Polyhydraminos (Complete) Flashcards
(15 cards)
Define polyhdraminos
Amniotic fluid index >95th percentile
Give examples of underlying aetiological causes of polyhdraminos
Increased foetal urination:
- Maternal diabetes
- Foetal renal abnormalities
- Foetal anaemia
- Twin-twin transfusion
Reduced foetal swallowing:
- Oesophageal/duodenal atresia
- Diaphragmatic hernia
- Anencephaly
- Chromosomal disorders
N.B. Most cases are idiopathic
What is the most common cause of polyhydraminos?
Idiopathic
Give examples of causes of polyhdraminos due to excess foetal urination (4)
Maternal diabetes
Foetal renal abnormalities
Foetal anaemia
Twin-twin transfusion
Give examples of causes of polyhdraminos due to reduced foetal swallowing (4)
Oesophageal/duodenal atresia
Diaphragmatic hernia
Anencephaly
Chromosomal disorders
What are the main clinical features of polyhydraminos?
Uterus feels tense and large for dates
Difficulty feeling foetal parts
What foetal complications can occur secondary to polhydraminos?
Pre-term labour and delivery
PROM
Placental abruption
Malpresentation of the foetus
- Easier for baby to move around
Umbilical cord prolapse
N.B. Basically associated with complications in delivery
What maternal complications can occur secondary to polhydraminos?
Respiratory comprimise
- Due to compressing diaphragm
UTIs
- Due to compressing urinry system
GERD
Stretch marks
Peripheral oedema
Increased incidence of caesarean section delivery (e.g. due to malpresentation of foetus)
Increased risk of amniotic fluid embolism
N.B. Basically complications from compressing nearby structures
What investigations should be conducted in woman with suspected polyhdraminos?
Bedside:
Pregnant abdomen examination
- Enlarged FSH
- Check if foetal malpresentation
Basic obs: Check for signs of respiratory comprimise
Dipstick/urinalysis: If signs of UTI
Bloods:
Maternal glucose tolerence test: Check for diabetes
Imaging:
USS: Definitive diagnosis
What investigation provides a definitive diagnosis?
USS
- Raised amniotic fluid index (AFI)
- Raised maximum pool depth (MPD)
What findings are indicative of polyhdraminos?
FSH larger than expected
Increased amniotic fluid index on USS
Increased maximum pool depth (MPD)
What additional investigation may be consider if foetal structural anomalies detected on USS?
CVS or amniocentesis for karyotyping
How is polyhdraminos managed?
First-line: Treat underlying cause (e.g. strict glycaemic control)
Amniotic fluid reduction (in severe cases)
What management may be considered in severe cases?
Amniotic fluid reduction
Basically amniocentesis
What are complications associated with amniotic fluid reduction?
Miscarriage
Infection
Rhesus disease
Club foot
