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Amniotic Fluid Complications

Amniotic fluid complications are generally a rare occurrence during pregnancy. However, if a complication arises and is not addressed quickly, it could lead to catastrophic consequences. Hence, it is necessary to be aware of the condition to help enable an early clinical diagnosis.

The fluid surrounding a pregnant woman’s foetus is called the amniotic fluid. This liquid plays a vital role in the healthy development and growth of the foetus. An amniotic sac develops inside the woman’s womb, containing her foetus and fluid within the membranes.

If a woman develops a complication with the amniotic fluid, she could experience the following during her pregnancy:

  • An intraamniotic infection is an infection of the placenta, amniotic sac or fluid.
  • The complication might lead to Oligohydramnios, an insufficient amount of amniotic fluid that is necessary throughout the pregnancy.
  • There can be an excess or deficiency of fluid, which is also not beneficial for the length of the pregnancy.

How common are Amniotic Fluid Complications?

Amniotic fluid complications or embolisms are rare in South Africa, affecting around 1% of pregnancies. While in most cases, this condition develops during the second half of the pregnancy, some may feel it as early as 16 weeks. Polyhydramnios (Amniotic fluid excess) occurs in 1%, while Oligohydramnios (deficiency of amniotic fluids) occurs in about 11% of the pregnancies in South Africa.

In case of mild complications caused by excessive or less amniotic fluids, there is generally nothing to worry about. Pregnancy care providers monitor each pregnancy closely and provide prompt treatment if necessary.

Symptoms of Excessive Amniotic Fluid Complications

Women with a mild case of polyhydramnios, as this condition is called, do not generally experience any symptoms. However, for those who suffer a worse case of it, they may experience the following symptoms:

  • Suffering frequent swelling in the feet, legs and external genitals (vulva)
  • Urinating more often
  • Feeling constipated or having difficulty passing stool
  • Heartburn
  • Shortness of breath
  • Feeling sensations like contraction, cramping or tightening of the stomach

Symptoms

  • Fewer movements of the baby
  • Smaller uterus compared to the gestational age of pregnancy
  • Broken sac
  • The slow growth of baby

When the uterus expands, it tends to exert more pressure on the nearby organs, such as the bladder, rectum, stomach, and lungs. The existence of amniotic fluid complications is often the cause of the increased pressure.

In many cases, the pregnancy care providers can suspect an excess or deficiency of amniotic fluids in the following cases:

  • They are unable to locate the position of the foetus in the woman’s uterus
  • The pregnancy care providers are unable to trace the foetal heartbeat
  • The size of the uterus is larger than expected, according to the gestational age of the patient’s pregnancy
  • Ultrasonographic assessments show less fluid volume
  • Absence of a fluid pocket that is at least 2-3 cm deep

Causes

In most mild cases, the cause of the complications is generally unknown. However, moderate to extreme cases of amniotic fluid complications can be caused by certain medical conditions:

  • The foetal heart rate isn’t healthy as per the gestational pregnancy age, or there are complications with it
  • The Rh factor differs, meaning the patient could be Rh-negative while the foetus could Eh-positive
  • When the patient is pregnant with identical twins, and there is the possibility of TTTS (twin-to-twin transfusion syndrome)
  • The patient’s blood glucose levels are high, perhaps due to a pre-existing case of diabetes or developing it post becoming pregnant.
  • The foetus has a congenital disorder due to which it is unable to swallow amniotic fluid.

Treatments

When a pregnant woman has a mild case of polyhydramnios or Oligohydramnios or is nearing childbirth, she will not require treatment.

Monitoring is usually the best plan in such cases. However, if it is a severe case of amniotic fluid complications, medical experts will treat the underlying condition, such as diabetes.

Other treatment options for amniotic fluid complications include:

  • Inducing labour before the delivery is due, perhaps between weeks 37 and 39 of the pregnancy
  • Draining excess amniotic fluid collected in the patient
  • In the case of amniotic fluid deficiency, the treatment includes monitoring and regular check-ups. In severe cases, medical experts may insert a special fluid into the amniotic sac called amnioinfusion. A patient might need this if she is in labour and her water breaks.
  • If Oligohydramnios becomes too risky for the patient or her child, she may need to deliver early.

When there is too much amniotic fluid, doctors typically plan to deliver the baby at around 39 weeks. When there is too little amniotic fluid, doctors recommend delivering the baby between 36 and 37 weeks depending on how the foetus is developing.

 
 
 

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