What is Polyhydramnios?

Ekai kaoo By Ekai kaoo, 4th Aug 2013 | Follow this author | RSS Feed | Short URL http://nut.bz/_i6mhkee/
Posted in Wikinut>Health>General Health>Pregnancy


This is a condition in which the quantity of amniotic fluid exceeds 1500mls. It may not become apparent until it reaches 3000mls. It is a fairly rare condition.

Types,management and complications of Polyhydramnios.


Polyhydramnios is associated with the following conditions:
• Oesophageal atresia
• Open neural tube defect
• Multiple pregnancy, especially in monozygotic twins
• Maternal diabetes mellitus
• Rarely in rhesus isoimmunisation
• Severe foetal abnormalities
There are two types of Polyhydramnios: chronic and acute.

Chronic Polyhydramnios
This occurs gradually, usually from about the 30th week
of pregnancy.
It is the most common type.

Acute Polyhydramnios
This is a rare type, which occurs at about 20 weeks and comes on very suddenly. The uterus reaches the xiphisternum in about three to four days. It is associated with monozygotic twins or severe foetal abnormality.
Polyhydramnios can be recognized in the following ways:
• The mother may complain of breathlessness
and discomfort.
• If the condition is acute in onset, she may complain of severe abdominal pain.
• The condition may aggravate other symptoms associated with pregnancy such as indigestion, heartburn, constipation, edema, varicose veins of the vulva and lower limbs.
• On abdominal inspection, the uterus is larger than expected for the period of gestation and is globular in shape. The abdominal skin appears stretched and tight with marked striae gravidurum and marked superficial blood vessels.
• On palpation, the uterus is tense and it is difficult to feel foetal parts.
• The abdominal girth is much more than expected for the period of gestation.
• Auscultation of the foetal heart is difficult because of the free movement of the foetus.
• Where possible an ultrasonic scan should be done to confirm the diagnosis. It may also reveal multiple pregnancy or foetal abnormality if these are present

Management of Polyhydramnios
The mother is admitted to hospital and, where possible, the cause of the condition is determined. The subsequent care will be determined by the condition of the mother, the cause and the period of gestation.
If there is foetal abnormality, the method and timing of delivery will depend on the severity. If there is gross abnormality, induction should be started. The nursing care should include rest in bed in sitting position to relieve dyspnoea. Assist the patient with personal hygiene and routine prenatal observations.
If abdominal discomfort is severe, abdominal amniocentesis may be considered. If it is done, infection prevention measures must be observed and only 500ml should be withdrawn at a time. Labour may be induced in the case of late pregnancy. Before the membranes are ruptured, the lie must be determined and the membranes ruptured cautiously allowing the fluid to flow slowly. This is to avoid cord prolapse, alteration of the lie and abruptio placenta which may occur after sudden reduction of uterine size.

Complications of Polyhydramnios
There are several complications associated with Polyhydramnios. These include:
• Increased foetal mobility leading to unstable lie
and malpresentation
• Cord presentation and cord prolapse
• Premature rupture of the membranes
• Placenta abruptio when the membranes rupture
• Premature labour
• Postpartum hemorrhage

Tags

Acute, Chronic, Conditions, Foetal Abnormality, Polyhydramnios

Meet the author

author avatar Ekai kaoo
Am a fourth year student undertaking Bachelor of science in Nursing.I like writing articles of medical field.

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