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Too much of a good thing

by Dr Howard Lee
Some conditions of the unborn baby or pregnancy can give rise to excess amniotic fluid, says Dr Howard Lee

What is amniotic fluid?
Amniotic fluid is usually sterile, and contained in the sac that surrounds a baby throughout pregnancy. It helps to protect and cushion, and also plays an important part in developing many of the baby's vital internal organs - like the lungs, kidneys and gut.

The normal amount may vary, but there's usually a slow increase until about 36 weeks of pregnancy - then a slow decrease. Most women carry about 500 ml of amniotic fluid. The fluid is produced by the inner lining of the sac (amnion) as well from the baby's lungs and kidneys - it is continually taken up by the baby's swallowing, and is also sent across the afterbirth (placenta) into the mother's circulation.

The commonest problems with amniotic fluid - which occur in about seven out of every 100 pregnancies - usually take the form of either too much fluid (hydramnios or polyhydramnios) or too little fluid (oligohydramnios). Both conditions are associated with abnormalities in the baby's development or some other pregnancy complication. Any abnormal difference in the amounts of the amniotic fluid may be either the cause or the result of a problem within a pregnancy.

Hydramnios
This is the condition, occurring in about three to four pregnancies in every 100, where there is too much fluid around the baby. A minor to moderate degree of fluid increase (two to three litres) is quite common and, if this increase develops in the second trimester (three month period), there is a good chance that your baby is fine and that the fluid increase will disappear on its own.

Hydramnios is a symptom of health problems, rather than the cause. Remember, too, that hydramnios may also occur during perfectly healthy multiple pregnancies.

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