What are the key symptoms of oligohydramnios (low amniotic fluid) or polyhydramnios (excess amniotic fluid)?

From the Guidelines

Oligohydramnios and polyhydramnios are identified by key symptoms including abnormal uterine size, fetal movement, and fetal heart rate patterns, with oligohydramnios typically presenting with a small uterus, reduced fetal movement, and abnormal fetal heart rate patterns, while polyhydramnios presents with rapid uterine enlargement, maternal discomfort, and shortness of breath. The symptoms of oligohydramnios (low amniotic fluid) include a uterus that appears small for gestational age, difficulty palpating fetal parts due to compression, reduced fetal movement reported by the mother, and abnormal fetal heart rate patterns 1. Women may experience leakage of fluid if there's premature rupture of membranes. On the other hand, polyhydramnios (excessive amniotic fluid) presents with symptoms including rapid uterine enlargement, uterus measuring large for gestational age, maternal discomfort and shortness of breath due to pressure on the diaphragm, difficulty palpating fetal parts due to excessive fluid, edema in the lower extremities, and potentially preterm labor 1.

Key Symptoms

• Oligohydramnios:
  • Small uterus for gestational age
  • Reduced fetal movement
  • Abnormal fetal heart rate patterns
  • Potential leakage of fluid
• Polyhydramnios:
  • Rapid uterine enlargement
  • Uterus measuring large for gestational age
  • Maternal discomfort and shortness of breath
  • Difficulty palpating fetal parts
  • Edema in the lower extremities
  • Potential preterm labor

These conditions are diagnosed through ultrasound measurement of amniotic fluid index or maximum vertical pocket, with management depending on the underlying cause and severity of the condition 1. Both conditions warrant close monitoring as they can indicate underlying fetal anomalies or maternal conditions that may require intervention.

From the Research

Key Symptoms of Oligohydramnios and Polyhydramnios

• Oligohydramnios (low amniotic fluid) symptoms include:
  • Fetal anomalies
  • Premature rupture of membranes (PROM)
  • Uteroplacental insufficiency (e.g., growth retardation, postdatism, abruptio placenta)
  • Abnormalities of twinning
  • Idiopathic oligohydramnios 2
• Polyhydramnios (excess amniotic fluid) symptoms include:
  • Maternal dyspnea
  • Preterm labor
  • Premature rupture of membranes (PPROM)
  • Abnormal fetal presentation
  • Cord prolapse
  • Postpartum hemorrhage
  • Fetal macrosomia (often associated with gestational diabetes) 3, 4

Associated Conditions and Complications

• Oligohydramnios is associated with:
  • Fetal growth restriction
  • Preeclampsia
  • Adverse pregnancy outcomes (e.g., preterm delivery, low birth weight, neonatal death) 5
• Polyhydramnios is associated with:
  • Gestational diabetes
  • Fetal anomalies
  • Congenital infections
  • Alloimmunization
  • Increased perinatal morbidity and mortality 3, 4