Polyhydramnios – What You Need to Know

Polyhydramnios What You Need to Know?

Polyhydramnios is the condition of having too much amniotic fluid around the fetus in the womb.

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Polyhydramnios is a condition that occurs when excess amniotic fluid accumulates in the uterus during pregnancy. Amniotic fluid is the fluid that surrounds the fetus in the uterus. Generally, the amount of amniotic fluid is spotted during a check-up in the later stages of pregnancy. In most cases, polyhydramnios is mild and does not cause symptoms, but it has the potential to become severe and cause serious pregnancy-related complications. Severe polyhydramnios may cause shortness of breath, pre-term labor, or other signs and other symptoms. In a woman diagnosed with this condition, gynecologists regularly monitor the fluid levels to until she is ready to give birth. Treatment modalities depend on the severity of the condition. Billing and coding for polyhydramnios can be challenging as there are several codes related to this condition.

Experienced obstetrics and gynecology medical billing outsourcing companies can ensure accurate clinical documentation of this disorder.

Here are the answers to commonly asked questions about polyhydramnios – What is Polyhydramnios?

Also called hydramniosis, polyhydramnios is a condition where in the fluid in amniotic sac (surrounding the fetus) becomes more than 2000ml. The maximum normal amount of amniotic fluid is 800ml, which is checked at 34 weeks of pregnancy. This amount further decreases as pregnancy progresses and is around 600 ml at 40 weeks. The excess fluid causes discomfort for the pregnant mother. The condition will also make it difficult for the gynecologist to estimate the position of baby by physical examination and will require an imaging test like sonography.

Is polyhydramnios common?

Women who have given birth multiple times have higher risks of condition than women who are going to have their first child. The condition may be acute, occurring over a few days, or chronic, occurring over a few weeks. Reports suggest that 1 out of 100 (1 percent) pregnant women have too much amniotic fluid. It usually happens when fluid builds up slowly during the second half of pregnancy. In other cases, fluid may build up quickly as early as 16 weeks of pregnancy and cause very early birth.

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What are the common causes?

In most cases, the exact cause of polyhydramnios is unknown. Mild cases are caused by the gradual buildup of amniotic fluid over the course of pregnancy. Other related causes include – maternal diabetes, birth defects, fetal anemia, blood incompatibilities between mother and baby, infection during pregnancy, multiple pregnancies (two or more fetuses in the womb) and congenital malformations.

What are the common symptoms?

Women with polyhydramnios may have no specific signs and symptoms. A uterus larger than expected for the fetus age could indicate that there is too much amniotic fluid. Women can notice a visible growth in the belly very quickly and there will be trouble feeling the baby due to this condition. Symptoms generally appear when extra pressure is being exerted within the uterus and on nearby organs. Common signs and symptoms of this condition include 

Shortness of breath or the inability to breathe

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Uterine discomfort or contractions

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Swelling in the lower extremities and abdominal wall

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Heartburn

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Fetal mal-position

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Feeling huge or tightness in the belly

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Constipation

What are the potential complications of polyhydramnios?

Research suggests that polyhydramnios can lead to an increased risk of certain complications for both the woman and baby. If left untreated, the condition can lead to certain complications such as premature birth, premature rupture of membranes (when water breaks early), umbilical cord prolapsed, abnormal fetal position, placental abruption (when the placenta peels away from the inner wall of the uterus before delivery), stillbirth, increased blood pressure during pregnancy, heavy bleeding (due to lack of uterine muscle tone after delivery) and C-section delivery. The earlier polyhydramnios occurs in pregnancy, the greater will be the amount of excess amniotic fluid and higher will be the risk of complications.

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How is Polyhydramnios diagnosed and treated?

Diagnosis of this condition begins before a baby is born. If a gynecologist or obstetrician suspects that a woman suffers from polyhydramnios, a fetal ultrasound (that shows images of the baby on a monitor) will be recommended. If the initial ultrasound confirms the evidence of polyhydramnios, the physician may perform a more detailed ultrasound to measure the amniotic fluid volume (AFV) by calculating the single largest, deepest pocket of fluid around the baby.

An AFV value of 8 centimeters or more suggests polyhydramnios. Additional tests that may be recommended include a glucose challenge test (for gestational diabetes), amniocentesis (sampling of amniotic fluid to test the baby for genetic abnormalities), non-stress test (to check for abnormalities in the baby’s heart rate) and blood tests (to check for infections).

