Answer:

Pregnant women with polyhydramnios should prioritize vaginal delivery unless there are factors necessitating a C-section, such as gestational diabetes, hypertension, preeclampsia, previous C-sections, difficult births, a large fetus, or breech presentation. The decision on the delivery method (vaginal or C-section) is based on the doctor's specific clinical assessment.

Polyhydramnios is an excess of amniotic fluid in the amniotic sac. It is classified into three groups according to severity: mild (AFI 25-30 cm), moderate (30.1-35 cm), and severe (≥ 35.1 cm). Polyhydramnios can often be related to maternal diabetes, multiple pregnancies, twin-to-twin transfusion syndrome, fetal anatomical or genetic abnormalities (such as Down syndrome, Edwards syndrome, Patau syndrome), fetal anemia, Rh incompatibility, metabolic disorders, and fetal infections. Polyhydramnios usually develops from the second trimester of pregnancy, starting between the 13th and 26th weeks, earliest at week 16, and increases the risk of preterm labor, premature rupture of membranes, abnormal fetal position, umbilical cord prolapse, placental abruption, and postpartum hemorrhage.

However, expectant mothers with polyhydramnios should not be overly worried, as most cases are mild and managed conservatively. For those with moderate or severe polyhydramnios, doctors consider appropriate interventions such as amnioreduction (removing excess amniotic fluid) or administering corticosteroids to promote lung maturity if there is a risk of preterm birth before 34 weeks. In severe cases, where the mother experiences shortness of breath or inability to breathe, chest tightness, or rapid abdominal enlargement, the doctor may recommend hospitalization for monitoring.

Some potential causes include gestational diabetes, genital infections, and gastrointestinal malformations. If there's an infection, the pregnant woman needs prompt examination and treatment. The treatment goal is to prevent dangerous complications for the fetus and reduce discomfort for the mother. The pregnancy prognosis depends on the severity and cause. Mild polyhydramnios with an unknown cause generally has a good prognosis.

Associate Professor Hong consults with an expectant mother. Photo: Tam Anh General Hospital

Associate Professor Hong consults with an expectant mother. Photo: Tam Anh General Hospital

When diagnosed with polyhydramnios, expectant mothers need to adhere to a strict pregnancy monitoring plan prescribed by their doctor. If unusual signs appear, such as shortness of breath, bloating, constipation, or swelling of the hands and feet, they should immediately go to a medical facility for timely treatment. Pregnant women should maintain a balanced diet, reduce salt intake, drink enough water, avoid stress, and increase rest. In some cases, expectant mothers can consider taking maternity leave early to ensure safety for both themselves and their fetus.

Associate Professor Dr. Luu Thi Hong

Deputy Director of the Obstetrics and Gynecology Center

Tam Anh General Hospital, Hanoi