Polyhydramnios And Oligohydramnios




Polyhydramnios



Polyhydramnios
Polyhydramnios

Polyhydramnios

Definition:


Is an excessive amount of amniotic fluid more than 2000 ml.

The exact cause is unknown, it is associated with:


- Maternal disease as DM, Renal disease.

- Multiple pregnancies.

- Fetal abnormalities that affect the swallowing mechanism.

- The condition leads to preterm delivery, malpresentation, and cord prolapse and abruptio placenta, thus increasing maternal mortality.

Clinical manifestations:

- Excessive uterine enlargement, fundal height increases out of proportion to gestational age.

- Difficulty in breathing.

- Difficulty finding a comfortable sleeping position.

- Difficult to hear FHR and palpate fetus.

- Pain in the abdomen, back and thighs due to increasing pressure.

- Difficult ambulating.

- Varicosities.

- Nausea and vomiting.

Management:

- Hospitalization, if the mother is dyspneic or in pain.

- Transabdominal or vaginal amniocentesis with aid of sonography and careful monitoring of vital signs. remove the fluid slowly to avoid abruptio placenta.

- Offer support by explaining procedures.

- Encourage the women to rest on the side in a semi-recumbent position to increase blood flow to uterus and fetus and to relieve symptoms.

- Watch carefully for signs of the abruption placenta, abnormal presentation and post-partum haemorrhage.



Oligohydramnios 



Oligohydramnios
Oligohydramnios

Oligohydramnios

Definition:

Is a small amount of amniotic fluid less than 400 ml.

It is associated with:

a- Fetal renal agenesis.

b- Post maturity.

Clinical manifestations:

- Small uterine size.

- Labour may be premature.

- Uterine contraction may be ineffectual and labour prolonged.

- Fetal hypoxia may occur because of cord compression.

Management:

- Monitor fetal status carefully during pregnancy and labour.

- Monitor the woman for labour complications.



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