[devon]

I am planning a HB for my third pregnancy (I'm 23 weeks). My second son was an unplanned HB. This time I'm seeing a wonderful midwife and seeing a family practice dr about every 8-12 weeks in case I have to go into the hospital for some reason.

I had a 20wk u/s and didn't hear anything back from the dr or the radiologist, which my midwife said means that probably everything is fine for the most part or they would have contacted me.

I went in this past week and saw the family practice dr (who I haven't seen since 14 weeks). She said the u/s looked good except "my amniotic fluid was on the high side of normal". She didn't give me an exact number for the AFI. She then goes on to talk about how this can be dangerous in labor because of cord prolapse. She does my fundal height and finds it at 28cm (I was 22 weeks). She said that this probably means I indeed do have a lot of fluid (the baby at 20w measured 21w at the u/s) and scheduled me for a repeat u/s in 4 weeks.

So now I am obviously freaked out. I called my MW and she talked to me about it, said the u/s is a good idea, but that I was measuring 'normal' at 20w with her so it could have just been a baby growth spurt. She also said don't worry about it until much closer to the end of pregnancy.

But I can't help but worry. I don't know if I had high amniotic fluid with my first 2 pregnancies - the dr's never said I did, but since this time I was technically still in the 'normal' range, maybe I did and they just didn't say anything. With DS#2, I know that I measured my fundal height at around 30cm at 26w so at some point I was big there, but my dr that pregnancy never said anything.

I am just so freaked now that I am going to have to end up with a c/s because of the fear of cord prolapse or a breech, or at the very least, stuck in the hospital. Anyone have this situation and be fine? My water has not broken until I was pushing in both previous labors, and my kiddos were both extremely engaged (-2 and -1) before I went into labor with them.

TIA!
devon

 

[alegna]

Don't freak.

I measured very large with ds. Around 8wks ahead most of the time. We didn't do an u/s but the MW felt that it was fluid.

Ds was born healthy and happy and totally in the caul at 43 weeks 5 days.

-Angela

 

[hikingmommy]

I had polyhydramnios w/ my first pregnancy. 2/3 of the time they have no idea what causes it. If the U/S looks normal and you aren't diabetic, then you're in the 2/3. We were using a mainstream birth center at the time, so we were risked out of that, but no one ever mentioned a planned c-section b/c of the risk of cord prolapse. Did your MW say what she'll do if you still have it later in the pregnancy? There is a homeopathic remedy that they say can help. I'm sorry I don't remember what it is, but I imagine you can find it w/ some on-line searching. I also read that watermelon, a mild diuretic, can help.

I just reread your post. If it's on the high side of NORMAL, what are they worried about? I mean, maybe it's worth monitoring if you keep measuring big, but if it's still w/n the normal range, I think it isn't worth worrying yourself over.

 

[library lady]

I had an ultrasound last month and it showed polyhydranimos (sp?). The upper end of normal is 25 and I was around 28. 2/3's of the time there is know known cause. GD is a big factor but there are also some other things that may cause it that aren't a big deal. One of the things that I read said being anemic can cause increased fluid.

 

[rockportmidwife]

Quote:

Originally Posted by devon My water has not broken until I was pushing in both previous labors, and my kiddos were both extremely engaged (-2 and -1) before I went into labor with them.

The risk of cord prolapse is if your water breaks while the baby is high. If the baby's head is engaged in your pelvis (usually considered 0 station) then there is not room for it to prolapse.

 

[Full Heart]

Your dr said you had fluid on the high side then measured you and found an outcome like expected. Could just be because she measured you and wanted to find you large. Esp since you said your mw measured you just 2 weeks before (in the same week as the u/s that showed higher fluid levels) and it was normal.

Typically different cps can come up with different measurements. Very normal anyway. Throw in there that she expected it to be big and yea you are gonna measure big. I wouldn't worry till your mw measures you again. Keep in mind too that they are just avgs. You measured bigger with your son too. Lost of things can cause you to measure big too. Baby position, growth spurt, needing a chiro adjustment, etc. Lots of things. I wouldn't worry too much just yet.

