8A) Antenatal Care: Polyhydramnios Flashcards
Incidence of polyhydramnios
1%
Classification of polyhydramnios
Mild: AFI 25-30cm
Moderate: AFI 30-35cm
Severe: AFI >35cm
DVP which is classed as polyhydramnios?
> 8cm
What proportion of polhydramnios cases are unexplained?
50-60%
When does amniotic fluid volume reach its peak?
33-38 weeks
Mean volume of amniotic fluid
600-800mL
What is the increase in perinatal morbidity and mortality with polyhydramnios?
2-5 x increased
How to investigate polyhydramnios?
USS for fetal weight, anomalies, movement and stomach/bladder.
Maternal investigations - GTT, TORCH, Red cell antibodies.
If remains unexplained & severe - refer to FMU and consider amniodrainage.
If remains unexplained & moderate/severe - serial growth scans, TVS for cervical length and no need for early IOL.
Risk of complications with amnioreduction
1.5%
Risk of major congenital anomaly with polyhydramnios
1% mild, 2% moderate, 11% severe (even with normal USS)
Risk of chromosomal abnormalities with polydramnios
If USS shows abnormalities - 10%.
If USS normal - 1%.
Risk of aneuploidy if persistent polyhydramnios
10-20%.