Polyhydramnios Obstetrics Gynecology > Polyhydramnios Key points Polyhydramnios (also known as hydramnios) is an excessive volume of amniotic fluid for a given gestational age during pregnancy Approximately 50% of pregnancies with polyhydramnios have no associated fetal anomalies or maternal complications If polyhydramnios is suspected clinically, on the basis of overlarge uterine size for dates, urgent sonographic assessment of the fetus and fluid measurements are necessary No immediate action is necessary except in the rare case of maternal respiratory distress due to extremely large amniotic fluid volume. Admit to specialist unit for amnioreduction Specialist assessment is advised in all suspected cases of polyhydramnios Serial sonographic assessment is the best way to quantify polyhydramnios and assess fetal normality Preterm labor is a major risk In monochorionic twin gestations, development of polyhydramnios in one fetus and oligohydramnios in the other might be a red flag for development of twin-to-twin transfusion syndrome (TTTS). If TTTS is suspected, referral to specialized centers should be made for appropriate treatment Background Description Polyhydramnios is an excessive volume of amniotic fluid for a given gestational age during pregnancy It is suggested clinically by a uterus that feels large for dates or measures more than 10% above the normal fundal height for gestational age Polyhydramnios is usually defined as an amniotic fluid index more than 24 cm or a single deepest pocket of fluid of at least 8 cm (measurement of the single deepest pocket is the method used in multiple gestations) Occurs in around 1% of pregnancies and is often suspected clinically and confirmed using ultrasonography Causes include underlying congenital fetal abnormalities, twin pregnancy, and maternal diabetes, but up to 50% of cases are idiopathic The perinatal mortality rate in idiopathic polyhydramnios is similar to normal pregnancies The main complications are premature rupture of membranes, preterm labor, placental abruption, malpresentation, and postpartum hemorrhage The severity of polyhydramnios correlates with the probability that a fetal malformation will be detected...
Posted on: Thu, 05 Sep 2013 14:23:41 +0000
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