Treatment for polyhydramnios would depend on the underlying causes and the severity of the condition. Generally, mild cases of this condition that develop around the middle stage of pregnancy usually resolve on their own without any treatment. Complete bed rest may be advised for such patients for a few days. On the other hand, women who experience severe symptoms like shortness of breath, abdominal pain or pre-term labor pain may require specific treatment in the hospital. Treatment modalities include - amniocentesis (drainage of excess amniotic fluid from the uterus) and medications. If the pregnancy is more than 37 weeks, amniocentesis is followed by delivery of the fetus. Oral medications like indomethacin (Indocin) may help reduce fetal urine production and amniotic fluid volume. After completion of the treatment, gynecologists will recommend monitoring amniotic fluid level approximately every one to three weeks.

Is it possible for a woman with polyhydramnios to have a healthy pregnancy and baby?

Most women with polyhydramnios do not experience any significant problems during their pregnancy period and will have a healthy baby. However, there is a slight chance of risk or complications like pregnancy and birth complications, problems with baby position, or a problem with the position of the umbilical cord (prolapsed umbilical cord) and a problem with the baby.

Physicians will conduct undergo extra checkups to identify these problems and usually advise women to give birth in a hospital setting.

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How can polyhydramnios be prevented?

The following measures can help manage or prevent polyhydramnios: early detection and control of maternal diabetes, genetic counseling to reduce the chances of fetal malformations, and administering Anti-D immunoglobulin to an Rh negative mother - within 72 hours of birth of an Rh-positive fetus to prevent hydrops fetalis in subsequent pregnancies.

ICD-10 Codes for Polyhydramnios Gynecologists or obstetricians who diagnose and treat polyhydramnios need to use the right medical codes to report the condition. The following ICD-10 codes are used to report diagnosis of polyhydramnios for reimbursement purposes – 

O40 Polyhydramnios

 O40.1 Polyhydramnios, first trimester 

O40.1XX0 Polyhydramnios, first trimester, not applicable or unspecified

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O40.1XX1 Polyhydramnios, first trimester, fetus 1

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O40.1XX2 Polyhydramnios, first trimester, fetus 2

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O40.1XX3 Polyhydramnios, first trimester, fetus 3

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O40.1XX4 Polyhydramnios, first trimester, fetus 4

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O40.1XX5 Polyhydramnios, first trimester, fetus 5

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O40.1XX9 Polyhydramnios, first trimester, other fetus

 O40.2 Polyhydramnios, second trimester 

O40.2XX0 Polyhydramnios, second trimester, not applicable or unspecified

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O40.2XX1 Polyhydramnios, second trimester, fetus 1

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O40.2XX2 Polyhydramnios, second trimester, fetus 2

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O40.2XX3 Polyhydramnios, second trimester, fetus 3

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O40.2XX4 Polyhydramnios, second trimester, fetus 4

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O40.2XX5 Polyhydramnios, second trimester, fetus 5

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O40.2XX9 Polyhydramnios, second trimester, other fetus

 O40.3 Polyhydramnios, third trimester 

O40.3XX0 Polyhydramnios, third trimester, not applicable or unspecified

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O40.3XX1 Polyhydramnios, third trimester, fetus 1

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O40.3XX2 Polyhydramnios, third trimester, fetus 2

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O40.3XX3 Polyhydramnios, third trimester, fetus 3

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O40.3XX4 Polyhydramnios, third trimester, fetus 4

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O40.3XX5 Polyhydramnios, third trimester, fetus 5

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O40.3XX9 Polyhydramnios, third trimester, other fetus

 O40.9 Polyhydramnios, unspecified trimester 

O40.9XX0 Polyhydramnios, unspecified trimester, not applicable or unspecified

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O40.9XX1 Polyhydramnios, unspecified trimester, fetus 1

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O40.9XX2 Polyhydramnios, unspecified trimester, fetus 2

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O40.9XX3 Polyhydramnios, unspecified trimester, fetus 3

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O40.9XX4 Polyhydramnios, unspecified trimester, fetus 4

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O40.9XX5 Polyhydramnios, unspecified trimester, fetus 5

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O40.9XX9 Polyhydramnios, unspecified trimester, other fetus

Outsourced obstetrics medical billing services are offered by experienced medical billing and coding companies to ensure timely and accurate claims filing and reimbursement.

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