How Do You Treat Polyhydramnios?

Mild cases of polyhydramnios

Polyhydramnios is the excess accumulation of amniotic fluid.
Polyhydramnios is the excess accumulation of amniotic fluid.

Doctors treat polyhydramnios by looking at its severity and causes.

Doctors will usually monitor mild cases of polyhydramnios for several weeks before deciding to treat them. Mild cases most often do not need treatment.

Moderate polyhydramnios

Doctors recommend expectant mothers with moderate polyhydramnios to take bed rest. This helps prevent preterm labor that may happen due to polyhydramnios.

Severe cases of polyhydramnios

Depending upon the risks involved, severe cases of polyhydramnios can be treated in any of the following ways

  • Amniocentesis: This is a procedure that involves removing amniotic fluid from the uterus at regular intervals using a large needle. 
  • Oral medication: An oral pill of Indocin (indomethacin) can be given before 31 weeks of pregnancy. This medication helps in the treatment of polyhydramnios by reducing fetal urine production and amniotic fluid volume.
  • Early induction of labor: If all other treatments fail or are deemed unfit for you, your doctor may plan to induce labor.

The condition can cause a lot of distress if not addressed. Pregnant women should make sure that they follow their doctor’s instructions throughout their gestational period to have a successful delivery.

What is polyhydramnios?

Polyhydramnios is a condition in which the uterus of a pregnant woman becomes filled with excess amniotic fluid (>2000 mL). It is a rare condition that happens in one out of every 100 pregnant women.

The amniotic fluid is a clear, yellow fluid that is present in a bag-like structure known as the amniotic sac in the uterus. The baby lies in this amniotic sac and derives its nutrition from the amniotic fluid. The amniotic fluid also protects the baby from any external shocks or injuries.

Polyhydramnios generally presents in the second trimester of pregnancy (13th to 28th week).

What causes polyhydramnios?

For most women, the cause of their polyhydramnios condition remains unknown.

The most common causes of polyhydramnios include

  • Gestational diabetes (mother has diabetes either before or after becoming pregnant)
  • Birth defects that affect the baby’s swallowing of amniotic fluid
  • Infections in the baby

Other causes include

  • Carrying identical twins with twin-to-twin transfusion syndrome (TTTS) (a condition in which there is imbalance in the blood flow between identical twins)
  • Difference in the blood types of the mother and her baby (the mother has Rh-negative blood group, whereas the baby has Rh-positive blood group)
  • Abnormalities in the baby’s digestive system
  • Problems with the placenta
  • Presence of infections
  • Fetal anemia
  • Presence of diabetes in the mother

What are the signs and symptoms of polyhydramnios?

Mild polyhydramnios usually does not cause any symptoms.

Women with a severe form of the condition may experience symptoms that include

How is polyhydramnios diagnosed?

Polyhydramnios is suspected when the mother’s abdomen measures more than it should for its gestational age. The diagnosis is usually confirmed by performing ultrasonography (USG) of the mother’s pelvis. USG is used to determine the amount of amniotic fluid.

Polyhydramnios may also affect the health of the baby. To check the baby’s condition, the doctor may also order additional tests that include

  • Amniocentesis: A sample of the amniotic fluid is sent to the lab to check if the baby has any genetic problems.
  • Non-stress test: This test uses a special device (tied to the mother’s abdomen) to track the changes in the baby’s heart rate in response to the activities of the mother.
  • Doppler ultrasound: This is a special type of ultrasound technique that helps to visualize the baby’s circulatory system.

What are the complications of polyhydramnios?

Complications may not come with mild to moderate polyhydramnios. The possible risks of severe polyhydramnios include

  • Maternal dyspnea (mother finds it difficult to breathe)
  • Preterm labor
  • Premature rupture of the membranes (early water breaking)
  • Premature birth
  • Fetal malposition (the baby turns to an abnormal position)
  • Umbilical cord prolapse (the cord drops down from the vagina before the baby)
  • Postpartum hemorrhage (excessive bleeding after delivery)
  • Large baby
  • Placental abruption (the placenta separates from the uterus before childbirth)
  • Stillbirth (death of a baby in the womb after the 20th week of pregnancy)


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