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 Vol. 7 No. 6, June 2006
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NeoReviews Vol.7 No.6 2006 e300
© 2006 American Academy of Pediatrics

Polyhydramnios: Etiology, Diagnosis, and Treatment

John D. Yeast, MD*

* Professor and Vice Chairman, Department of Obstetrics and Gynecology, University of Missouri-Kansas City School of Medicine; Director of Medical Affairs, Saint Luke’s Hospital of Kansas City, Kansas City, Mo

The first 300 words of the full text of this article appear below.


   Objectives
 
After completing this article, readers should be able to:

  1. Understand the various causes of polyhydramnios.
  2. Describe the pathways of amniotic fluid production and removal.
  3. Appreciate the reason for preterm delivery following the diagnosis of polyhydramnios.
  4. Recognize the treatment methods for polyhydramnios.
  5. Explain the importance of sudden changes in fundal size during pregnancy.


   Introduction
 
Polyhydramnios, sometimes referred to as hydramnios, is a relatively uncommon complication affecting pregnancy that refers to the presence of an excessive amount of amniotic fluid relative to gestational age. Onset may be gradual or sudden, based on the cause. Gradual onset may be largely asymptomatic. In this situation, the diagnosis is suspected when fundal height exceeds that expected for gestational age. In contrast, sudden onset of polyhydramnios often is symptomatic, characterized by contractions and significant abdominal discomfort. Polyhydramnios has potential serious consequences, primarily related to the cause, but also due to the increased risk of adverse pregnancy outcome, such as preterm labor (PTL) or preterm premature rupture of the membranes (PPROM).


   Incidence and Frequency
 
The exact incidence of polyhydramnios is unknown because mild, asymptomatic cases may be discovered only at the time of delivery and are underreported. Several series have suggested that the incidence may range up to 1.6% in a low-risk population. Most cases are mild and often not associated with any significant sequelae. Approximately 35% of cases could be classified as moderate or severe, requiring further diagnostic or therapeutic measures.

Prior to the routine use of diagnostic ultrasonography, the incidence of polyhydramnios seemed much lower. Today, though, ultrasonography studies may reveal an abnormal increase in amniotic fluid volume earlier in pregnancy, resulting in more cases being reported. Intuitively, it seems that earlier diagnosis via ultrasonography could improve outcome, but that has not yet been proven conclusively.


   Diagnosis
 
The clinical suspicion of abnormally large fundal size remains critical to the diagnosis . . . [Full Text of this Article]






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Copyright © 2006 by the American Academy of Pediatrics.