Polyhydramnios is excessive amniotic fluid; it is associated with complications in the mother and fetus. Diagnosis is made by ultrasound measurement of amniotic fluid. Maternal disorders due to polyhydramnios are treated. If severe symptoms or painful early contractions occur, treatment may also include manual reduction in the amount of amniotic fluid

The amniotic fluid volume can not be reliably measured directly, except perhaps during caesarean section. Therefore, excess liquid is indirectly defined by ultrasonic criteria, usually mittesls of amniotic fluid index (AFI). AFI is the sum of the vertical depth of fluid is determined in each quadrant of the uterus. The normal AFI varies between 5 to 25 cm; Values> 25 cm show polyhydramnios.

Polyhydramnios is excessive amniotic fluid; it is associated with complications in the mother and fetus. Diagnosis is made by ultrasound measurement of amniotic fluid. Maternal disorders due to polyhydramnios are treated. If severe symptoms or painful early contractions occur, treatment may also include manual reduction in the amount of amniotic fluid. The amniotic fluid volume can not be reliably measured directly, except perhaps during caesarean section. Therefore, excess liquid is indirectly defined by ultrasonic criteria, usually mittesls of amniotic fluid index (AFI). AFI is the sum of the vertical depth of fluid is determined in each quadrant of the uterus. The normal AFI varies between 5 to 25 cm; Values> 25 cm show polyhydramnios. Among the causes of polyhydramnios include the following: malformations (. Eg GI or urinary tract, brain and spinal cord defects) multiple pregnancy Maternal diabetes Fetal anemia, einschlie├člihc hemolytic anemia due to Rh incompatibility Other fetal diseases (eg infections.) Or genetic abnormalities Idiopathic complications polyhydramnios is increasing the risk of the following complications: premature contractions and possibly preterm labor premature rupture of fetal deformity respiratory deterioration in the mother prolapsed cord uterine premature separation of placenta Fetal death (risk auc h increased when Polyhydramnios is idiopathic) risks are proportional to the degree of accumulation of fluid in the control and vary with the cause. Other problems (eg. As low Apgar score, fetal distress, nuchal need for caesarean section) may occur. Women with polyhydramnios may have a pregnancy-induced hypertension. Symptoms and complaints Polyhydramnios often asymptomatic. But some women, v. a. in severe polyhydramnios, difficulty breathing and / or painful premature contractions have. Sometimes the uterus is significantly larger than expected for the appointment diagnostic ultrasound measurement of the AFI Comprehensive ultrasound examination, including assessment of fetal malformations of the parent studies on causes that are at the anamnesis, suspected based. Polyhydramnios is usually based on ultrasound findings or uterine size that is larger than would be expected for the appointment suspected. Qualitative assessment of amniotic fluid volume, however, appear to be subjective in general. So when polyhydramnios is suspected, the amniotic fluid should be quantitatively assessed with the AFI. Clarification of the cause If a polyhydramniotic recommended further tests to determine the cause. What tests are carried out may depend on what causes are suspected clinically (usually on the basis of medical history). Tests may include comprehensive ultrasound examination for fetal malformations (always recommended) glucose tolerance test in the mother Kleihauer-Betke test Serological (at fetomaternal bleeding) tests in the mother (eg. As syphilis, parvovirus, cytomegalovirus, toxoplasmosis and rubella) amniocentesis and fetal karyotyping tests for clinical suspicion of hereditary diseases such as anemia therapy is possible manual extraction of amniotic fluid (Amnioreduktion) Since polyhydramnios increases the risk of fetal death, should begin prenatal monitoring in the 32 weeks of gestation and included Nonstress test at least 1 time / week. However, it has not been proven that such monitoring reduces the fetal mortality. Maternity approximately in the 39th SSW should be scheduled. The mode of delivery should be based on the usual obstetric indications are based (eg. As of previous part). Reducing the amount of amniotic fluid (. Eg by Amnioreduktion) or reduce their production should be considered only if preterm labor occurs or polyhydramnios caused severe symptoms; However, there is no indication that this approach improves the results. There is no consensus on how much fluid can be seen and this should be taken as quickly, although the removal of about 1 liter was for 20 minutes suggested. Disorders that are due to polyhydramnios (z. B. maternal diabetes) should be controlled. Important points Polyhydramnios can be caused by malformations, multiple pregnancy, maternal diabetes and various fetal disorders. It is associated with an increased risk of premature labor, premature rupture of membranes, respiratory deterioration of the mother, fetal deformity or death as well as a variety of problems during labor and birth. If polyhydramnios is suspected, determine the amniotic fluid index and test for possible causes (including a comprehensive sonographic examination). Drag a reduction in amniotic fluid volume only be considered if premature labor occur or Polyhydramnios causes severe symptoms. Begin prenatal monitoring with weekly Nonstress tests in 32 weeks.

Health Life Media Team

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