Polyhydramnios

Published on 30/05/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 30/05/2015

Print this page

rate 1 star rate 2 star rate 3 star rate 4 star rate 5 star
Your rating: none, Average: 2 (1 votes)

This article have been viewed 3119 times

Chapter 218 Polyhydramnios

INTRODUCTION

Description: Polyhydramnios is an abnormal increase in the amount of amniotic fluid surrounding the fetus. This diagnosis is generally reserved for volumes >2 L and amniotic fluid index >24 to 25 cm. (At term, there should be about 800 mL of amniotic fluid present.) This fluid may accumulate gradually over time (chronic hydramnios) or acutely over the course of several days (more common in early pregnancy).
Prevalence: In 0.9% to 1.6% of women, some increase in amniotic fluid is seen during pregnancy (80% mild, 5% severe).
Predominant Age: Reproductive.
Genetics: No genetic pattern.

ETIOLOGY AND PATHOGENESIS

Causes: Idiopathic (two thirds), maternal diabetes, multiple gestation, fetal anomalies (50% of patients with severe hydramnios: central nervous system, gastrointestinal tract, chromosomal).
Risk Factors: Fetal anomalies that impair swallowing or alter urine production, multiple gestation (twin–twin transfusion), maternal diabetes, erythroblastosis.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Uterine size larger than normal for stage of pregnancy
• Increased amniotic fluid measured by ultrasonography (amniotic fluid index [AFI] >24 to 25 cm)
• Dyspnea (especially when supine)
• Lower-extremity and vulvar edema
• Premature labor
• Difficulty palpating fetal parts or hearing fetal heart tones

DIAGNOSTIC APPROACH

Differential Diagnosis

• Inaccurate gestational age
• Normal multiple gestation
• Fetal anomalies
• Ascites
• Ovarian cyst

Associated Conditions: Anencephaly, esophageal atresia, prematurity, umbilical cord prolapse, and placental abruption.

Workup and Evaluation

Buy Membership for Obstetrics & Gynecology Category to continue reading. Learn more here

Related posts:

Cervical Incompetence Pessary Fitting Eating Disorders: Anorexia Nervosa and Bulimia Bartholin’s Gland: Abscess/Infection Pre-Eclampsia and Eclampsia (Toxemia of Pregnancy) Breast: Galactocele