Amniotic fluid is the liquid within the amniotic cavity, serving as the "ocean" nurturing fetal growth and development. Within the uterus, amniotic fluid protects the fetus from external injury, prevents adhesion between the fetus and amniotic membrane, maintains optimal intrauterine temperature, and allows the fetus freedom of movement. Additionally, during labor, it transmits uterine pressure, aids cervical dilation, and lubricates the birth canal after membrane rupture, facilitating delivery.
During a normal full-term pregnancy, amniotic fluid volume is approximately 1000 milliliters. If the volume exceeds 2000 milliliters, it is termed polyhydramnios. Causes of excessive amniotic fluid include acute polyhydramnios, where the volume increases rapidly over several days, and chronic polyhydramnios, where the volume increases gradually over a longer period.Approximately 60% of fetuses in cases of polyhydramnios exhibit abnormalities. Polyhydramnios frequently occurs concurrently with multiple pregnancies, gestational diabetes, and maternal conditions such as neonatal hemolytic disease. Therefore, pregnant women with polyhydramnios should be vigilant for these associated conditions.
Acute polyhydramnios typically occurs around 24 weeks of gestation, causing rapid uterine enlargement. Patients often experience pronounced compression symptoms such as abdominal distension and pain, palpitations, shortness of breath, and inability to lie flat. Edema may develop in the lower limbs, vulva, and even the abdominal wall. Chronic polyhydramnios occurs in late pregnancy, usually without noticeable symptoms, but can be detected through ultrasound and prenatal examinations.
Polyhydramnios frequently coexists with preeclampsia, clinically manifesting as hypertension, edema, and proteinuria. Severe cases may involve convulsions and coma, posing life-threatening risks to both mother and fetus. Excessive amniotic fluid also increases susceptibility to malpresentation and preterm labor.Following membrane rupture, rapid amniotic fluid outflow causes sudden intrauterine pressure drop, potentially leading to umbilical cord prolapse and fetal life-threatening complications. After fluid loss, the uterine cavity abruptly shrinks, risking placental abruption or maternal shock due to sudden decreased abdominal pressure. During the third stage of labor, uterine atony may cause postpartum hemorrhage.Perinatal mortality rates in cases of polyhydramnios can exceed 35%.
For patients with chronic polyhydramnios, a low-salt diet may be prescribed alongside oral diuretics such as hydrochlorothiazide (25 mg three times daily) combined with potassium chloride (0.5 g three times daily). Alternatively, diuretic Chinese herbal formulas may be administered, such as:Alisma orientale, Poria cocos, and Citrus peel (Chenpi), each 100 grams. Grind into a fine powder and take 10 grams twice daily with rice water. Alternatively, reduce the dosage and decoct for oral administration. For dietary therapy, prepare a porridge with 50 grams of adzuki beans, 30 grams of coix seed, and 100 grams of japonica rice, boiled in water. Consume once daily.Allow natural delivery at full term. However, if fetal abnormalities or acute polyhydramnios are present, pregnancy should be terminated promptly to ensure maternal safety.
Is Amniotic Fluid Volume Related to Water Intake?
When diagnosed with polyhydramnios during prenatal checkups, many expectant mothers become anxious, often attributing it to excessive water consumption.In fact, this belief is incorrect. The volume of amniotic fluid is unrelated to one's daily water intake. Therefore, polyhydramnios has no connection to drinking excessive amounts of water. Amniotic fluid volume varies throughout pregnancy. If the fluid exceeds 2000 milliliters, it is considered polyhydramnios.
To prevent polyhydramnios, guard against fetal abnormalities by avoiding consanguineous marriages. During early pregnancy, steer clear of harmful chemicals and X-rays. Avoid contact with cats to prevent toxoplasmosis infection. Attend prenatal checkups regularly, promptly address pregnancy complications, and treat polyhydramnios based on its underlying cause. If caused by a teratoma, pregnancy termination should be considered immediately.