Signs of Polyhydramnios

The signs and symptoms of Polyhydramnios are usually caused by increased pressure in and around the uterus. They can be very similar to those expected in the third trimester of a normal pregnancy, only more exaggerated. When asked what polyhydramnios feels like, many moms will agree that intense contractions, trouble breathing, trouble doing normal activities, and extreme anxiety were some of their most difficult symptoms. Occasionally, Polyhydramnios can present with very bothersome symptoms that require intervention, while other moms do not experience any exaggerated symptoms at all.

Table of Contents

Symptoms

Trouble Breathing

Shortness of breath, the inability to breathe, and breathlessness are all common complaints of women with Polyhydramnios. As the uterus swells with fluid, it puts more pressure on the surrounding organs, including the lungs, thus making it harder to breathe.

Breathing may become increasingly more difficult in severe cases of Polyhydramnios. In these cases, an amnioreduction can provide temporary relief.

Swollen Legs

Swelling is the accumulation of fluid in your body’s tissues and is a normal, expected part of most pregnancies. During pregnancy, your body makes roughly 50% more blood and body fluid to be able to meet the needs of your growing fetus. Pair that with normal fluid retention and changing hormones and you’ve got the perfect foundation for swollen extremities. In addition to those factors, your growing uterus impacts the return of blood to your heart and causes even more swelling. So, when excess amniotic fluid causes extra growth of your uterus, extra swelling is to be expected.

Polyhydramnios swelling can be so bad that it can affect feet, ankles, legs, hips, thighs, and your abdominal wall.

Swollen Vulva

Again, normal increased blood flow to support your growing fetus will also contribute to a swollen vulva. With Polyhydramnios though, when your larger-than-normal uterus causes increased return of blood to your heart, you may experience inflammation of the vaginal arteries and ducts as a result. That inflammation presents itself as edema, or swelling, in your vulva.

Tight Belly

Extreme stretching of the uterus can cause pain and tightening in the abdominal wall. Imagine a tightrope with too many people walking on it… that’s kind of how your ligaments feel about pregnancy! Round ligament pain can be more intense with Polyhydramnios than in a normal pregnancy because your uterus is being stretched further, faster. 

More frequent Braxton Hicks contractions are also a common cause of abdominal tightening with Polyhydramnios. Braxton Hicks contractions may start as early as 16 weeks. They are irregular, non-painful tightenings of the uterus that usually pick up if you’ve been on your feet a lot or are dehydrated. Braxton Hicks can usually be eased by rest, change of position, or rehydrating.

Increased contractions / Irritable Uterus

It is common in cases of Polyhydramnios for your expanding uterus to become irritable, causing frequent and intense “real-feeling” contractions.  An irritable uterus is when you are having strong, regular contractions but they don’t produce any change in your cervix. Unlike Braxton Hicks, irritable uterus contractions don’t respond to rest or hydration.
 
Even though an irritable uterus can be frustrating to deal with, as long as the contractions aren’t causing changes to the cervix, they are nothing to worry about. There are studies though that have shown that 18% of women with an irritable uterus will also experience preterm labor. So, anytime you experience more than 6 contractions in an hour, you should contact your health-care provider, just to be safe.

Fetal Malposition

With Polyhydramnios, your baby basically has an olympic-sized swimming pool to float around in. Breech and transverse presentations are very common, especially in the early to mid third trimester when baby still has a lot of room to move around. This can be especially concerning to anxious mommas who are having weekly ultrasounds watching, waiting, and hoping for baby to flip. The good news is, many babies do!

But, as you near your baby’s arrival date, if your baby hasn’t turned head down there are things that can be done to try to get your baby into a more favorable position for delivery. Even in an uncomplicated pregnancy, there are risks and benefits involved with each method. Polyhydramnios presents some extra risk factors that you and your healthcare team will need to carefully consider before attempting to turn your baby.

Constipation

Constipation occurs at some point in about half of all pregnancies. Normal contributing factors can include worry, anxiety, limited physical activity, a low-fiber diet, pregnancy hormones, an expanding uterus, and iron supplements. 

With Polyhydramnios thrown into the mix, many mommas find that their worry and anxiety increase, and physical activity may become more difficult due to the increased swelling and breathing troubles. When you add in the extra pressure that your larger-than-normal uterus puts on your intestines, then it makes sense that you might be dealing with some extra constipation. 
Jump to how to ease constipation.

Increased Heartburn / Indigestion

Studies show that about 45% of all pregnant women suffer from heartburn. There are three contributing factors: 

  1. Progesterone causes the normally tight valve that separates the stomach from the esophagus to relax allowing stomach contents to flow back up into the esophagus.
  2. Your growing uterus puts pressure on one end of the stomach causing its contents to spill out on the other end (like when you squeeze a tube of toothpaste and it comes out of the opening.)
  3. Progesterone again causes slowed digestion which means stomach contents hang out longer in the stomach, giving them more of a chance to cause heartburn.

So again, with Polyhydramnios, a bigger uterus is to blame as it puts increased pressure on the stomach, and leads to increased heartburn.

Enlarged Uterus

The hallmark symptom of Polyhydramnios is a larger than expected uterus. Many mommas with Polyhydramnios measure several weeks ahead in fundal height due to the excess fluid they are carrying. An enlarged uterus may also look bigger than expected for gestational age, and it may feel much heavier than that of a normal pregnancy.

