polyhydramnios (hydramnios)

Introduction

increased amount of amniotic fluid

Etiology

• risk factors
  • multiple gestation
  • maternal diabetes mellitus, especially poorly-controlled
  • 50% without risk factors
• absence of fetal swallowing (occurs physiologically, removes amniotic fluid)
• fetal GI obstruction (reduces clearance of amniotic fluid)

Epidemiology

• 1% of pregnancies

Laboratory

• serum glucose, urine glucose, hemoglobin A1c
• glucose tolerance test
• erythrocyte antibody screen
  • screening for maternal antibodies to D, C, Kell, Duffy, & Kidd antigens
• VDRL to screen for syphilis
• serum rubella virus Ab
  • serum rubella virus IgM
  • serum rubella virus IgG
• serum CMV Ab
  • serum CMV IgM
• Toxoplasma Ab in serum
  • serum Toxoplasma IgM
  • serum Toxoplasma IgG
• parvovirus B19 DNA in amniotic fluid
• Kleihauer-Betke test to evaluate fetal-maternal hemorrhage
• Hemoglobin Bart in patients of Asian descent
• fetal karyotyping for trisomy 21, trisomy 13, & trisomy 18

Diagnostic procedures

• ultrasound

Complications

• congenital anomalies (20%)
• preterm labor & delivery (26%)
• premature rupture of the membranes
• abruptio placenta
• malpresentation
• need for cesarean section
• postpartum hemorrhage

Management

• bedrest
• oral hydration
• OB-Gyn consult

More general terms

• pregnancy disorder; obstetric disorder; pregnancy complication
• sign/symptom

Additional terms

• amniotic fluid
• oligohydramnios