Definition amniotic fluid volume > 2 L at any stage in pregnancy > 8 cm x 8 cm pocket on U/S 1/250 deliveries up to 2/3 of...
Definition
- amniotic fluid volume > 2 L at any stage in pregnancy
- > 8 cm x 8 cm pocket on U/S
- 1/250 deliveries
- up to 2/3 of fetuses with severe polyhydramnios have chromosomal problems
- idiopathic
- most common
- maternal
- DM: causes abnormalities of transchorionic flow (IDDM)
- maternal-fetal
- chorioangiomas, multiple gestation, erythroblastosis
- fetal
- chromosomal anomaly
- respiratory - cystic adenomatoid malformed lung
- CNS (anencephaly, hydrocephalus, meningocele)
- GI (tracheoesophageal fistula, duodenal atresia)
- facial clefts, neck masses (interfere with swallowing)
- cord prolapse
- placental abruption
- malpresentation
- preterm labour
- uterine dysfunction and postpartum hemorrhage
- increased perinatal mortality rate
- pressure symptoms from overdistended uterus (dyspnea, edema, hydronephrosis)
- uterus large for dates, difficulty palpating fetal parts and hearing fetal heart tones
- find cause (40% idiopathic)
- complete fetal U/S evaluation
- mild to moderate cases require no treatment
- screen for maternal disease/infection as indicated
- if severely symptomatic, hospitalize and consider therapeutic amniocentesis
- admit if contracting or cervix dilating
