An article on polyhydromnios

Polyhydromnios is a state where amniotic fluid is more than 2000 ml .

Polyhydrominos is a proper state where amniotic fluid causing discomfort to the patient. It is state where excessive accumulation of liquor amni may be seen.

Causes:

Anencephaly
Open Spina bifida
Oesophageal or duodenal atresia
Facial clefts and neck masses
Hydrops fetallis
Multiple pregnancy

Sign and symptoms of polyhydromnios :

Respiratory dyspnonea
Palpitations
Edema of legs
Varicosities in legs
Dyspenic state
Evidence of preeclampsia

Inspection :

Abdomen is markedly enlarged
The skin is tense, shiny with large straie palpitations .
Height of the uterus may be seen more than that of amenorrhea.
Girth of the abdomen ground the umbilicus is more than normal.
Fluid thrill can be elicited.
Fetal parts cannot be well defined.

Auscultation:

Fetal heart sound is not felt in the steps.

Management:

Minor degree hydramnios :

Commonly found in mid trimester and usually required no treatment except extrabed rest for some days .

Severe degree hydramnios:

Principles of treatment include to relieve the symptoms to find out the causes.

To avoid and deal with the complications.
Supportive therapy include bed rest.
Analgesics and sedative as required.

Indomethacin given orally to mother 25 mg every 6 hours.

Investigation are done to exclude congenital ,fetal malformations with the available methods.

Treatment: pregnancy less than 37 weeks is made to relieve the distress with a hope of continuation of pregnancy by amniocentesis.

Pregnancy more than 37 weeks induction of labour should be done.

Drainage of amniotic fluid may be done and this procedure is known as amniocentesis.

Check out the favourable lie and presentation of foetus.

Stabilising oxytocin infusion is started.

Low rupture of membrane

With congenital fetal abnormalities

Termination of pregnancy irrespective if the duration of pregnancy

During labour usual management may done.

We have to prevent post partum hemorrhage.