Materiały źródłowe

• #1 Polyhydramnios – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polyhydramnios/symptoms-causes/syc-20368493

  Polyhydramnios happens in about 1% to 2% of pregnancies. […] Most of the time, the condition is mild. It’s often found during the middle or later stages of pregnancy. […] If you learn that you have polyhydramnios, your health care team carefully tracks your pregnancy to help prevent health problems. […] Risk factors for polyhydramnios include certain conditions that develop during pregnancy, such as gestational diabetes. […] Greater health problems usually are linked with severe polyhydramnios.

• #2 Polyhydramnios: Etiology, diagnosis, and management in singleton gestations – UpToDate

  https://www.uptodate.com/contents/polyhydramnios-etiology-diagnosis-and-management

  Polyhydramnios (also known as hydramnios) refers to an excessive volume of amniotic fluid. It should be suspected clinically when uterine size is large for gestational age (fundal height [cm] that exceeds the weeks of gestation by >3). Prenatal diagnosis is based upon documentation of excessive amniotic fluid volume (AFV) by a quantitative ultrasound technique, such as amniotic fluid index (AFI) ≥24 cm or single deepest pocket (SDP) ≥8 cm. […] The incidence of polyhydramnios in a general obstetric population generally ranges from 1 to 2 percent. Reported rates are highly influenced by the gestational age at the time of the ultrasound examination (higher preterm, lower postterm), the population studied (low or high risk, screening or indicated ultrasound examination, antepartum or intrapartum), and variations in diagnostic criteria (use of amniotic fluid index [AFI] versus single deepest pocket [SDP]). […] In a series including over 93,000 singleton pregnancies over six years at a single hospital, polyhydramnios was diagnosed during prenatal sonography in 0.7 percent and was described as mild, moderate, or severe in 66, 22, and 12 percent of cases, respectively.

• #3 Polyhydramnios – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562140/

  Polyhydramnios occurs in 1% to 2% of all pregnancies. Of patients with polyhydramnios, approximately 65% to 70% have mild disease, 20% have moderate disease, and less than 15% have severe disease. The condition is often identified incidentally in asymptomatic patients during ultrasonographic evaluation for other conditions in the third trimester. […] Chamberlin et al used ultrasonography to obtain qualitative amniotic fluid volumes to evaluate the perinatal mortality rate in 7562 patients with high-risk pregnancies. The perinatal mortality rate of patients with normal fluid volumes was 1.97 deaths per 1000 patients but increased more than 2-fold to 4.12 deaths per 1000 patients with polyhydramnios.

• #4

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  Polyhydramnios is defined as a pathological increase of amniotic fluid volume in pregnancy and is associated with increased perinatal morbidity and mortality. […] The reported prevalence of polyhydramnios ranges from 0.2 to 1.6% of all pregnancies. […] The diagnosis is obtained by ultrasound. […] The prognosis of polyhydramnios depends on its cause and severity. […] Typical symptoms of polyhydramnios include maternal dyspnea, preterm labor, premature rupture of membranes (PPROM), abnormal fetal presentation, cord prolapse and postpartum hemorrhage. […] Due to its common etiology with gestational diabetes, polyhydramnios is often associated with fetal macrosomia. […] In the German Maternity Guidelines, assessment of amniotic fluid is a standard examination in prenatal care. Oligohydramnios and polyhydramnios are considered indicative of a developmental disorder.

