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POLYHYDRAMNIOS

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Definition

  1. amniotic fluid volume > 2 L at any stage in pregnancy
  2. > 8 cm x 8 cm pocket on U/S
  3. 1/250 deliveries
  4. up to 2/3 of fetuses with severe polyhydramnios have chromosomal problems
Causes

Idiopathic : most common

Maternal : DM: causes abnormalities of transchorionic flow (IDDM)

Maternal-fetal

  1. chorioangiomas,
  2. multiple gestation,
  3. erythroblastosis

Fetal


  1. chromosomal anomaly
  2. respiratory - cystic adenomatoid malformed lung
  3. CNS (anencephaly, hydrocephalus, meningocele)
  4. GI (tracheoesophageal fistula, duodenal atresia)
  5. facial clefts, neck masses (interfere with swallowing)
    Complications

    1. cord prolapse
    2. placental abruption
    3. malpresentation
    4. preterm labour
    5. uterine dysfunction and postpartum hemorrhage
    6. increased perinatal mortality rate
    Clinical Features 

    1. pressure symptoms from overdistended uterus (dyspnea, edema, hydronephrosis) 
    2. uterus large for dates, difficulty palpating fetal parts and hearing fetal heart tones
      Management

      1. find cause (40% idiopathic)
      2. complete fetal U/S evaluation
      3. mild to moderate cases require no treatment
      4. screen for maternal disease/infection as indicated 
      5. if severely symptomatic, hospitalize and consider therapeutic amniocentesis
      6. admit if contracting or cervix dilating
      POLYHYDRAMNIOS POLYHYDRAMNIOS Reviewed by Radiology Madeeasy on December 25, 2010 Rating: 5
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