Polyhydramnios Diagnosis

Last week, I was diagnosed with polyhydramnios.   What this means is that I have an excess of amniotic fluid.  It occurs in about 1% of pregnancies (my body sure likes to fall into that 1% category of things, doesn't it {Less than 1% of those with cancer have my type of cancer.}  Clearly odds just aren't in my favor.)  Of those with polyhydramnios, about 65% of the time, there is no known cause.  The other 35%, they can nail down a cause.

But before I jump into all of that.  Let me start from the beginning.  I wasn't sure if I wanted to post about this, but now that I have "answers" and more clarification, (and the few who know have posted things on my wall and I couldn't delete them before others saw), I decided I can make it known.  Sorry some of you are finding out this way.  But I assure you it's not awful.  It's just a long story that I do not have time to retell many, many times, especially since I really only have two-ish hours of free time a day.  (I'm writing this at 1am during an insomnia spell).

I had been having Braxton Hicks contractions for about three weeks.  When I saw my doctor, I told her about them and it was then that she informed me that I was having too many an hour.  They say less than 5 an hour is okay and normal, but I was having, on average, about 8 an hour.  My OB told me the next time it was happening that frequently, to pop in and they'd monitor me and baby.  At this appointment, she also informed me that my cervix is on the short end.  It could have been short to begin with, but their concern was also that my contractions might be shortening it.  (What does a short cervix mean?  Risk of pre-term labor.  She explained it like this:  Think of a lifesaver.  When you first put it in your mouth, it's hard and thick.  But over time, it grows thinner and weaker.  That's what a shortening cervix does.  Once it becomes too short, it's too weak to hold baby in because there's no cushion anymore)

Fast forward about a week, and I drove the half a mile down the road to the hospital and went up to my OB's office.  First they measured my cervix (this is done via transvaginal ultrasound.  Let me say, having three of these in 3 weeks is not fun!).  Thankfully my cervix hasn't changed since the last visit which is great news!  They also did an abdominal ultrasound to check on Baby Obie and make sure things were still looking good with him.  And they were :)  :)   He appeared as perfect as could be.  He's now head down, (which made getting a good measurement of the cervix difficult.  He did NOT like her poking his head.  But I'll admit, it was cute the way he'd turn his head and kind of look down (or up for him since he was upside down) at my cervix, where the pressure was coming from.)  She then informed me that he had his hands up near his face.  I told her that I'm not surprised because at 27 weeks, we did a 3D ultrasound and he hid his face the entire time with his feet and hands.  She responded, "Oh no!  So you never saw his face?"  Nope, not really.  She then said, "let's see if we can get you a peek" and switched transducers, flipped on the 3D and attempted to look at his face!  My office charges extra for these 3D scans but she did it free of charge.  She made my day!!!  Sadly, he remained hidden.  He kept shunning us.  This was all we saw....his shoulder, ear, side of his face (and that's his blurry arm creating a shadow and hiding his face.  But I appreciated her trying (if you live in Jacksonville, FL, I cannot recommend my OB practice enough!)  And who am I to deny watching my little miracle for an additional 15 minutes?!

After my cervix and baby were checked, they hooked me up to the NST machine to monitor my contractions, as well as how baby does during them.  After about 45 minutes, my doctor came in to tell me that while I am having quite a few contractions, baby and I are doing just fine during them.  Because of this, she has no major concerns.  She just told me to be careful and watch for signs of true labor.  She also warned me that while they aren't an issue now, things in pregnancy can change in 24 hours so they will monitor me a little more closely.  But I am approaching the point where I have an appointment every two weeks, instead of every four, so they won't order additional tests or scans.

So back to work I went and feeling much more relieved.

Fast forward six days to this past Thursday.  I went in for my normal routine visit.  They checked my cervix again just to make sure it's not shortening and they again took another look at Little Man.  Once I was back in the exam room, the nurse practitioner came in and said, "Baby looks great!  Your cervix is the same as last week, which is good!  But, we have a pretty big concern.  You have polyhydramnios, which is an excess of amniotic fluid.  When you came in last Friday, we noticed it was a little above average, but we didn't mention it to you.  Some times women's levels are high for a day due to too much water and we didn't want to freak you out over nothing so we decided to wait and see how it was today since we knew we were seeing you in less than a week.  But today, it's risen significantly.  And you've gained a few pounds in those six days."

She then told me that more than half the time, they don't know the cause and the other half, they do.  I asked what the causes were and she went through them:
-  Fetal anemia, which would mean he would need to get a blood transfusion, in utero.
-  Genetic disorders, most commonly Downs Syndrome.  However, she said she didn't think this was the case.  My risk factors for genetic disorders came back so low after I had all the blood work done in the first trimester.  Not to mention, we've seen him many times and his measurements are perfect and right on track for where he should be.
-  Birth defects in the digestive tract, such as cleft palate, cleft lip, or an obstruction in his esophagus, all of which would cause him to have issues swallowing the amniotic fluid.  Thankfully, we've seen his mouth and know that he doesn't have cleft lip or palate.  She was confident he didn't have an issue with his esophagus, but she said the high-risk doctors would take a look and confirm that.
-  Gestational diabetes.  She's almost positive this isn't the case.  I had the test done a little under two weeks ago and my levels came back almost as low as can be.  She said she'd never seen anyone suddenly reach diabetic levels or the levels needed to cause this in just two weeks.
-  Kidney issues.  It could be that his kidneys are not functioning properly, but again, the high-risk doctors would look into this.
-  A virus, but she said one severe enough to cause this, I would have been very symptomatic.  And I haven't been sick at all this pregnancy so we ruled that out.

