Polyhydramnios

Posted by e-Medical PPT
Polyhydramnios is a medical condition describing an excess of amniotic fluid in the amniotic sac. It is seen in 0.2 to 1.6% of pregnancies.
A single case of polyhydramnios may have one or more causes. About 14% of cases are due to maternal diabetes mellitus, which causes fetal hyperglycemia and resulting polyuria and also rh-isoimmunisation can cause it. About another 20% of cases are associated with fetal anomalies that impair the ability of the fetus to swallow . These anomalies include:
    * gastrointestinal abnormalities such as esophageal atresia, duodenal atresia, facial cleft, neck masses, and tracheoesophageal fistula
    * fetal renal disorders that results in increased urine production during pregnancy, such as in antenatal Bartter syndrome.
    * chromosomal abnormalities such as Down's syndrome and Edwards syndrome 
    * neurological abnormalities such as anencephaly, which impair the swallowing reflex
In a multiple gestation pregnancy, the cause of polyhydramnios usually is twin-twin transfusion syndrome.
During the pregnancy, certain clinical signs may suggest polyhydramnios. 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. When examining the fetus, faint fetal heart sounds are also an important clinical sign of this condition.
Fetuses with polyhydramnios are at risk for a number of other problems including cord prolapse, placental abruption, premature birth and perinatal death.


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