Polyhydramnios

Question 1

What is it?

Answer 1

increased liquor volume

Question 2

What is aetiology of polyhydramnios?

Answer 2

Idiopathic
Maternal disorders - established and gestational DM, renal failure
Twins - particularly TTTS
Fetal anomaly - particularly upper GI obstructions or inability to swallow, chest abnormalities, myotonic dystrophy

Question 3

what are clinical features of polyhydramnios?

Answer 3

• Maternal discomfort
• Large for dates
• Taut uterus
• Fetal parts difficult to palpate

Question 4

What are complications?

Answer 4

• Preterm labour
• Maternal discomfort
• Abnormal lie
• Malpresentation

Question 5

What are investigations?

Answer 5

To diagnose fetal abnormality: US

Diagnose DM: maternal BM testing

Question 6

What is antenatal management if less than 34w and it is severe?

Answer 6

amnioreduction or use of NSAIDs to fetal UO, consider steroids

Question 7

what is recommended mode of delivery, what are contraindications for this?

Answer 7

vaginal unless persistent unstable lie or other obstetric indication