Patient's question:
I was pregnant for 7 months last year when I had a 4D ultrasound and found that the fetus had severe pulmonary edema and excessive amniotic fluid. What could have caused this?Follow-up question: I have had an abortion, and now I want to get pregnant again. What should I pay attention to or what tests should I undergo?
Doctor's answer:
Hello:Amniotic fluid volume increases gradually from the early stages of pregnancy and begins to decrease in the last four weeks. In full-term pregnancy, the amount of amniotic fluid is approximately 1000-1500 ml. If the amniotic fluid volume exceeds 2000 ml at any stage of pregnancy, it is referred to as polyhydramnios. Slowly increasing amniotic fluid is called chronic polyhydramnios, while rapid short-term increases are termed acute polyhydramnios. Polyhydramnios is more common in patients with fetal abnormalities, twins, diabetes, or ABO incompatibility between mother and fetus.
Common Causes. The exact cause has not yet been fully elucidated. The main causes include idiopathic polyhydramnios, which accounts for 30%–40% of cases and has an unknown etiology; fetal abnormalities, accounting for about 25%, with central nervous system defects and upper gastrointestinal tract abnormalities being the most common; multiple pregnancies, where polyhydramnios is 10 times more frequent than in single pregnancies; ABO incompatibility, leading to villous edema and impaired maternal-fetal fluid exchange; and diabetes in pregnant women, where excessive fetal glucose causes polyuria.
Clinical Manifestations. Chronic polyhydramnios develops slowly, and pregnant women often adapt with relatively mild symptoms. However, when the uterus is highly distended, compression symptoms may still occur. Patients with acute polyhydramnios typically experience severe compression symptoms. The main symptoms include abdominal distension and pain, digestive disorders; elevation of the diaphragm and displacement of the heart, affecting pulmonary and cardiac function, leading to rapid breathing, palpitations, and a rapid pulse, making it difficult to lie flat; due to high abdominal pressure and impaired venous return, edema and varicose veins may appear in the external genitalia and lower limbs. Due to excessive uterine tension, premature birth is more likely, and it is often combined with preeclampsia. When the fetal membranes rupture, a large amount of amniotic fluid rapidly flows out, causing the uterus to suddenly contract, which may lead to placental abruption. Umbilical cord