Amniotic fluid surrounds a baby in the uterus, protecting them from external trauma and infections. It also allows them to move and grow more easily. The amount of amniotic fluid in the uterus depends on the urine production of the baby, which means that it can indicate whether a baby is healthy and developing properly. Inadequate amniotic fluid is known as oligohydramnios. This condition may result from high blood pressure (or blood pressure medications), diabetes, a post-term pregnancy, or birth defects. Oligohydramnios also may arise when the amniotic sac breaks after 37 weeks of pregnancy but before labor.
In contrast, polyhydramnios involves too much amniotic fluid in the uterus. While the cause of this condition is often not identified, risk factors for polyhydramnios may include diabetes, infections, a genetic condition or an esophageal blockage in the child, or a pregnancy involving twins or other multiples. A condition known as rhesus (hemolytic) disease, often linked to anemia and jaundice, also may cause polyhydramnios.
Rhesus disease occurs when antibodies in the blood of the mother attack the blood cells of the child.
Diagnosing and Treating Oligohydramnios
Delays in the growth of a fetus or fluid leaking from the vagina may indicate oligohydramnios. A doctor also may suspect this condition if a mother does not gain as much weight as expected during pregnancy. Through an ultrasound, a doctor can check the volume of amniotic fluid in the uterus. The amniotic fluid index measures the depth of fluid in four areas of the uterus and combines them. Meanwhile, the maximum vertical pocket measures the depth of fluid in the deepest part of the uterus. An AFI less than five centimeters or an MVP less than two centimeters indicates oligohydramnios.
Sometimes oligohydramnios does not require treatment, especially if it occurs near the end of a pregnancy. However, a doctor may monitor the condition carefully and perform regular ultrasounds. They might use amnioinfusion, which involves instilling a saline solution through the cervix into the uterine cavity. This can prevent umbilical cord compression and ensure that the fetus receives a proper supply of oxygen and nutrients. Sometimes a doctor will advise a mother to consider inducing labor if oligohydramnios appears to be worsening or affecting the health of the fetus.
Complications of Oligohydramnios
If it is not properly addressed, oligohydramnios can lead to serious consequences during the first or second trimester of pregnancy. These can include birth defects or premature birth, which increases the risk of health conditions in a baby. Oligohydramnios even can cause miscarriage or stillbirth. Miscarriage occurs when a fetus dies before 20 weeks of pregnancy, while stillbirth occurs when a fetus dies at or after 20 weeks.
Less serious consequences may result from oligohydramnios during the third trimester of pregnancy. Still, a baby may suffer from delayed growth or umbilical cord compression, which can interfere with their ability to get food and oxygen from the placenta. A mother may be more likely to give birth through a C-section rather than a traditional vaginal delivery.
Diagnosing and Treating Polyhydramnios
Some pregnant women do not suffer from obvious symptoms of polyhydramnios. Often, its symptoms overlap with other conditions that are common during pregnancy, such as heartburn, swollen ankles and feet, and breathlessness. If a pregnant woman notices that her stomach expands suddenly, this may indicate an increase in amniotic fluid and should be addressed promptly.
Testing Related to Polyhydramnios
Blood test to check for diabetes
Ultrasound to check for problems inside the womb
Amniocentesis: extracting a sample of amniotic fluid from the uterus
Treatment for polyhydramnios may depend on the cause. If diabetes resulted in the condition, medication or dietary changes may help address it. A doctor also may prescribe medicine to prevent the production of more amniotic fluid, or they may even drain fluid with a needle. While a doctor may recommend labor induction or a C-section in some cases, a pregnant woman generally can undergo a natural vaginal delivery despite polyhydramnios. Their doctor may want to monitor the fetal heartbeat carefully during labor. The baby may need to undergo extra tests after they are born to check for issues related to polyhydramnios.
Complications of Polyhydramnios
Generally, polyhydramnios is not a cause for alarm. A child born after a pregnancy that involved this condition should be able to lead a healthy life in most cases. A mother also should not expect to suffer from serious health conditions. However, polyhydramnios can increase the risk of certain complications, such as premature birth or umbilical cord prolapse, when the cord enters the birth canal before the fetus, gets squeezed during contractions, and fails to provide enough oxygen to the baby. Excessive amniotic fluid can cause the uterus to stretch, which may lead to a hemorrhage after childbirth. Doctors should be aware of these potential concerns when they identify polyhydramnios in a mother.
Medical Malpractice Involving Oligohydramnios and Polyhydramnios
Although these conditions are usually not emergencies, a doctor should account for oligohydramnios or polyhydramnios when it develops during a pregnancy. They may want to schedule more frequent appointments and tests to monitor the volume of the amniotic fluid, and they may need to prescribe treatment to reduce the risk of complications. If a complication arises, a doctor should be prepared and know how to respond. Failing to competently address a childbirth complication can cause serious harm to a mother and her child.
In these situations, a family should consider pursuing a medical malpractice claim against any health care provider who was at fault. They could recover compensation for the medical costs required to treat the consequences of the malpractice. They also could recover compensation for non-economic harm, such as pain and suffering and emotional distress. To get these damages, a patient must file a medical malpractice claim within the statute of limitations. If they miss this deadline, a court probably will dismiss the claim, even if it has a strong foundation. By promptly consulting a birth injury lawyer, parents have a better chance of preserving their legal rights and avoiding procedural pitfalls such as the statute of limitations.