Polyhydramnios

Frequency and possible causes

Polyhydramnios occurs in about 1% of all pregnancies. Frequent incidence is observed in the presence of diabetes mellitus pregnant women ( gestational diabetes ).

In addition, it may lead to accumulation of amniotic fluid when the growing child does not drink or only very little of it.

In some cases with polyhydramnios to features found in the unborn child. Polyhydramnios is considered sonographic soft markers for:

  • Achondroplasia (short- membered dwarfism )
  • Beckwith- Wiedemann syndrome
  • Accompanying symptom in hydrops fetalis and prenatal infection
  • Chorangion ( benign vascular tumor of the placenta )
  • Down's Syndrome (Trisomy 21)
  • Duodenal stenosis (narrowing of the duodenum )
  • Tetralogy of Fallot ( heart defect consisting of four specific malformations)
  • Fetofetal transfusion syndrome ( polyhydramnios in the acceptor / the larger twin )
  • Fryns syndrome
  • Esophageal stenosis or atresia (narrowing or occlusion of the esophagus / polyhydramnios may develop due to an accompanying dysphagia )
  • Jejunalstenose (narrowing of the jejunum )
  • Congenital syphilis (infection of pregnant women with the spirochete Treponema pallidum / causative agent of syphilis leads to disease in the unborn child )
  • Congenital chickenpox / varicella ( varicella- zoster virus infection of pregnant women, the risk of infection of the unborn child is less than 5%)
  • Cleft lip and cleft palate ( polyhydramnios may develop due to an accompanying dysphagia )
  • Majewski syndrome (Short -Rib Polydactyly Syndrome Type II / polyhydramnios in the second trimester lockable)
  • Mediastinal shift ( shift of the mediastinum )
  • Meconium (bowel perforation )
  • Multiple pterygium syndrome
  • New Laxova syndrome
  • Patau syndrome ( trisomy 13)
  • Pena - Shokeir syndrome (pseudo - trisomy 18)
  • Peters - plus syndrome
  • Prader -Willi syndrome
  • Rh incompatibility ( hemolytic disease fetalis )
  • Fifth disease (infection of pregnant women with the Parvo B 19 virus / polyhydramnios in severe cases can be ascertained)
  • Dysphagia ( due to muscular or central dysregulation )
  • Steißbeinteratome ( teratoma / germ cell tumor in the Sakrokokzygealregion )
  • Thanatophoric dysplasia
  • Teratoma / germ cell tumors in the brain with cystic and solid areas ( polyhydramnios may develop due to an accompanying dysphagia )
  • Trisomy 14
  • Toxoplasmosis infection of pregnant women, which is transferred through the placenta ( transplacental ) on the unborn child and causes severe disease in about 10 % of cases
  • VACTERL
  • Enlargement of the thyroid gland in the unborn (fetal goiter, mostly for hypothyroidism / in 70% of children in whom the pregnant woman has Graves' disease )
  • Diaphragmatic hernia ( breakthrough of the diaphragm )
  • Cystic fibrosis ( CF )

A recent study distinguishes between moderate and severe polyhydramnios and showed that Apgar scores occurred less than 7, perinatal mortality and structural malformations only in women with severe polyhydramnios. In another study, all patients with polyhydramnios, which had a sonographically normal fetus showed no chromosomal abnormalities.

Treatment

Forms the polyhydramnios not reset itself, the possibility of amniotic fluid discharge puncture can be considered. The amniotic sac is punctured with a hollow needle and a catheter introduced the excess amniotic fluid is drained.

Amniotic fluid index Beckwith–Wiedemann syndrome Down syndrome Prader–Willi syndrome Parvovirus B19 VACTERL association
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