polyhydramnios (hydramnios)

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 Special laboratory: - 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

Related

amniotic fluid oligohydramnios

General

pregnancy disorder; obstetric disorder; pregnancy complication sign/symptom

References

- Boyd RL MedScape: Polyhydramnios and Oligohydramnios http://emedicine.medscape.com/article/975821-overview