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Does the mother with excess amniotic fluid suffer from any adverse effects?
If the abdominal distension is excessive, then there could be considerable discomfort and backache. She may not be able to find a comfortable sleeping position. In extreme cases, she may even get breathless. These are exceptional circumstances.
The risk of a caesarean delivery is higher in this group of women, regardless of the cause of increased fluid volume. This is because the fact that there is excess fluid makes her prone to complications such as placental abruption, abnormal lie of the fetus and premature labour, all of which may make caesarean section unavoidable.
Amniotic fluid problems: Management options
Are there any effective treatment methods for excessive fluid?
Again, treatment will depend on the cause. The mainstay of any treatment regime is to ensure the relief of symptoms for the mother and to prolong pregnancy to prevent prematurity, whenever possible.
Rest is generally advised and avoidance of physical over-exertion may be useful in this regard.
In conditions like anencephaly, where the baby has no hope of survival outside the womb, termination of pregnancy may be advised unless the mother has objections to this.
Indomethacin is one drug that may be used both to control the amount of amniotic fluid (through reduction of the fetal urine output) and to prolong the pregnancy (through suppression of the uterine activity).
Indomethacin is not always successful and sometimes causes fetal complications of its own. Its use is limited to below thirty-five weeks of gestation. In some conditions, such as twin-to-twin transfusion, its use is probably unwise.
What is the most effective method of relieving the symptoms of polyhydramnios?
In very excessive fluid accumulation, the one effective method of relieving the symptoms is to repeatedly drain the fluid. This is called "amnio-reduction". A certain amount of fluid is removed each time using a long needle through the abdominal wall, under ultrasound guidance. The relief from symptoms usually lasts a short time, certainly not more than a day or two. The procedure has to be repeated several times.
Are there any risks arising from the procedure of amnio-reduction?
Yes. It could lead to rupture of the membranes, which will almost certainly lead to labour within days, if not hours.
The procedure could also provoke a more serious condition in the form of placental abruption which, in most cases, calls for immediate delivery by caesarean section. This could be at an extremely premature stage and the baby may not survive.
The other major risk is that of introducing infection, which may also lead to the baby not surviving.
All these are serious potential complications but are uncommon. Your obstetrician will discuss the situation with you to allow you to decide, on balance, how to proceed. Decisions are never easy in such circumstances.
Last update: January 24, 2013