Amniotic Fluid Disorders: Polyhydramnios

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Amniotic Fluid Disorders : Polyhydramnios -
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Amniotic fluid disorders are conditions characterized by abnormal amounts of amniotic fluid surrounding the fetus during pregnancy, which can be either too much (polyhydramnios) or too little (oligohydramnios). The etiology of these disorders varies based on the type.

Polyhydramnios is commonly associated with fetal anomalies such as gastrointestinal obstructions (e.g., esophageal or duodenal atresia), maternal diabetes, and multiple gestations. In contrast, oligohydramnios is often caused by fetal urinary tract abnormalities (e.g., renal agenesis), rupture of membranes, post-term pregnancy, or placental insufficiency.

The signs and symptoms of polyhydramnios include rapid uterine enlargement, maternal discomfort due to increased pressure, difficulty breathing, and preterm labor, while oligohydramnios may present as reduced fetal movements, smaller uterine size than expected for gestational age, and complications during delivery due to lack of cushioning for the fetus.

Diagnosis of amniotic fluid disorders is typically made via ultrasound, which measures the amniotic fluid index (AFI) or the single deepest pocket of amniotic fluid. Polyhydramnios is diagnosed when the AFI is greater than 24 cm, while oligohydramnios is defined by an AFI less than 5 cm. Management depends on the severity of the condition. For polyhydramnios, treatment may include close monitoring, treating underlying maternal conditions like diabetes, or amnioreduction (draining excess fluid). In severe cases, preterm delivery might be considered. Oligohydramnios management includes increased maternal hydration, monitoring fetal well-being, and in certain cases, amnioinfusion during labor to reduce the risk of cord compression. In both conditions, fetal monitoring and timely delivery are crucial to reduce the risks of complications such as preterm labor, cord prolapse, or fetal growth restriction. Early identification and appropriate intervention are essential for optimizing maternal and fetal outcomes in these conditions.

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