Polyhydramnios Overview and Management
Learn about polyhydramnios, its causes, symptoms, and potential complications during pregnancy, along with effective management and treatment approaches.
Written by Dr. Rohinipriyanka Pondugula
Reviewed by Dr. J T Hema Pratima MBBS, Fellowship in Diabetes Mellitus
Last updated on 13th Jan, 2026
Pregnancy is a beautiful journey, but it can sometimes come with unexpected challenges. One such condition is polyhydramnios, which refers to an excessive amount of amniotic fluid surrounding the baby in the womb. While it may sound concerning, understanding the condition, its causes, and management can help ease worries and ensure a healthy pregnancy.
What is Polyhydramnios?
Amniotic fluid plays a crucial role in protecting and nourishing the baby during pregnancy. However, when there is too much of this fluid (usually more than 2 liters by the third trimester), it is called polyhydramnios. This condition occurs in about 1-2% of pregnancies and can develop gradually or suddenly.
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What Causes Polyhydramnios?
Several factors can lead to excess amniotic fluid, including:
1. Maternal Diabetes – Poorly controlled diabetes (gestational or pre-existing) can increase amniotic fluid levels.
2. Birth Defects – Certain fetal abnormalities, such as gastrointestinal or nervous system issues, may prevent the baby from swallowing fluid normally.
3. Twin-to-Twin Transfusion Syndrome (TTTS) – A condition in identical twins where one baby receives more blood flow, leading to excess fluid.
4. Infections – Some infections during pregnancy can affect amniotic fluid levels.
5. Idiopathic (Unknown Cause) – In many cases, no specific cause is found, but the pregnancy progresses normally.
Symptoms to Watch For
Most women with mild polyhydramnios may not notice any symptoms. However, in moderate to severe cases, possible signs include:
Rapid increase in belly size
Shortness of breath (due to pressure on the lungs)
Swelling in legs or abdomen
Discomfort or pain in the abdomen
Decreased fetal movement (in some cases)
If you experience any of these symptoms, consult your doctor for further evaluation.
How is Polyhydramnios Diagnosed?
Your doctor may detect polyhydramnios during a routine ultrasound by measuring the amniotic fluid index (AFI) or deepest vertical pocket (DVP). Additional tests may include:
Detailed ultrasound – To check for fetal abnormalities.
Glucose tolerance test – To rule out gestational diabetes.
Karyotyping (genetic testing) – If a birth defect is suspected.
How Does Polyhydramnios Affect Pregnancy?
While many women with mild polyhydramnios have healthy pregnancies, severe cases can increase the risk of:
Premature labor (due to excessive uterine stretching)
Placental abruption (early separation of the placenta)
Umbilical cord prolapse (cord slipping into the birth canal before the baby)
Postpartum hemorrhage (heavy bleeding after delivery)
Your doctor will monitor you closely to manage these risks.
Management and Treatment Options
Treatment depends on the severity and underlying cause. Here’s what you can expect:
1. Mild Polyhydramnios (No Symptoms)
Regular monitoring with ultrasounds to track fluid levels.
No active treatment is needed if the baby is developing well.
2. Moderate to Severe Polyhydramnios
Medication – Certain drugs (like indomethacin) may help reduce fluid production.
Amnioreduction – A procedure to drain excess fluid using a needle (similar to amniocentesis).
Early Delivery – If complications arise, your doctor may recommend inducing labor.
Lifestyle and Self-Care Tips
Stay hydrated but avoid excessive fluid intake.
Monitor fetal movements – Report any decrease in activity.
Rest frequently to reduce discomfort.
Follow a balanced diet, especially if diabetes is a factor.
When to Seek Medical Help?
Contact your doctor immediately if you experience:
Severe abdominal pain
Difficulty breathing
Sudden swelling
Reduced fetal movements
Need Expert Advice?
If you're pregnant and experiencing unusual symptoms, Apollo24|7 offers online consultations with experienced gynecologists. You can also schedule an ultrasound for a detailed check-up.
Can Polyhydramnios Be Prevented?
While some causes (like birth defects) cannot be prevented, managing underlying conditions like diabetes can help. Regular prenatal care is essential for early detection and management.
Final Thoughts
Polyhydramnios can be concerning, but with proper medical care, most women deliver healthy babies. If you suspect any symptoms or have risk factors, consult your doctor for personalized guidance.
Consult a Top Gynecologist
Consult a Top Gynecologist
Dr. Karuna Ratwani
Obstetrician and Gynaecologist
11 Years • MBBS, MS( Obstetrics & Gynaecology), F.MAS, FICRS Advanced Diploma in Minimal Access surgery Fellow of International College of Robotic Surgeons Diploma in Reproductive Medicine, Kiel-Germany Masters in Cosmetic Gynaecology , Greifswald-Germany Masterclass in Obstetrics & Gynaecology Ultrasound ( ISUOG, UK)
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