POLYHYDRAMNIOS

We should know

the cause，clinical manifestation，effects

on mother and fetus，and management of

Polyhydramnios.
 In pregnancy, amniotic fluid more than

2000ml is called polyhydramnios.

 acute

 chronic
Incidence:1% of all pregnancies
AFI(amniotic fluid index)>24-25cm
Mild: 80%，pockets measuring 8-11 cm
in vertical dimension
Moderate: 15%，12-15 cm
Severe: 5%，≥16 cm
 Cause
A fetus cannot swallow a normal amount
of amniotic fluid.
1 . F e t a l m a l f o r m a t i o n and chromosome
abnormality:
in almost half of moderate or severe
central nervous system, gastrointestinal
tract
2.Multiple pregnancy:
 Cause
A fetus cannot swallow a normal amount
of amniotic fluid.
3.complications of pregnancy
 gestational diabetes mellitus
 maternal-fetal blood group incompatibility
4.the placental umbilical cord lesion
 large placenta
 cord velamentous insertion
 Clinical manifestation
acute hydramnios
20-24weeks
abdominal pain dyspnea
varicosity
edema
oliguria
 Clinical manifestation
chronic hydramnios
late pregnancy
uterine is bigger than normal
pregnancy
tolerate, little discomfort
 The influence in mother or fetal
In mother
increased uterine tension
the risk of hypertension increasing
postpartum hemorrhage
premature rupture of membranes
preterm delivery
placental abruption
shock
 The influence in mother or fetal
In fetal
abnormal fetal position
prolapse of the umbilical cord
fetal distress
increase perinatal mortality
Diagnosis:

Uterine enlargement
Ultrasonic evaluation
 Auxiliary examination:
Ultrasound AFI >25cm

MVP or AFV >8cm

Fetal malformation chromosome karyotyping

Others except GDM and

maternal fetal blood group incompatibility

 Management
Hydramnios with fetal malformation
terminate pregnancy
artificial rupture of membrane induced labor
high rupture
sandbag press abdomen
monitor BP and HR

transabdominal amniotic cavity puncture

take out amniotic fluid and put in Ethacridine

 Management
Hydramnios with normal fetus
expectation treatment drink less
lateral position
amniocentesis ultrasound monitor
500ml/h <1500ml once
monitoring BP, HR
preventing infection
amniocentesis
indomethacin therapy：1.5-3mg/Kg/d,
impairs lung liquid production or
enhances absorption, decreases fetal
urine production, and increases fluid
movement across fetal membranes.
 potential for closure of the fetal ductus
arterious