• #5 Polyhydramnios: Etiology, diagnosis, and management in singleton gestations – UpToDate

  https://www.uptodate.com/contents/polyhydramnios-etiology-diagnosis-and-management

  Polyhydramnios (also known as hydramnios) refers to an excessive volume of amniotic fluid. It should be suspected clinically when uterine size is large for gestational age (fundal height [cm] that exceeds the weeks of gestation by >3). Prenatal diagnosis is based upon documentation of excessive amniotic fluid volume (AFV) by a quantitative ultrasound technique, such as amniotic fluid index (AFI) ≥24 cm or single deepest pocket (SDP) ≥8 cm. […] The incidence of polyhydramnios in a general obstetric population generally ranges from 1 to 2 percent. Reported rates are highly influenced by the gestational age at the time of the ultrasound examination (higher preterm, lower postterm), the population studied (low or high risk, screening or indicated ultrasound examination, antepartum or intrapartum), and variations in diagnostic criteria (use of amniotic fluid index [AFI] versus single deepest pocket [SDP]). […] In a series including over 93,000 singleton pregnancies over six years at a single hospital, polyhydramnios was diagnosed during prenatal sonography in 0.7 percent and was described as mild, moderate, or severe in 66, 22, and 12 percent of cases, respectively.

• #6 Polyhydramnios: Etiology, diagnosis, and management in singleton gestations – UpToDate

  https://www.uptodate.com/contents/polyhydramnios-etiology-diagnosis-and-management

  Polyhydramnios (also known as hydramnios) refers to an excessive volume of amniotic fluid. It should be suspected clinically when uterine size is large for gestational age (fundal height [cm] that exceeds the weeks of gestation by >3). Prenatal diagnosis is based upon documentation of excessive amniotic fluid volume (AFV) by a quantitative ultrasound technique, such as amniotic fluid index (AFI) ≥24 cm or single deepest pocket (SDP) ≥8 cm. […] The incidence of polyhydramnios in a general obstetric population generally ranges from 1 to 2 percent. Reported rates are highly influenced by the gestational age at the time of the ultrasound examination (higher preterm, lower postterm), the population studied (low or high risk, screening or indicated ultrasound examination, antepartum or intrapartum), and variations in diagnostic criteria (use of amniotic fluid index [AFI] versus single deepest pocket [SDP]). […] In a series including over 93,000 singleton pregnancies over six years at a single hospital, polyhydramnios was diagnosed during prenatal sonography in 0.7 percent and was described as mild, moderate, or severe in 66, 22, and 12 percent of cases, respectively.

• #7

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  The risk of the following obstetric complications is increased when polyhydramnios is present due to over-expansion of the uterus: maternal dyspnea, preterm labor, premature rupture of membranes, abnormal fetal presentation, umbilical cord prolapse, postpartum hemorrhage, fetal macrosomia due to maternal diabetes mellitus, hypertensive disorders of pregnancy, urinary tract infections. […] These risks vary depending on the severity and etiology of the polyhydramnios. […] A prospective longitudinal study of normal singleton pregnancies lists the following potential complications: higher rates of cesarean sections for fetal indications, higher rates of admission to neonatal intensive care units, higher birth weight, lower 5-minute Apgar scores. […] In a large study of 85000 pregnancies, of which 3900 pregnancies had an increased AFI, it was found that polyhydramnios was an independent risk factor for perinatal mortality.

• #8 Polyhydramnios – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562140/

  Polyhydramnios occurs in 1% to 2% of all pregnancies. Of patients with polyhydramnios, approximately 65% to 70% have mild disease, 20% have moderate disease, and less than 15% have severe disease. The condition is often identified incidentally in asymptomatic patients during ultrasonographic evaluation for other conditions in the third trimester. […] Chamberlin et al used ultrasonography to obtain qualitative amniotic fluid volumes to evaluate the perinatal mortality rate in 7562 patients with high-risk pregnancies. The perinatal mortality rate of patients with normal fluid volumes was 1.97 deaths per 1000 patients but increased more than 2-fold to 4.12 deaths per 1000 patients with polyhydramnios.

