syndrome.

(5) Multiple malformations: In addition to the fetal malformations mentioned above, congenital cerebrovascular malformations, cardiovascular malformations, pulmonary cystic adenomas, etc. are all related to polyhydramnios. Multi-system and multi-organ malformations are often accompanied by polyhydramnios, and the mechanism is complex. The mechanisms of many diseases are still unclear.

2. Multiple pregnancy and twin pregnancy are complicated by polyhydramnios in 10%. The incidence of monozygotic twins is 4 times higher than that of dizygotic twins. Among monozygotic twins, the incidence is highest in monozygotic monochorionic twins, especially twin-twin transfusion syndrome. The vascular anastomosis rate between monozygotic monochorionic twin placentas is as high as 85% to 100%. Vascular anastomosis can be done in two ways: artery-artery, artery-venous, and vein-venous. The most significant approach is arteriovenous anastomosis.

3. Pregnant women's diseases: The incidence of polyhydramnios in pregnant women with diabetes mellitus is significantly increased, accounting for 10% to 25%. The incidence of polyhydramnios increases in cases of maternal and fetal blood type incompatibility. Polyhydramnios can be caused by anti-fetal blood cell antibodies produced by pregnant women, fetal hemolytic anemia, edema, increased urine volume, and increased placental volume.

4. Fetal appendage diseases Hormones secreted by the placenta may regulate the amount of amniotic fluid, especially human placental lactogen (HPL). The HPL concentration was increased in those with enlarged placenta. On the other hand, HPL receptors are present in the placental chorionic lobules and are significantly reduced in idiopathic polyhydramnios.

Placental chorioangioma is a common benign tumor of the placenta, but those with a diameter of more than 5 cm are rare. Placental chorioangioma is often accompanied by polyhydramnios.

The above are some basic symptoms of excessive amniotic fluid and some solutions that should be taken. The health of pregnant women is the guarantee of family happiness, so as family members of pregnant women, they should protect pregnant women. This is a husband's responsibility, isn't it?