“Polyhydramnios: Deep Water!” – with Dr. Jen Lam-Rachlin

By on November 13, 2023

Polyhydramnios (high levels of amniotic fluid) might sound like a frightening condition, but it is usually not a cause for concern. On the Healthful Woman podcast, Dr. Jen Lam-Rachlin joins Dr. Nathan Fox to discuss polyhydramnios and what it means to receive this diagnosis.

Understanding Polyhydramnios

Polyhydramnios is a common occurrence during pregnancy. Typically, this is not a concern and will not cause adverse effects but follow-up ultrasound tests will be scheduled to regularly monitor fluid levels.. Dr. Fox describes the amniotic fluid amount in pregnancy as a bell-shaped curve with varying amounts of fluid that are considered normal. Fluid levels can also change from day to day, so if polyhydramnios is seen, patients will often be asked to come back for another ultrasound the following week.

It’s also important to recognize that high fluid levels might not be an indication of amniotic fluid alone. What many people don’t realize is that babies essentially live in and swallow their own urine. Increased urination or less swallowing on a particular day could lead to high fluid levels being seen on an ultrasound examination.

How is Amniotic Fluid Measured?

Fluid is typically measured in two ways. Using an AFI, the belly is visually separated into four quadrants and a measurement is taken of the deepest pocket within each quadrant. Dr. Lam-Rachlin explains that “if the sum total is 24 centimeters or higher, it’s considered polyhydramnios.” Another way of measuring fluid levels is to look solely at the deepest pocket. If the fluid in that pocket is higher than eight centimeters, it is considered polyhydramnios.

If high fluid levels are detected, Dr. Lam-Rachlin says that the next step is to check the size of the baby. Larger babies will urinate more, which could lead to higher fluid volume. Large babies might also be a sign of gestational diabetes so she will check and make sure the mother has been screened for this condition. A movement assessment of the baby might also be conducted to make sure the baby is moving and swallowing well. Another thing to look for is whether the fluid goes all the way down to the stomach; if not, there could be a blockage. Luckily, this condition is much less common so there is often not a need for immediate concern if you have high fluid levels.

When is Polyhydramnios a Concern?

Whether polyhydramnios is a concern depends on many factors, including the amount of fluid and gestational age. If the excess fluid is expanding the uterus, there is the risk of the mother going into preterm labor. Like other muscles, when the uterus expands, it can also contract. Dr. Lam-Rachlin further explains “That’s not necessarily scary, but sometimes the head is not fully engaged during labor because it’s floating around in a big bag of water. And sometimes when the membrane is ruptured, the umbilical cord can slip between the baby’s head and cervix.” These are very rare circumstances but ones that are taken into consideration. Draining some of the fluid through a procedure called an amnioreduction is a possibility if rare occasion in the preterm period

Consistently high fluid or rising levels around 20 weeks (especially once it reaches mid-30s and higher) is also more of a concern than high fluid in the third trimester. In this circumstance, Dr. Fox recommends an amniocentesis or an echocardiogram to check for genetic abnormalities or developmental issues, Again, this might sound scary but it is a very rare circumstance.

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At MFM Associates, your health and well-being are our top priority. Our expert team of maternal-fetal health specialists, ultrasound technicians, and gynecologists are dedicated to compassionate care. To learn more about our services or to schedule an ultrasound examination, we encourage you to call our office today or fill out an online contact form.

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!