• #9 Polyhydramnios: Etiology, diagnosis, and management in singleton gestations – UpToDate

  https://www.uptodate.com/contents/polyhydramnios-etiology-diagnosis-and-management

  Polyhydramnios (also known as hydramnios) refers to an excessive volume of amniotic fluid. It should be suspected clinically when uterine size is large for gestational age (fundal height [cm] that exceeds the weeks of gestation by >3). Prenatal diagnosis is based upon documentation of excessive amniotic fluid volume (AFV) by a quantitative ultrasound technique, such as amniotic fluid index (AFI) ≥24 cm or single deepest pocket (SDP) ≥8 cm. […] The incidence of polyhydramnios in a general obstetric population generally ranges from 1 to 2 percent. Reported rates are highly influenced by the gestational age at the time of the ultrasound examination (higher preterm, lower postterm), the population studied (low or high risk, screening or indicated ultrasound examination, antepartum or intrapartum), and variations in diagnostic criteria (use of amniotic fluid index [AFI] versus single deepest pocket [SDP]). […] In a series including over 93,000 singleton pregnancies over six years at a single hospital, polyhydramnios was diagnosed during prenatal sonography in 0.7 percent and was described as mild, moderate, or severe in 66, 22, and 12 percent of cases, respectively.

• #10 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Polyhydramnios […] Prevalence: […] 1 in 100 pregnancies. […] Ultrasound diagnosis: […] The vertical measurement of the deepest pocket of amniotic fluid free of fetal parts is used to classify polyhydramnios into mild (8-11 cm), moderate (12-15 cm) and severe (≥16 cm). […] In about 80% of cases the polyhydramnios is mild, in 15% moderate and in 5% severe. […] Most cases of mild polyhydramnios are idiopathic, but most cases with moderate or severe polyhydramnios are due to maternal or fetal disorders. […] In most cases, polyhydramnios develops late in the second or in the third trimester of pregnancy. Acute polyhydramnios at 16-22 weeks is mainly seen in association with twin-to-twin transfusion syndrome. […] Associated abnormalities: […] There are essentially two major causes of polyhydramnios:

• #11

  https://journals.lww.com/obgynsurvey/Fulltext/2014/12000/Polyhydramnios_and_Adverse_Perinatal_Outcome__.1.aspx?generateEpub=Article%7Cobgynsurvey:2014:12000:00001%7C10.1097/ogx.0000000000000136%7C

  Polyhydramnios complicates 1% to 3% of all pregnancies, and approximately 50% to 60% of cases are idiopathic. […] Polyhydramnios is subdivided into mild (2430), moderate (30.135), and severe (AFI 35). […] A significantly increased rate of perinatal mortality was noted as AFI increased. […] The main finding of the study is the increased adverse perinatal outcome as AFI rises in a dose-response manner from AFI of greater than 20. […] The widely accepted cutoff for polyhydramnios is AFI of greater than 24, with established associations between polyhydramnios and adverse perinatal outcomes. […] The accepted definition of polyhydramnios as AFI of greater than 24 should be further reevaluated.

• #12 Polyhydramnios – Possible Causes and Next Steps – The ObG Project

  https://www.obgproject.com/2016/08/05/polyhydramnios-what-is-it/

  The term polyhydramnios, also known as hydramnios, refers to an excessive amount of amniotic fluid. The overall incidence is 0.2-2.0 % of pregnancies […] More common in twins, likely due to complications of monochorionic placentation. Idiopathic polyhydramnios will occur in approximately 1% of pregnancies. Causes of polyhydramnios are many and account for varying percentages of cases: Idiopathic polyhydramnios (50-60%), Congenital anomalies and genetic disorders (8-45%), Maternal diabetes (5-26%), Multiple gestation (8-10%), Fetal anemia (1-11%). Increasing severity of polyhydramnios correlates with an increased risk of perinatal mortality and congenital abnormalities.

