Polyhydramnios Flashcards
Define
Polyhydramnios – AFI >95th centile, 2-3L fluid, deepest pool >8cm | affects 1-4% pregnancies
Risk factors for polyhydramnios (may be idiopathic):
Basics anything which incr foetal urine production or decreases foetal swallowing
Maternal
- Diabetes mellitus
- AV fitsula
- Chorioangioma
Foetal
- Multiple pregnancy -> usually TTTS causes this
- Idiopathic
- Oesophageal/duodenal atresia -> baby unable to swallow Amniotic fluid
- Neuromusc disorders/ Anencephaly -> baby unable to swallow fluid
Symptoms
Symptoms of underlying cause
Abdomen – increased fundal height, impalpable foetal parts, tense abdo
Investigations
Liquor volume, foetal growth, umbilical artery dopplers, exclude foetal anomalies
Other – exclude maternal diabetes
Management
Antenatal monitoring of foetus, ensure diabetes control, paediatrician present at delivery
Amnioreduction (if gross polyhydramnios à discomfort)
COX inhibitors to decrease foetal urine output
Complication
Pre-term labour (PTL), malpresentation, placental abruption, cord prolapse, PPH, increased risk CS
o Prognosis – increased perinatal morbidity and mortality, related to PTL/congenital