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

This article may require cleanup to meet Wikipedia's quality standards. Please improve this article if you can. (May 2009)

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 1 Causes 2 Associated conditions 3 Treatment 4 See also 5 References 6 External links

[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.

This article may require cleanup to meet Wikipedia's quality standards. Please improve this article if you can. (May 2009)

[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

• In some cases, amnioreduction, also known as therapeutic Amniocentesis, has been used in response to polyhydramnios.^[3]
  
• Dietary salt restriction is recommended.^{[citation needed]}

[edit] See also

• Amniotic fluid index

[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

• 00329 at CHORUS

v • d • e Pathology of pregnancy, childbirth and the puerperium (O, 630-676) Complications of pregnancy Pregnancy with abortive outcome Ectopic pregnancy · Hydatidiform mole · Miscarriage Oedema, proteinuria and hypertensive disorders Gestational hypertension (Pre-eclampsia, Eclampsia, HELLP syndrome) · Gestational diabetes Other, predominantly related to pregnancy digestive system: Hyperemesis gravidarum · Intrahepatic cholestasis of pregnancy · Acute fatty liver of pregnancy integumentary system: Dermatoses of pregnancy (list) nervous system: Chorea gravidarum Maternal care related to the fetus and amniotic cavity amniotic fluid (Polyhydramnios, Oligohydramnios) · chorion/amnion (Chorioamnionitis, Chorionic hematoma, Premature rupture of membranes, Amniotic band syndrome, Monoamniotic twins) · placenta (Placenta praevia, Placental abruption, Monochorionic twins, Twin-to-twin transfusion syndrome) · Braxton Hicks contractions · Antepartum haemorrhage Obstetric labor complications Preterm birth · Postmature birth · Cephalopelvic disproportion · Dystocia (Shoulder dystocia) · Fetal distress · Vasa praevia · Uterine rupture · hemorrhage · placenta (Placenta accreta) · Umbilical cord prolapse · Amniotic fluid embolism Puerperal disorders Puerperal fever · Peripartum cardiomyopathy · Postpartum thyroiditis · Galactorrhea · Postpartum depression · Diastasis symphysis pubis Other Maternal death obstetric navs: conditions, eponymous signs, proc