 

[kJad29]

I have higher than normal fluid levels and have been measuring big from 28 weeks. It really isn't that bad especially if your baby has descended into the pelvis before labor starts (as mine has). Sometimes that's just the way women grow their babies and if you don't have GD then it isn't an issue really unless like PPs have said, your water breaks and baby's head isn't engaged.

 

[mommato5]

http://www.healthline.com/blogs/preg...s-related.html

If you have too much fluid, please do not HB.

I had too much fluid and delivered a premature little girl with under developed lungs who passed away. The excess fluid should have risked me out of homebirth but I didn't know that back then.

Quote:

Similarly, Biggio and colleagues (Obstet Gynecol 1999;94:773-7) compared 370 women with singleton pregnancies beyond 20 weeks' gestation and hydramnios with 36,426 controls who had normal amniotic fluid volumes. "The perinatal mortality rate in all women with hydramnios was 49 per 1000 births, compared with 14 per 1000 births in the control group (P < .001). Women with hydramnios had 25 times more anomalies than controls (8.4% versus 0.3%; P < .001)&#8230;the cesarean rate was three times higher in women with hydramnios compared with controls (47.0% versus 16.4%; P < .001)." Interestingly, in their study, the increased risks were concentrated in the nondiabetic women with hydramnios.

 

[MsBlack]

As mommato5 has pointed out, true polyhydramnios is associated with a greater chance of fetal malformations and possibly stillbirth or early neonatal death. However, 2 things:

1. You do not have true polyhydramnios--just more fluid than some moms do but still IN NORMAL RANGE. Your dr is scaremongering to suggest that this is a potential problem at this point. Besides, for most women, the amount of amniotic fluid tends to drop some toward term. I think your mw is probably right, baby had a growth spurt. And you're seeing the mw more often than the doc, right? Which means your mw--who is likely doing some fairly thorough palpation of your belly during visits--has a much better sense of your baby's growth from month to month than your doc does. Don't know about your doc, also--but most docs do not tend to do very thorough palpation. They tend to rely more on u/s and fundal height to tell them about baby--and there is a real loss of contact and information when they skimp on the belly palpation.

2. While most cases of 'extra fluid' are of unknown cause, a significant portion of women with true polyhydramnios are carrying babies with anomalies. So, it is only natural that the stillbirth and early neonatal death rates are higher than with 'normal-fluid-level' pregnancies. Don't let those stats scare you--they are not presented in a very intelligent, informative way in any event. The authors would like us to believe that it is simply polyhy. that is causal--and this is not the case.

Also, cord prolapse is extremely unlikely to occur if no one breaks your water while the baby is still riding high. Well, I'm not a fan of AROM at all--but AROM with a high baby is a recipe for cord prolapse, particularly in the presence of a lot of fluid.

In any event, your situation suggests nothing that makes homebirth less safe for you than for any normally healthy mom/baby. If you later get more information that changes the present picture, you can rethink it then--but for now, as Angela said "don't freak"! There is no reason to.

 

[devon]

Thanks ladies.

I am seeing my MW every 4 weeks, so more often. And like MsBlack said, she thoroughly feels my belly while the dr just measures it quickly.

Mommato5 - I am so sorry about your loss. How heartbreaking.

I got the exact measurements today and got really ticked off - it is measuring 14.98, which the normal range is 8-18, so I am well within the normal range! The radiologist said "subjectively, there seems to be a lot of fluid". Um, talk about subjective. The AFI is not even in the 18-22 range for polyhydraminos.

That being said, I feel better now, and also thanks to you ladies. I would never risk a HB if my midwife (who I feel would not take unneccesary risks) thought I was not a good candidate. The dr said the baby looked wonderful and didn't show any signs of being the 'reason' for the fluid - that I just had more.

 

[MsBlack]

Hmmmmm.....

:

"subjectively"...kinda makes you want to slap the sillyhead for saying that, eh?

Glad to hear you got some real info to go on now!