Polyhydramnios

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Polyhydramnios
Classification and external resources
ICD-10 O40.
ICD-9 657
DiseasesDB 10319
MedlinePlus 003267
eMedicine radio/566
MeSH D006831

Polyhydramnios (polyhydramnion, hydramnios) is a medical condition describing an excess of amniotic fluid in the amniotic sac. It is seen in 0.5 to 5% of pregnancies.[citation needed] It is typically diagnosed when the amniotic fluid exceeds 2500 mL.[citation needed]

The opposite to polyhydramnios is oligohydramnios, a deficiency in amniotic fluid.

Contents

[edit] Causes

A single case of polyhydramnios may have one or more causes. About 20% of cases are due to maternal diabetes mellitus, which causes fetal hyperglycemia and resulting polyuria (fetal urine is a major source of amniotic fluid). About another 20% of cases are associated with fetal anomalies that impair the ability of the fetus to swallow (the fetus normally swallows the amniotic fluid). These anomalies include:

  • gastrointestinal abnormalities such as esophageal atresia, duodenal atresia, facial cleft, neck masses, and tracheoesophageal fistula
  • fetal renal disorders that results in increased urine production during pregnancy, such as in antenatal Bartter syndrome[1]. Molecular diagnosis is available for these conditions [2].
  • chromosomal abnormalities such as Down's syndrome and Edwards syndrome (which is itself often associated with GI abnormalities)
  • neurological abnormalities such as anencephaly, which impair the swallowing reflex

In a multiple gestation pregnancy, the cause of polyhydramnios usually is twin-twin transfusion syndrome.

It can also be caused by some systemic medical conditions in the mother, including cardiac or kidney problems.

Additionally, chorioangioma of the placenta can also cause this condition.

However, it should be reported that in 60-65% of cases it is unknown why polyhydramnios happens.

[edit] Associated conditions

Fetuses with polyhydramnios are at risk for a number of other problems including cord prolapse, placental abruption and perinatal death. At delivery the baby should be checked for congenital abnormalities. Another cause of polyhydramnios is skeletal dysplasia, or dwarfism, in the baby. There is a possibility of the chest cavity not being large enough to house all of the baby's organs causing the trachea and esophagus to be restricted, not allowing the baby to swallow the appropriate amount of amniotic fluid.

[edit] Treatment

[edit] See also

[edit] References

  1. ^ Seyberth HW. (2008). "An improved terminology and classification of Bartter-like syndromes.". Nat Clin Pract Nephrol. 4 (10): 560-7. PMID 18695706. 
  2. ^ http://www.moldiag.de/en/dis/bartter.htm
  3. ^ Piantelli G, Bedocchi L, Cavicchioni O, et al. (2004). "Amnioreduction for treatment of severe polyhydramnios". Acta bio-medica : Atenei Parmensis 75 Suppl 1: 56–8. PMID 15301292. 

[edit] External links