Can the Baby Die From Too Much Amniotic Fluid

Polyhydramnios is an aberration occurring during pregnancy in which there is an excessive amount of amniotic fluid in the womb. Polyhydramnios occurs in about ii% of pregnancies.

Although excessive amniotic fluid is not inherently harmful to the baby, it can lead to other complications and condition (such as prematurity) that are potentially harmful. Approximately 30% of pregnancies with polyhydramnios cease in neonatal expiry. Polyhydramnios is ofttimes caused past infections, gestational diabetes, and genetic fetal anomalies.

About Polyhydramnios

During pregnancy the womb fills with a critical liquid substance chosen amniotic fluid. Amniotic fluid serves several of import functions in fetal development. It acts like a absorber to protect the baby from external trauma and insulates the baby from temperature changes. During gestation the infant likewise inhales or "eats" the amniotic fluid which facilitates lung development.

The volume of amniotic fluid in the female parent's womb varies somewhat depending on the mother and size of the baby, merely generally stays within certain ranges that are considered normal. The normal amount of fluid also varies depending on the phase of gestation. The normal maximum volume of amniotic fluid shoulder never exceed m ml during whatever stage of pregnancy.

In a sure percentage of pregnancies, the female parent retains backlog levels of amniotic fluid in her womb. This is an aberrant complexity called polyhydramnios. Polyhydramnios can range from mild to severe depending on how much excess amniotic fluid is being retained in the womb.

And then polyhydramnios is only likewise much fluid. The delicate yin and yang to maintain fluid rest has gone awry. Typically, the problem is the fetus is producting too much urine or whatsoever secretions are being made aren't being re-captivated.

Mild cases of polyhydramnios are often harmless and symptomless while more than severe cases can trigger significant physical symptoms and lead to major complications.

Symptoms of Polyhydramnios

At that place are iii classifications for polyhydramnios: mild, moderate and severe. Mild polyhydramnios is characterized by a value of eight to xi centimeters. Moderate polyhydramnios between 12 to 15 centimeters. Astringent polyhydramnios are higher up 16 cm. Astringent polyhydramnios may necessitate early on labor. Even so, mild cases of polyhydramnios are managed expectantly meaning that the patient is monitored until the condition goes abroad on its ain.

Mild polyhydramnios will usually not take whatever physical symptoms at all and is mostly harmless. Severe cases of polyhydramnios, where the level of backlog amniotic fluid is very loftier, will accept a number of acute physical symptoms. The concrete symptoms are caused by the expansion of the womb every bit information technology swells with excess fluid and begins pushing up against the mother'due south internal organs. The most mutual symptoms associated with severe or moderate cases of polyhydramnios include:

• Difficulty or pain when breathing
• Swelling in lower body
• Abnormal urination or bowel movements
• Heartburn
• Pelvic force per unit area / abdominal hurting
• Swelling of the vulva

The majority of polyhydramnios cases are diagnosed in the last phase of pregnancy. However, more problematic cases tend to occur earlier and the condition can start as early on as the xv^th week of pregnancy.

Polyhydramnios Risks and Complications

Excess amniotic fluid is non directly harmful to the baby, even so, it frequently leads to the evolution of other complications and problems that tin be very dangerous. The most serious pregnancy or childbirth complications that are often triggered by polyhydramnios include:

• Premature Birth: when there is as well much amniotic fluid in the womb it creates outward uterine pressure as the baby grows. This is known to stimulate premature labor forcing the baby to exist born before it is fully prepare. Premature birth tin can be disastrous for the baby's wellness and profoundly increase the risk of numerous wellness bug and birth injuries.
• Fetal Malposition: excessive levels of amniotic fluid oft cause the baby to floats into an abnormal delivery presentation such every bit breech or transverse. Breech position and other abnormal presentations make vaginal delivery much more difficult and potentially hazardous for the baby. The risk of harmful complications or events during childbirth such as umbilical string prolapse is significantly increased.
• Placenta Abnormalities: polyhydramnios significantly increases the take a chance of developing placental abnormalities or complications such equally placental abruption or placenta previa. Complication involving the placenta can be very harmful to the infant since the placenta and umbilical cord are critically important to the delivery or oxygen and nutrients to the baby.

Polyhydramnios & Medical Malpractice

Polyhydramnios is oft a key component in birth injury cases. Amniotic fluid levels are not difficult for doctors to measure then you don't really meet any nativity injury malpractice claims based on failure to diagnose polyhydramnios. What you lot exercise meet are cases in which polyhydramnios is diagnosed in advance but doctors fail to properly manage the condition or have proper precautions to account for the increased chance of secondary complications.

Some doctors use Indocin to treat polyhydramnios. This drug is not approved for polyhydramnios. Indomethacin is actually non-steroidal anti-inflammatory analgesic used to treat rheumatoid arthritis, ankylosing spondylitis, and osteo-arthritis. But many doctors prescribe it anyhow for excessive amniotic fluid, arguing that it is the cheapest, fastest, and least complicated solution. This is arguably an acceptable practice. But the lack of research is troubling. There is defoliation as to what is the appropriate dosage. As well, the doctor has to manage and monitor the complications and consider an amnioreduction if the Indocin does not do the flim-flam. There is a risk of rupture with an amnioreduction because information technology is invasive and requires a large needle to exist injected remove the excessive fluid.

How Does Excessive Amniotic Fluid Crusade a Brain Injury?

Excessive amniotic fluid does non itself cause oxygen loss that can lead to brain damage. But it can set off a chain reaction that causes loss of oxygen causing hypoxia or decease. What can happen is polyhydramnios can cause uterine overdistension. This tin induce placental dysfunction or uteroplacental insufficiency. Damage to the placenta tin deprive the child of oxygen that tin atomic number 82 to a brain injury.

