If the blood sugar levels of the pregnant woman are high, the fetus will also receive increased glucose from the mother, leading to elevated fetal urine output and resulting in polyhydramnios.
1. Gestational diabetes
Diabetes mellitus (diabetes) is a syndrome related to the disorder of glucose metabolism in the body, leading to increased blood sugar levels. The cause of diabetes is the pancreas not producing or producing insufficient insulin, or due to an increase in substances that resist insulin, leading to reduced biological effectiveness of insulin on target cells. Currently, diabetes is rapidly increasing, mainly due to a sedentary lifestyle and consumption of high-energy foods such as starch, sugar, and fat.
Gestational diabetes is the most common medical condition during pregnancy. It is often caused by hormonal changes in the mother's body during pregnancy, leading to increased insulin resistance, making it difficult for the pregnant woman's body to regulate blood sugar levels. In particular, pregnant women with a family history of diabetes have a significantly higher risk of developing this condition.
Gestational diabetes is typically detected around the 20th week of pregnancy. At this time, the processes and activities related to insulin production are influenced by reproductive hormones. This is why gestational diabetes screening is recommended as a routine check-up for pregnant women, regardless of their medical history. The condition usually manifests between the 24th and 28th weeks of pregnancy, although symptoms can appear a few weeks before or after this period. Symptoms of gestational diabetes: many pregnant women may not know they have diabetes until their urine and blood sugar levels are tested. In many cases, there are some symptoms, such as:
- Patients often feel thirsty, and despite drinking a lot of water, still feel thirsty.
- Patients frequently urinate, needing to urinate more often than other pregnant women.
- Genital area infected with yeast, and cannot be cleaned with regular antibacterial solutions.
- Wounds, scratches, or sores heal slowly.
- Patients experience weight loss and fatigue, leading to a lack of energy and exhaustion.
2. Origin of amniotic fluid
Amniotic fluid has three sources: the amniotic membrane, maternal blood, and the fetus.
- Amniotic fluid originates from the amniotic membrane: The amniotic membrane covering the placenta and umbilical cord also secretes amniotic fluid.
- Amniotic fluid originates from maternal blood: There is an exchange of substances between amniotic fluid and maternal blood through the amniotic membrane.
- Amniotic fluid originates from the fetus: In the early stages of pregnancy, the fetal skin is involved in the formation of amniotic fluid. When vernix appears between the 20th and 28th week of pregnancy, this pathway ceases. Starting from the 20th week, amniotic fluid originates from the tracheobronchial tree, as fetal plasma permeates through the respiratory mucosa. However, the most significant source of amniotic fluid is the urinary tract; the fetus excretes urine into the amniotic cavity from the 16th week of pregnancy.
The primary source of amniotic fluid is the urine excreted by the fetus into the amniotic sac. The fluid undergoes a continuous and closed regenerative cycle, entering and exiting the lungs and stomach of the fetus. Once the fluid is absorbed through the digestive tract, it is excreted by the kidneys, subsequently re-entering the amniotic sac, thus perpetuating the cycle. This mechanism ensures that the volume of amniotic fluid remains consistent, avoiding both excess and deficiency throughout the pregnancy. However, in cases where the volume of amniotic fluid becomes elevated and cannot self-regulate, it may result in polyhydramnios.
3. The relationship between gestational diabetes and polyhydramnios
One of the symptoms of gestational diabetes is frequent thirst and urination. Despite drinking a lot of water, the feeling of thirst persists. This is because when blood sugar levels are high, the body automatically draws water from the cells and pumps it into the blood to dilute the excess sugar. At this point, the water-deprived cells stimulate the thirst center, causing a persistent feeling of thirst. With the excess sugar in the body, the kidneys work harder to eliminate the surplus sugar, and with increased water intake, it leads to more frequent urination.
If a pregnant woman has gestational diabetes, her blood sugar levels will rise. Consequently, the fetus receiving nutrients from the mother will also experience elevated blood sugar levels. As a result, the fetus will exhibit symptoms of continuous thirst and frequent urination. One of the most important sources of amniotic fluid is the urinary tract; starting from the 16th week, the baby will begin excreting urine into the amniotic sac. When the mother has diabetes, her blood sugar levels are not well controlled. Therefore, the fetus may produce more urine than usual, increasing the volume of amniotic fluid and leading to polyhydramnios.
The cause of polyhydramnios has been identified in 10% of pregnant women with gestational diabetes, particularly in the third trimester of pregnancy. To detect the condition early and take measures to treat and prevent complications caused by gestational diabetes, pregnant women should attend regular check-ups. During each visit, they should undergo blood and urine tests. If they experience any of the above symptoms or notice any unusual signs, they should promptly visit healthcare facilities for early diagnosis.
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