• #13 Polyhydramnios — CREOGS Over Coffee

  https://creogsovercoffee.com/notes/2022/9/25/polyhydramnios

  Polyhydramnios […] Prevalence: can complicate 1-2% of singleton gestations, but it is more common in twin gestations, primarily due to complications of monochorionic placentation […] […] Most mild polyhydramnios is idiopathic or due to T2DM, and only 6-10% risk of fetal anomaly, with 1% of neonatal abnormality […] […] However, with severe poly, there is increased risk of fetal anomaly to as high as 20-40% and even risk of neonatal abnormality of 10% […] […] Therefore, those with severe poly should deliver at tertiary care center due to possibility for fetal anomaly […] […] Currently recommendation from SMFM is that antenatal fetal surveillance is not required for the sole indication of mild idiopathic poly […] […] Similarly, recommendation is that labor should be allowed to occur spontaneously at term for women with mild idiopathic poly, and that induction, if planned, should not occur at 39 weeks of gestation in the absence of other indications […] […] Most of delivery should be determined based on usual obstetric indications.

• #14 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  In about half of cases, we don’t know what causes polyhydramnios. […] When an ultrasound shows you have too much amniotic fluid, your provider does a more detailed ultrasound to check for birth defects and twin-to-twin transfusion syndrome. […] About 2 out of 100 (2 percent) pregnant people have too much amniotic fluid.

• #15 Hydramnios and Polyhydramnios

  https://www.webmd.com/baby/what-is-hydramnios

  Hydramnios is a condition specific to pregnant women. It occurs when you have too much amniotic fluid around your baby. […] It occurs in around 1-2% of pregnancies. […] Polyhydramnios is a different word for hydramnios. The two terms can be used interchangeably. […] The condition can be mild, moderate, or severe. In general, the earlier the condition begins, the more fluid thats likely to build up. More fluid means that you have a greater risk of complications and birth defects. […] Between 60% and 70% of all cases dont have a detectable cause this is known as idiopathic polyhydramnios. […] In more severe cases, polyhydramnios can lead to serious complications with your pregnancy and is linked to an increased rate of birth defects in your child. For example, around 20% of all infants affected by hydramnios have some kind of congenital anomaly or heart defect.

• #16 What Can I Do About High Amniotic Fluid Levels? | ParentData by Emily Osterframe_1-svgframe_2-svgframe_3-svg

  https://parentdata.org/what-can-i-do-about-high-amniotic-fluid-levels/

  Polyhydramnios is a condition in which there is excess amniotic fluid (in contrast to oligohydramnios, which is not enough fluid). Polyhydramnios is generally classified as mild, moderate, or severe. The overall incidence is 1% to 2%. […] In about 40% of cases, the condition is idiopathic, basically meaning it seems to occur without any other reason. In the other 60%, it is associated with another fetal condition — for example, a genetic disorder (trisomy 18 or 21) or a fetal abnormality that impedes swallowing — or with a maternal condition (often, diabetes). […] For idiopathic cases, there are some elevated risks, both to you and the baby. This includes preterm birth and neonatal complications like a low Apgar score. Although it’s very rare, stillbirth risk is elevated.

• #17 polyhydramnios Archives – The ObG Project

  https://www.obgproject.com/tag/polyhydramnios/

  The term polyhydramnios, also known as hydramnios, refers to an excessive amount of amniotic fluid. The overall incidence is 0.2-2.0 % of pregnancies […] More common in twins, likely due to complications of monochorionic placentation. Idiopathic polyhydramnios will occur in approximately 1% of pregnancies. Causes of polyhydramnios are many and account for varying percentages of cases: Idiopathic polyhydramnios (50-60%) […] Congenital anomalies and genetic disorders (8-45%) […] Maternal diabetes (5-26%) […] Multiple gestation (8-10%) […] Fetal anemia (1-11%). Increasing severity of polyhydramnios correlates with an increased risk of perinatal mortality and congenital abnormalities. SMFM suggests that “antenatal fetal surveillance is not required for the sole indication of mild idiopathic polyhydramnios” (GRADE 2C).