Unfortunately, once you're flagged with polyhydramnios, you have to go through the entire checklist again to rule things out and find a cause.  So I have to get all the blood work done for genetic disorders.  I have to repeat the one-hour blood sugar test.  I will go back to the high-risk doctors  (even though I'm still concerned a high-risk pregnancy, it was going so smoothly that they didn't make me see both them and my regular OB.).  The high-risk docs have better machines and can get a better look at him.

I asked my OB what this all means for me, and she said it puts me at a great risk for pre-term labor.  It also puts me at risk for umbilical cord prolapse once I'm in labor (that is when the umbilical cord slips out of the cervix ahead of baby and will require an emergency c-section) and it also puts me at risk for placental abruption.   She said it can also cause increased back pain, abdominal pain, and more intense/painful (false labor) contractions.
Of course then she told me to get things in order (nursery, birth plan, hospital bag, etc) and we went over signs of true labor.
Cue my freak out!!!!  I'm only 29 weeks (at that point.)  She could see the tears in my eyes and told me to stay calm.  She informed me that she's pretty certain I'll fall into the "unknown cause" category, which is good because the other ones mean something is wrong with baby.  She also informed me plenty of women have this and see no side effects from it and carry to term.  But that she has to be honest and prepare me in case I do go early or something is wrong.
Lastly, she measured my belly and while baby is measuring on track, my belly is a little bigger than normal for this week.  I was in week 29, almost week 30 but my belly was measuring week 32.  But she said that (and the huge jump in weight in 6 days) is due to the rise in amniotic fluid.


That Thursday to Tuesday was a long wait to see the high-risk specialists.  Thank goodness Nick was with me for this appointment (and thank goodness for a very family-oriented and understanding squadron.  They changed him to flying late that night instead of earlier in the day so he could come to this appointment with me.)

When I arrived, they took me right back for the ultrasound.  I still have an excess of amniotic fluid, but good news is that it isn't anymore than it was at my last visit.
Baby looked great!  He's measuring right on track (which also indicates no signs of genetic disorders) and weighs 3 pounds and 5 ounces, putting him in the 47th percentile, which is average and perfect!  He was moving all over (again, hiding is face most of the time.  We waited (and poked him) for a good 20 minutes to attempt to get him to move his hand from his face so she could measure his nasal bone. We have one stubborn child who takes after his father and hates photos.  I like to think he doesn't want his face seen until he has a name to go with the face.)
He was swallowing just fine and we could see nothing wrong with his digestive tract or esophagus, and his kidneys looked great!!!
Everything checked out great!!
As the doctor said, "Baby just likes a big swimming pool!"  Of course, it doesn't mean we're in the clear as I'm still at risk for pre-term labor.  But we are thrilled to know that he is healthy and nothing is wrong with him.  (I still have to get the blood work and redo the blood sugar test, but I'll do that at my next regular visit next week.)
And since nothing is wrong with Little Man, and it's just a lot of fluid for an unknown reason, I don't have to come back to the high-risk doctors for another four weeks :)

The ultrasound tech and student that did the ultrasound printed quite a few pictures for us, which we are thankful for.  AND we learned he now has hair!  It's light colored (hopefully blond or strawberry blonde and not Nick's Irish beard orange hair lol).   It's not much she said, but he has some now whereas at our 3D scan at 27 weeks, he was very bald!

He appears to have his mama's chin! Maybe?  I think so!

(Top left, his eyes and mouth are open and he looks a little (a lot) creepy.
Bottom right, that's the hair sticking off the back of his head!!!)


I am so relieved to know he's okay.  Of course, I'm concerned about going into labor early.  At this point, 30 weeks, his rate of survival is 95% which is awesome!  But I don't want him to come early. Sure, I'm anxious to meet him, but I want him to come when he's done cooking so that he can come home WITH us and not spend any additional time in the hospital.
Now we are working hard and fast to get his nursery done (furniture was ordered end of last week and paint samples are bought with the intentions of painting three of the walls this weekend!).  Yes, I know he won't be sleeping in it for a while, but I really don't want to worry about setting up a nursery once he's arrived.
Additionally, my hospital bag is now mostly packed, Nick's checklist for his bag is made, and I'm working on the very few things we'll take in Baby Obie's bag (still on the hunt for a good baby book if anyone has one they love and want to recommend!)  (OR if you have suggestions of things you were happy to have or wished you would have had in the hospital.  Yes, I know they provide everything you need, but I'd rather have my own things if it'll make me more comfortable.  I'd rather have it and not use it than not have it and wish I did have it, especially since we live about 30 minutes from the hospital).

I'd appreciate prayers (from you praying type) and good thoughts that Baby Obie stays put at least another 7 weeks and that we don't come across any issues and all goes well for us both!!!!  We're in the home stretch now, Little Man!  We got this!!!