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Polyhydramnios


Presentation

  • Although most cases have normal amniotic fluid volume, some cases present with early oligohydramnios and renal failure associated with high perinatal mortality.[ncbi.nlm.nih.gov]
Dyspnea
  • The objective was that of evaluating the efficacy of amnioreduction in improving the principal complications given by polyhydramnios such as maternal dyspnea and uterine activity.[ncbi.nlm.nih.gov]
  • In the mother, the physician may observe increased abdominal size out of proportion for her weight gain and gestation age, uterine size that outpaces gestational age, shiny skin with stria (seen mostly in severe polyhydramnios), dyspnea, and chest heaviness[en.wikipedia.org]
  • […] moderate: single deepest pocket at 12-15 cm or AFI 30.1-35 severe: single deepest pocket 16 cm or AFI 35 The risk of the following obstetric complications is increased when polyhydramnios is present due to over-expansion of the uterus 13 : maternal dyspnea[radiopaedia.org]
  • Respiratory — The patient may suffer from dyspnea or even remain in the sitting position for easier breathing.[slideshare.net]

Workup

  • Although rare, metabolic causes for polyhydramnios should be considered when no obvious cause is found in workup of the pregnant woman and when structural survey of the fetus is normal.[ncbi.nlm.nih.gov]
Mediastinal Shift
  • The procedure not only decompressed the lung cyst but also improved the secondary physiological changes, i.e. mediastinal shift, hydrops and polyhydramnios.[ncbi.nlm.nih.gov]

Treatment

  • Even after the discontinuation of NSAID treatment, the amniotic fluid production normalized, and the woman delivered a healthy boy at 39 weeks 2 days' gestation.[ncbi.nlm.nih.gov]
  • […] for polyhydramnios Usually, mild polyhydramnios may need no treatment as it will go away on its own.[hellodoktor.com]
  • Treatments for more severe forms of polyhydramnios sometimes focus on addressing the underlying cause(s). Additional treatments/interventions include: Amnioreduction : This involves using a long needle to drain excess amniotic fluid from the uterus.[abclawcenters.com]

Prognosis

  • If polyhydramnios is not associated with any other findings, the prognosis is usually good.[emedicine.medscape.com]
  • This poor prognosis may be attributed to the combined effects of tissue compression from the thoracic space occupying lesion and premature delivery of a hydropic baby following rupture of the membranes in the presence of polyhydramnios.[ncbi.nlm.nih.gov]

Etiology

  • Etiology- Fetal Anencephaly Esophageal atresia Spina Bifida Cleft lip & Palate Hydrocephalus Aneuploidy 6. Etiology- Placental Normal Placenta Chorioangioma 7. Etiology- Multiple pregnancy 8. Etiology- Maternal Maternal diabetes 9.[slideshare.net]
  • The etiology of polyhydramnios may be idiopathic, the consequence of fetal structural anomalies, or the consequence of various fetal and maternal conditions.[ncbi.nlm.nih.gov]

Epidemiology

  • Fetal goiter is only rarely observed in pregnant women without autoimmune thyroid disorders, and there is no epidemiological data on its pathophysiology.[ncbi.nlm.nih.gov]
  • Also Read: What is Fanconi Anemia: Causes, Symptoms, Treatment, Prognosis, Life Expectancy, Diagnosis Amniocentesis: Procedure, Indications, Benefits, Risks, Accuracy Anencephaly or Anencephalic Baby: Causes, Symptoms, Survival Rate, Treatment, Epidemiology[epainassist.com]
  • Maternal metabolic abnormalities such as hypercalcaemia. [ 2 ] Epidemiology [ 3 ] There are few recent studies but polyhydramnios is said to affect 0.2-1.6% of all pregnancies.[patient.info]
  • Section 1: Epidemiology and aetiology In pregnancy, the amniotic sac contains the fetus surrounded by amniotic fluid. Initially amniotic fluid is maternal body water partitioned in the fetoplacental extracellular space.[gponline.com]
Sex distribution
Age distribution

Pathophysiology

  • The following pathophysiological mechanism for explaining polyhydramnios in recipient twins is proposed: chronic overload in recipient twins causes enhanced release of ANF from the fetal heart.[ncbi.nlm.nih.gov]
  • Polyhydramnios is over the 95th centile, oligohydramnios is below the 5th centile Pathophysiology The volume of amniotic fluid increases steadily until 33 weeks of gestation.[teachmeobgyn.com]

Prevention

  • Antenatal fetal cyst decompression successfully reversed the polyhydramnios and prevented premature delivery, resulting in a full-term healthy infant delivered vaginally at thirty-nine weeks.[ncbi.nlm.nih.gov]
  • You may not be able to prevent polyhydramnios. The following may lower the risk: Do not smoke. Nicotine increases the risk for problems with your pregnancy and your baby's health.[drugs.com]

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