• #18 polyhydramnios Archives – The ObG Project

  https://www.obgproject.com/tag/polyhydramnios/

  The term polyhydramnios, also known as hydramnios, refers to an excessive amount of amniotic fluid. The overall incidence is 0.2-2.0 % of pregnancies […] More common in twins, likely due to complications of monochorionic placentation. Idiopathic polyhydramnios will occur in approximately 1% of pregnancies. Causes of polyhydramnios are many and account for varying percentages of cases: Idiopathic polyhydramnios (50-60%) […] Congenital anomalies and genetic disorders (8-45%) […] Maternal diabetes (5-26%) […] Multiple gestation (8-10%) […] Fetal anemia (1-11%). Increasing severity of polyhydramnios correlates with an increased risk of perinatal mortality and congenital abnormalities. SMFM suggests that “antenatal fetal surveillance is not required for the sole indication of mild idiopathic polyhydramnios” (GRADE 2C).

• #19 Transient Polyhydramnios during Pregnancy Complicated with Gestational Diabetes Mellitus: Case Report and Systematic Review

  https://www.mdpi.com/2075-4418/12/6/1340

  Polyhydramnios is an obstetrical condition defined as a pathological increase in the amniotic fluid and is associated with a high risk of maternal-fetal complications. Common causes of polyhydramnios include fetal anatomical and genetic abnormalities, gestational diabetes mellitus, and fetal viral infections. […] Polyhydramnios is an obstetrical condition occurring in 0.2–2% of pregnancies. Polyhydramnios pregnancies have a high risk of maternal and fetal complications, with a higher incidence of in utero fetal death, premature birth, and the need for emergency fetal extraction. Identifying the etiology of polyhydramnios may play a crucial role in subsequent prenatal medical care and pregnancy evolution. […] Approximately 50% of polyhydramnios cases are idiopathic. Etiological causes include gestational diabetes mellitus (GDM), anatomic abnormalities, genetic diseases, rhesus isoimmunization, infectious diseases during pregnancy, Dandy-Walker syndrome, and Bartter syndrome. GDM is one of the etiological causes of polyhydramnios with a variable prevalence.

• #20 polyhydramnios Archives – The ObG Project

  https://www.obgproject.com/tag/polyhydramnios/

  The term polyhydramnios, also known as hydramnios, refers to an excessive amount of amniotic fluid. The overall incidence is 0.2-2.0 % of pregnancies […] More common in twins, likely due to complications of monochorionic placentation. Idiopathic polyhydramnios will occur in approximately 1% of pregnancies. Causes of polyhydramnios are many and account for varying percentages of cases: Idiopathic polyhydramnios (50-60%) […] Congenital anomalies and genetic disorders (8-45%) […] Maternal diabetes (5-26%) […] Multiple gestation (8-10%) […] Fetal anemia (1-11%). Increasing severity of polyhydramnios correlates with an increased risk of perinatal mortality and congenital abnormalities. SMFM suggests that “antenatal fetal surveillance is not required for the sole indication of mild idiopathic polyhydramnios” (GRADE 2C).

• #21 polyhydramnios Archives – The ObG Project

  https://www.obgproject.com/tag/polyhydramnios/

  The term polyhydramnios, also known as hydramnios, refers to an excessive amount of amniotic fluid. The overall incidence is 0.2-2.0 % of pregnancies […] More common in twins, likely due to complications of monochorionic placentation. Idiopathic polyhydramnios will occur in approximately 1% of pregnancies. Causes of polyhydramnios are many and account for varying percentages of cases: Idiopathic polyhydramnios (50-60%) […] Congenital anomalies and genetic disorders (8-45%) […] Maternal diabetes (5-26%) […] Multiple gestation (8-10%) […] Fetal anemia (1-11%). Increasing severity of polyhydramnios correlates with an increased risk of perinatal mortality and congenital abnormalities. SMFM suggests that “antenatal fetal surveillance is not required for the sole indication of mild idiopathic polyhydramnios” (GRADE 2C).

