What is Polyhydramnios?

Dear Dr

I wedded recently and got pregnant immediately. I have enjoyed antenatal care at one of the best centres in the north central zone up until now. In my seventh month, I went for routine ultrasound scan from one of the best sonologists in town and I got a diagnosis of polyhydramnios. When I asked the doctors what that is they explained but have not been so forthcoming. First of all what is polyhydramnios and why have the doctors been so stingy with information about it? I was asked to do the fasting blood sugar test for diabetes which came out negative after which the matter was closed; my doctors have said there will be no trouble but I am scared. How can you help me?

Deidre Fahnbulleh, Lekki

Dear Deidre,

Generally less than or up to just 1% of pregnancies are diagnosed with polyhydramnios, so doctors don’t get to see the condition too often; again generally we do not  have a cure for it, nor do we know what causes it. This may be why your doctors have not been forthcoming with information on it—there simply precious too little. What is polyhydramnios? Too much fluid in the womb during pregnancy; that’s all. You see, all pregnancies have some fluid or liquid or water surrounding the baby. This is the waterfall that comes out during labour which the midwife always wants to know about—has she seen her waters, have the waters broken? Now, long before labour as the pregnancy progresses, every baby and pregnancy has this bag of waters around the baby which helps cushion any accidental fall or trouble like infection from easily getting to the baby. This fluid we call amniotic fluid located in the amniotic sac. When it is too plenty, a pregnant mother has what we call polyhydramnios. Some factors are associated with polyhydramnios including infection, a condition of the placenta called chorioangioma, multiple pregnancies and Rh isoimmunisation. Infection includes Toxoplasmosis, Other infections like chicken pox, chlamydia, syphilis and HIV. Rubella, Cyto-megalovirus and Herpes Simplex. When a twin pregnancy has polyhydramnios, the twin-to twin transfusion syndrome is usually what is going on. Conditions or abnormalities that affect the ability of the baby in the womb to swallow the amniotic fluid as is normal for babies in the womb also cause this condition. These include duodenal and esophageal atresia. Diagnosis is by the overlarge abdomen or womb that is larger than the age of the pregnancy, tight shiny abdominal skin with marks called striae, difficulty breathing, heart-burn and chest pain in the woman and by ultrasound findings.

What can a mother with this condition expect? Delivery complications like cord prolapse is common as is abruption placenta; premature births; perinatal death and congenital abnormalities. Treatment is symptomatic; nothing to cure. Most cases pull through without any repercussion. This, obviously is why your doctors have been lethargic. In my own opinion, polyhydramnios must not be managed passively but most actively by reversal through prayers and the reversal must be confirmed by ultrasound before delivery – how else can anyone guarantee the delivery of a baby without complications or abnormalities? Call the helplines