Anxiety

According to Healthline, “anxiety is your body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come.” So it totally makes sense that anxiety is a natural symptom for most moms dealing with Polyhydramnios. The risk factors, unknowns, and possibility that something could go very wrong with your baby all contribute to the fear and stress that can put you into anxiety mode both during your pregnancy and after. 

Many moms who go through a polyhydramnios pregnancy develop some form of medical anxiety disorder that continues to affect them after their pregnancy has ended. This is normal, sometimes even expected depending on the things you experienced, and usually eases with time. If it doesn’t get better with time and coping strategies, there are other options that you can explore to help you with the things you are going through.

Ideas to Manage the Symptoms of Polyhydramnios

How to Manage Breathing Problems

Being upright is the best way to help with breathing because it puts the least amount of pressure on your diaphragm. If you’re really having trouble breathing, try standing up and doing this mindful breathing technique: inhale slowly through your nose while counting to seven, then slowly exhale while counting to seven again. The counting helps you to focus on your breath and not everything else. If you can’t inhale for a full seven counts at first, start with 4 or 5 and eventually work your way up.

If you’re having trouble sleeping due to shortness of breath, you may find more relief if you sleep propped up. Try sleeping in a comfortable chair or on the couch with plenty of pillows for support.

Tips to Handle Excess Swelling

To help alleviate swollen extremities, try resting for short periods with your legs propped above your heart. Staying very well hydrated will also help. Try to avoid too much time in the heat, and also try not to spend too much time sitting since both of these things can contribute to swelling.

What to do When you Have Braxton Hicks or an Irritable Uterus

If you’re having braxton hicks, try simple tricks like drinking a glass of water, changing position, or changing activity. 

Unfortunately, if your contractions are being caused by an irritable uterus, there isn’t much you can do aside from waiting them out. Sometimes drinking several glasses of water will help to ease them, but not always. The good news about all of those irritable contractions though is that they are a great time to practice some mindful breathing techniques for when true labor actually happens. Plus, mindful breathing alongside all of those frustrating irritable uterus contractions may just be the best way to help you get through them. 

This is a great video with tips for how to breathe through labor contractions. You can use these exact same techniques with your irritable uterus contractions to help your body relax through them. 

Ideas to Turn a Malpositioned Baby

The two most popular ways to get your baby in the optimal head down position before labor begins are external cephalic version (ECV) and Spinning Babies. ECV is always done in a hospital setting so its not exactly a “self help” technique. Spinning Babies is was developed by a midwife with the goal of optimizing the physical relationship between mamas and babies to help ease pregnancy pains, and make for a more natural, comfortable, and successful labor. Many women have had success getting their babies to turn using these techniques. You can check out the website here, but remember you should get your healthcare provider’s approval before trying any of the techniques.

If spinning babies is too much to sort through for you, you might like the video below. It uses techniques that you can begin as early as 30 weeks to get your baby to turn into an optimal position, engage in the birth canal, and stay that way until (and during) labor.

How to Ease Constipation

The best way to fight constipation is by eating high fiber foods, limiting constipating foods, and drinking enough water. You should aim for about 10 cups (2.3 liters) of fluid per day. Your body takes in water from most fluids you drink, including milk, juice, tea, and coffee. The best way to tell if you are well hydrated is by the color of your urine. If its dark, you need more fluid, if its very light or clear, you are well hydrated!

25-30 grams of fiber per day while pregnant is a healthy target. Some of the highest fiber foods include raspberries, green peas, whole grain spaghetti, split peas, beans, lentils, and chia seeds. This chart from the Mayo Clinic has a good list of other high fiber foods and how many grams of fiber each contains.

Some of the most constipating foods include dairy products, fast food, fried food, eggs, sugary treats, and white bread.

How to Ease Heartburn

You may find relief from over the counter remedies such as maalox, tums, or pepcid ac. More severe cases might find relief from prescription acid relievers. If you prefer a more holistic approach, you could try tissue salts or baking soda in water. However, anything you decide to ingest needs to be approved by your healthcare provider first.

Other self-help tricks for relieving heartburn include eating smaller meals, avoiding certain foods that trigger your symptoms, not eating past 7pm, and sleeping in a propped up position.

Coping with the Anxiety Caused by Polyhydramnios

The anxiety caused by the unknowns of Polyhydramnios is one of the hardest symptoms to manage. Mindful breathing can really help to calm your mind and body. Some mamas also find that gentle exercise like yoga can help them to relax. 

Another great way some mamas deal with anxiety is to plan ahead as much as possible. Using our tools like the doctor discussion guide to plan for all of the possibilities, can help give you back a sense of control.

Finally, studies have recently shown that high doses of folate and vitamin D may be beneficial to help ease anxiety. As always, please consult your doctor before taking any kind of medication or supplements.

Check out our shareable infographic for more ideas to help you cope with the anxiety caused by Polyhydramnios.

FAQs

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Read Next

Risks of Polyhydramnios – Some of the risks of Polyhydramnios include preterm labor, premature ROM, cord prolapse, fetal malpresentation, and maternal hemorrhage.

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