Does Excessive Amniotic Fluid Cause Labor to be Longer and More Difficult?

Excessive amniotic fluid can cause a more challenging labor. It tin can crusade prolonged labor because the uterus does not properly contract. Some obstetricians try to reduce the polyhydramnios by breaking the bag of water. Then if the uterus is overdistended, it may not contract properly which will cause extended labor.

Does Excessive Amniotic Fluid Advise Congenital Defect in the Fetus?

There is a higher correlation between excessive amniotic fluid and built defects and you meet that in i of the sample polyhydramnios settlements beneath.

Are Medical Malpractice Cases Involving the Failure to Care for Excessive Amniotic Fluid Common?

Lawsuits for failing to treat excessive amniotic fluid are less common. The more than viable claims tend to involve the chain reaction we discussed in a higher place and that causes oxygen deprivation during the birthing process, leading to a hypoxic injury.

Polyhydramnios Related Lawsuits - Settlements and Verdicts

Below are instance verdicts and settlements from nascency injury malpractice cases involving negligent management or handling of polyhydramnios and resulting complications.

• Graham 5. Aristocracy OB/GYN P.C. (New Jersey 2020) $1 million: This is an singular polyhydramnios nascence injury case. An expectant mother underwent an ultrasound. The result indicated polyhydramnios. Her OB/GYN failed her mention this to her. Two months after, her son was delivered with Beckwith-Wiedemann Syndrome. This syndrome is non a nascency injury; it is genetic defect. The child requires lifelong treatments and 24-hour care. His mother alleged that her OB/GYN failed to inform her of possible genetic abnormalities. What's is the connection? High amniotic fluid levels are a marker for Beckwith-Wiedemann Syndrome. She claimed she would have undergone amniocentesis, sought genetic counseling, and considered terminating the pregnancy if she was properly informed. The lawsuit settled for $ane million.
• McDaniel v Ritchey (Alaska 2018) $ane million: mother goes to OB/GYN office for prenatal care visit midway through pregnancy and she is diagnosed with polyhydramnios and a calcifying placenta. Doctors accept no action at the point except to schedule her for a follow upwardly visit the next week. Before the follow up visit occurs the baby dies and mother sues doctors alleging that they negligently failed to recognize the danger signs resulting from polyhydramnios and her placental issues which should take prompted immediate intervention.
• Harris v University of Penn (Pennsylvania 2013) $41.vi one thousand thousand: mother with high-risk pregnancy goes to her OB/GYN office at Academy of Penn Hospital for prenatal examination with complaints of pelvic pressure. Exam indicates funneling of the cervix and severe polyhydramnios but no course of activeness is taken at that time. iii days later on the baby has to exist delivered via emergency C-section and is extremely premature at merely 25 weeks gestation. She suffers numerous health problems related to her prematurity including encephalon bleeds, hydrocephalus, respiratory distress syndrome. She is permanently bullheaded, deaf, and diagnosed with very severe cerebral palsy. Her mother sues the infirmary and doctors alleging that they were negligent in failing to administer steroids and acknowledge her to infirmary after noting polyhydramnios and cervical funneling in prenatal examination. Doctors deny wrongdoing insisting they acted accordingly. A jury in Philadelphia disagrees and awards plaintiff $41.6 million in damages.
• Coverdale v Women's Health Services (Pennsylvania 2011) $5 million: plaintiff mother presents to accused hospital and is diagnosed with polyhydramnios. Her levels of backlog amniotic fluid are found to be very loftier. Doctors decide to delivery baby simply instead of performing C-section they opt for vaginal commitment and administer Pitocin to induce labor. Several hours into labor a placental abruption occurs and the baby dies from oxygen deprivation. Plaintiff alleges that doctors were negligent in failing to deliver via C-department and in administering Pitocin which is never supposed to be used on mother's with polyhydramnios. Case is settled out of court for $five million.

Medical Literature

• Hughes DS, et al. Accuracy of the Ultrasound Estimate of the Amniotic Fluid Volume (Amniotic Fluid Index and Unmarried Deepest Pocket) to Identify Actual Low, Normal, and Loftier Amniotic Fluid Volumes equally Determined by Quantile Regression. J Ultrasound Med 2020; 39:373. Written report found that
• Bruner JP, Crean DM. Equalization of amniotic fluid volumes after amniocentesis for treatment of the twin oligohydramnios - polyhydramnios sequence. Fetal Diagn Ther xiv: fourscore-5, 1999.
• Bruner JP, Rosemond RL. Twin-to-twin transfusion syndrome: A subset of the twin oligohydramnios/polyhydramnios sequence (TOPS). Am J Obstet Gynecol 169:925, 1993. (You can read more about the twin-twin transfer trouble.)
  
• Damato N, et. al: Frequency of fetal anomalies in sonographically detected polyhydramnios.) Ultrasound Med 1993; 12:11-15
• Kirshon B, et.al: Indomethacin therapy in the handling of symptomatic polyhydramnios. Obstet Gynecol 1990;75:202-v.
• Hashimoto B, et. al: Ultrasound evaluation of polyhydramnios and twin pregnancy. Am J Obstet Gynecol 1986; 154:1069-1072

Call Miller & Zois Nigh Polyhydramnios Birth Injuries

If you believe your doctors mishandled your polyhydramnios and it harmed your baby phone call the nascency injury lawyers at Miller & Zois for a free consultation. Our malpractice lawyer are based in Maryland but handle birth injury cases all over the country. Phone call us at 800-553-8082 or request a consultation online.

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