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Polyhydramnios


  • Normal amniotic fluid is 500-1500 ml

Symptoms

  • Chronic

    • discomfort

    • dyspnoea

    • indigestion

    • oedema

    • increased varicose veins, haemorrhoids

    • abdominal pain

  • Acute

    • acute abdominal pain

    • feeling of 'bursting'

    • vomiting

Signs

  • Chronically

    • Uterus bigger than expected

    • identification of foetal parts difficult

    • foetal heart difficult to hear

    • ballottement of foetus easy

    • fluid thrill detected

    • abdominal girth at umbilicus greater than 100cm - varies (ebb and flow)

  • Acutely

    • abdominal skin

      • glazed

      • oedematous

      • fresh striae

    • uterus

      • tense

      • tender

Causes

Differential diagnosis

  • multiple pregnancy
    • no fluid thrill
  • ovarian cyst
    • presses cervix into pelvis
  • hydatidiform mole
    • usually accompanied by bleeding
  • full bladder

Complications

Management

  • detailed USS
  • glucose tolerance test
  • indomethacin
  • amniocentesis
 

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