• #22 polyhydramnios Archives – The ObG Project

  https://www.obgproject.com/tag/polyhydramnios/

  The term polyhydramnios, also known as hydramnios, refers to an excessive amount of amniotic fluid. The overall incidence is 0.2-2.0 % of pregnancies […] More common in twins, likely due to complications of monochorionic placentation. Idiopathic polyhydramnios will occur in approximately 1% of pregnancies. Causes of polyhydramnios are many and account for varying percentages of cases: Idiopathic polyhydramnios (50-60%) […] Congenital anomalies and genetic disorders (8-45%) […] Maternal diabetes (5-26%) […] Multiple gestation (8-10%) […] Fetal anemia (1-11%). Increasing severity of polyhydramnios correlates with an increased risk of perinatal mortality and congenital abnormalities. SMFM suggests that “antenatal fetal surveillance is not required for the sole indication of mild idiopathic polyhydramnios” (GRADE 2C).

• #23 Treatment & Monitoring of Polyhydramnios: | Know Polyhydramnios

  https://polyhydramnios.org/learn-more-about-polyhydramnios/treatment-and-management-of-polyhydramnios/

  Indomethacin on the other hand is NOT RECOMMENDED to be used solely for the purpose of reducing fluid because it can harm your baby. […] Although indomethacin does reduce the amount of amniotic fluid surrounding a baby, the Society for Maternal-Fetal Medicine recommends that indomethacin NOT be used for the sole purpose of reducing amniotic fluid in the setting of Polyhydramnios. […] Polyhydramnios has been associated with several anomalies both in women and infants. […] At the time of delivery, 61% of Polyhydramnios cases are idiopathic, 18% are attributed to a genetic anomaly, 10% to infection or blood incompatibility, 4% to fetal anemia, 4% to Twin to Twin Transfusion, and 3% to gestational diabetes.

• #24 Polyhydramnios – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/polyhydramnios/

  Polyhydramnios is an amniotic fluid volume that is greater than expected for gestational age. Causes may be idiopathic (in approx. 70% of cases) or due to maternal (e.g., diabetes, rhesus incompatibility) or fetal factors (e.g., conditions that impair swallowing or increase urine production). Polyhydramnios is often discovered incidentally on routine prenatal ultrasound or during an evaluation for increased fundal height for gestational age. All patients should be referred to maternal-fetal medicine for further evaluation and management of underlying causes and/or complications. Complications include intrauterine fetal demise, fetal malposition, umbilical cord prolapse, premature labor and birth, and complications due to underlying fetal factors. […] Polyhydramnios is diagnosed with an obstetric ultrasound, typically in the 2nd or 3rd trimester.

• #25 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Polyhydramnios […] Prevalence: […] 1 in 100 pregnancies. […] Ultrasound diagnosis: […] The vertical measurement of the deepest pocket of amniotic fluid free of fetal parts is used to classify polyhydramnios into mild (8-11 cm), moderate (12-15 cm) and severe (≥16 cm). […] In about 80% of cases the polyhydramnios is mild, in 15% moderate and in 5% severe. […] Most cases of mild polyhydramnios are idiopathic, but most cases with moderate or severe polyhydramnios are due to maternal or fetal disorders. […] In most cases, polyhydramnios develops late in the second or in the third trimester of pregnancy. Acute polyhydramnios at 16-22 weeks is mainly seen in association with twin-to-twin transfusion syndrome. […] Associated abnormalities: […] There are essentially two major causes of polyhydramnios:

• #26 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Polyhydramnios […] Prevalence: […] 1 in 100 pregnancies. […] Ultrasound diagnosis: […] The vertical measurement of the deepest pocket of amniotic fluid free of fetal parts is used to classify polyhydramnios into mild (8-11 cm), moderate (12-15 cm) and severe (≥16 cm). […] In about 80% of cases the polyhydramnios is mild, in 15% moderate and in 5% severe. […] Most cases of mild polyhydramnios are idiopathic, but most cases with moderate or severe polyhydramnios are due to maternal or fetal disorders. […] In most cases, polyhydramnios develops late in the second or in the third trimester of pregnancy. Acute polyhydramnios at 16-22 weeks is mainly seen in association with twin-to-twin transfusion syndrome. […] Associated abnormalities: […] There are essentially two major causes of polyhydramnios:

