Polyhydramnios and baby has a large belly - 31 weeks - handhold, please

[Wireless77]

Hi all, I'm a first time mum aged 44 (5 previous losses) and currently just over 31 weeks. Despite multiple risk factors, my baby boy has been fine all along (numerous scans + SAFE test). At my 31 week growth scan it was noted that there is too much amniotic fluid, AFI total was 26 and largest pool 12 (3 pools were normal). He is also measuring big (about 3 weeks ahead with a big belly). My gestational diabetes test at 24 weeks was normal and I'm on Metformin due to being obese and having slight PCOS. I'm now supposed to monitor my blood sugars at home (so far they seem normal). I'm sick with worry. Just a big baby is fine, I'm having a C section for different reasons. But I read too much amniotic fluid may mean some rare genetic disorders or birth defects. Has anyone been in a similar situation and share their outcome, please? Thank you!

I had severe polyhydramnios, deepest pool was 16-18cm for weeks. Are they going to repeat your GTT? I had to have the test 3 times because my consultant was convinced that was causing the issue (fluid and big baby). I assume they can see stomach bubble (so know that baby is swallowing) and a detailed anatomy scan hasn’t revealed any other issues?
My T1 is nearly 14 months now and totally fine btw. I was monitored twice a week and every appt told they might need to drain 1.5L

Thank you so much @Twinmammaplusone. Yes, anomaly scan was perfect (had 2, on NHS and privately) and also scans at 24 and 28 weeks, all perfect. Bladder, kidneys and stomach all normal and they could see baby swallowing and said all looks good. They will test my blood sugars again, but I have a feeling these are fine. Were any genetic disorders mentioned to you at all? Baby is at 97th/98th percentile. He was between 66% and 74% for many weeks until now.

Yes. But, I should say that I have previously had a daughter with a severe genetic condition so there was an much increased risk for me. I think (but might be wrong) the genetic issue thing refers to conditions like TOF etc and this is why they check for stomach bubble/ swallowing.

I also had a fetal mri and 3 (!) fetal cardiac scans. Although the only issue was the polyhydramnios (no other issues on scans), my consultant told me it might not be good news and we wouldn’t know until the babies were born. I think this was mainly because of my history. I remember one fetal medicine midwife telling me that sometimes these things happen without explanation and the baby is totally fine.
If there are no issues on a detailed anatomy scan I would feel reasonably confident that baby is fine....I really hope it all works out ok for you.

Thank you @Twinmammaplusone!

GD is progressive and always gets worse around 31-32 weeks - diagnosis of polyhydramnios and a jump in centiles at this particular stage would suggest GD - possibly not picked up at 24 weeks because control was good with metformin. I really think GD is much much more likely than any type of condition baby might have, everything is pointing towards it really.

I've had polyhydramnios with 2 singletons and milder with one of our twins. They are perfectly healthy but were big babies, no problems during pregnancy or at birth, no GD. Our 2nd was 4 weeks ahead on growth from 28wk and was a chunky 10lb 12oz, I had a natural unassisted birth at 40+5. Others were a bit smaller than him, having 2 above average at the same time meant I was mahoosive with our twins.

Thank you so much, everyone! I was wondering if taking Metformin might mask GD...

I had additional fluid with both of my children, and both had large bellies also. My first was 8lb 6 and my second 9lb 7, both around a week early. The additional fluid wasn’t discovered until 37 ish weeks both times when I had growth scans. The first time I was induced a week early and my son, who is six now, is absolutely fine. The second time they made me monitor my sugar levels at home for a week, and they were completely fine. My little girl is 18 months and has also been healthy so far. She had a slight floppy larynx when born which caused some feeding issues, but she has grown out of this and I was told it would have been nothing to do with the extra fluid. Both of them had a tube put down their throat and x rays when they were born to make sure their oesophagus was connected to their stomach but nothing else was done. I read that the vast majority of additional fluid is related to GD, then there are genetic factors, but that around 50% of cases have no know cause. The fact I’ve had it twice and didn’t have GD either time makes me think that must just be how my body reacts when pregnant. Hopefully will be the same for you

Thank you @Poseyrose11!

I had poly and my daughter has a rare genetic issue causing disabilities, however our genetic consultant said more often than not it's just something that happens and isn't indicative of any issues

Thank you @zeromango! I'm sorry and I hope your girl is doing well! Can I ask how serious your poly was and if any markers of a potential genetic issue were picked up on scans before birth? Was your little girl measuring big too? All the best!

I also think if could be GD but your metformin is helping to keep your numbers down.

24 weeks is quite early for a glucose tolerance test and GD can get literally get worse overnight. My blood sugar was fine at 28 weeks but high at 29 weeks.

I had excess fluid but about under the Polyhydramnios diagnosis and mine was caused by GD.

I also had a friend who was diagnosed with Polyhydramnios with no reason found and her DS is absolutely fine.

I had a very similar situation at about the same gestation with my youngest. They were preparing for an off the scale baby. I was warned he may have certain disabilities. I didn’t have GD or anything like that. Baby was 7lb 2oz and had no disabilities.

They don’t always get it right.

I had polyhydramnios with my 3rd DC. I was never told all the measurements of the fluid etc. I was measuring 43 weeks at 34 weeks and that's when all the investigations began. I was given steroids for baby's lungs at 35 weeks.

Absolutely no cause was ever found, no GD and my DD was perfectly healthy.

I was put on hospital bed rest at 36 weeks, planned C-Section at 38 weeks. They ended up bringing it forward to 37 weeks as I was so huge, literally could not walk. They whisked baby away at birth to do a quick test (I think they check the throat or stomach, sorry I can't remember- all came back clear so no cause was ever found. Just 'one of those things.'

DD weighed 7lb 6oz at 37 weeks.

I had polyhydramnios with my dd. Was on finger prick tests for gd, but didn’t have it. Mine they believe is hereditary. Both my mother and grandmother flooded the room when waters were broken ( they couldn’t tell then if too much water)
Dd 20mths now absolutely fine, I’m expecting to have the same in this pregnancy too, I’m 42. Was told big baby, dd was 7lb at c section when I was 38 weeks.

Thank you so much everyone again! You really help me to worry a little less.