• #27 Polyhydramnios: Etiology, diagnosis, and management in singleton gestations – UpToDate

  https://www.uptodate.com/contents/polyhydramnios-etiology-diagnosis-and-management

  Polyhydramnios (also known as hydramnios) refers to an excessive volume of amniotic fluid. It should be suspected clinically when uterine size is large for gestational age (fundal height [cm] that exceeds the weeks of gestation by >3). Prenatal diagnosis is based upon documentation of excessive amniotic fluid volume (AFV) by a quantitative ultrasound technique, such as amniotic fluid index (AFI) ≥24 cm or single deepest pocket (SDP) ≥8 cm. […] The incidence of polyhydramnios in a general obstetric population generally ranges from 1 to 2 percent. Reported rates are highly influenced by the gestational age at the time of the ultrasound examination (higher preterm, lower postterm), the population studied (low or high risk, screening or indicated ultrasound examination, antepartum or intrapartum), and variations in diagnostic criteria (use of amniotic fluid index [AFI] versus single deepest pocket [SDP]). […] In a series including over 93,000 singleton pregnancies over six years at a single hospital, polyhydramnios was diagnosed during prenatal sonography in 0.7 percent and was described as mild, moderate, or severe in 66, 22, and 12 percent of cases, respectively.

• #28 Polyhydramnios: Etiology, diagnosis, and management in singleton gestations – UpToDate

  https://www.uptodate.com/contents/polyhydramnios-etiology-diagnosis-and-management

  Polyhydramnios (also known as hydramnios) refers to an excessive volume of amniotic fluid. It should be suspected clinically when uterine size is large for gestational age (fundal height [cm] that exceeds the weeks of gestation by >3). Prenatal diagnosis is based upon documentation of excessive amniotic fluid volume (AFV) by a quantitative ultrasound technique, such as amniotic fluid index (AFI) ≥24 cm or single deepest pocket (SDP) ≥8 cm. […] The incidence of polyhydramnios in a general obstetric population generally ranges from 1 to 2 percent. Reported rates are highly influenced by the gestational age at the time of the ultrasound examination (higher preterm, lower postterm), the population studied (low or high risk, screening or indicated ultrasound examination, antepartum or intrapartum), and variations in diagnostic criteria (use of amniotic fluid index [AFI] versus single deepest pocket [SDP]). […] In a series including over 93,000 singleton pregnancies over six years at a single hospital, polyhydramnios was diagnosed during prenatal sonography in 0.7 percent and was described as mild, moderate, or severe in 66, 22, and 12 percent of cases, respectively.

• #29 Polyhydramnios Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/404856-overview

  Polyhydramnios is the presence of excess amniotic fluid in the uterus. By definition, polyhydramnios is diagnosed if the deepest vertical pool is more than 8 cm or amniotic fluid index (AFI) is more than 95th percentile for the corresponding gestational age. With a deep pocket of 8 cm or more as the criterion of polyhydramnios, the incidence is 1-3% of all pregnancies. Most cases of mild polyhydramnios are idiopathic, but the 2 most common causes are maternal diabetes mellitus and fetal anomalies. The amniotic fluid index (AFI) defines polyhydramnios defined as 24 cm or more. […] The degree of polyhydramnios is frequently categorized as mild, moderate, or severe, based on an AFI of 24.029.9 cm, 30.034.9 cm, and 35 cm, respectively, or a deep vertical pocket of 811 cm, 1215 cm, or 16 cm, respectively.

• #30 Polyhydramnios – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/polyhydramnios

  Polyhydramnios is excessive amniotic fluid; it is associated with maternal and fetal complications. Diagnosis is by ultrasonographic measurement of amniotic fluid volume. Management is by treating maternal disorders contributing to polyhydramnios. If symptoms are severe or if painful preterm contractions occur, treatment may also include manual reduction of amniotic fluid volume. […] With polyhydramnios, risk of the following complications is increased: Preterm contractions and possibly prelabor rupture of membranes (sometimes followed by placental abruption) or preterm labor, Fetal malposition, Maternal respiratory compromise, Umbilical cord prolapse, Uterine atony, Postpartum hemorrhage, Fetal death (risk is increased even when polyhydramnios is idiopathic). […] Polyhydramnios is usually suspected based on ultrasonographic findings or uterine size that is larger than expected for dates. However, qualitative estimates of amniotic fluid volume tend to be subjective. So if polyhydramnios is suspected, amniotic fluid should be assessed quantitatively using the amniotic fluid index (AFI) or single deepest pocket (SDP).

• #31 Polyhydramnios Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/404856-overview

  Polyhydramnios is the presence of excess amniotic fluid in the uterus. By definition, polyhydramnios is diagnosed if the deepest vertical pool is more than 8 cm or amniotic fluid index (AFI) is more than 95th percentile for the corresponding gestational age. With a deep pocket of 8 cm or more as the criterion of polyhydramnios, the incidence is 1-3% of all pregnancies. Most cases of mild polyhydramnios are idiopathic, but the 2 most common causes are maternal diabetes mellitus and fetal anomalies. The amniotic fluid index (AFI) defines polyhydramnios defined as 24 cm or more. […] The degree of polyhydramnios is frequently categorized as mild, moderate, or severe, based on an AFI of 24.029.9 cm, 30.034.9 cm, and 35 cm, respectively, or a deep vertical pocket of 811 cm, 1215 cm, or 16 cm, respectively.

• #32 Polyhydramnios Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/404856-overview

  Polyhydramnios is the presence of excess amniotic fluid in the uterus. By definition, polyhydramnios is diagnosed if the deepest vertical pool is more than 8 cm or amniotic fluid index (AFI) is more than 95th percentile for the corresponding gestational age. With a deep pocket of 8 cm or more as the criterion of polyhydramnios, the incidence is 1-3% of all pregnancies. Most cases of mild polyhydramnios are idiopathic, but the 2 most common causes are maternal diabetes mellitus and fetal anomalies. The amniotic fluid index (AFI) defines polyhydramnios defined as 24 cm or more. […] The degree of polyhydramnios is frequently categorized as mild, moderate, or severe, based on an AFI of 24.029.9 cm, 30.034.9 cm, and 35 cm, respectively, or a deep vertical pocket of 811 cm, 1215 cm, or 16 cm, respectively.

• #33 Indications for Outpatient Antenatal Fetal Surveillance | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/06/indications-for-outpatient-antenatal-fetal-surveillance

  The degree of polyhydramnios is frequently categorized as mild, moderate, or severe, based on a deepest vertical pocket of 8-11 cm, 12-15 cm, or 16 cm or greater, or an amniotic fluid index of 24.0-29.9 cm, 30.0-34.9 cm, and 35 cm or greater, respectively. The increased risk of fetal mortality associated with polyhydramnios has been attributed to higher incidence of fetal anomalies. However, a retrospective cohort study of nonanomalous births found that the risk of stillbirth in pregnancies complicated by polyhydramnios is 1.14 per 1,000 at 32 weeks, 1.34 per 1,000 at 34 weeks, 1.64 per 1,000 at 36 weeks, and 2.91 per 1,000 at 39 weeks. When adjusted for multiple confounding variables, polyhydramnios remained associated with increased odds of stillbirth (aOR 5.5; 95% CI, 4.1-7.6). The significance persisted after excluding pregnancies with pregestational or gestational diabetes mellitus. The authors concluded that polyhydramnios may warrant increased antenatal surveillance, particularly in the last weeks of pregnancy. For patients with moderate or severe polyhydramnios (deepest vertical pocket equal to or greater than 12 cm or amniotic fluid index equal to or greater than 30 cm), once or twice weekly antenatal fetal surveillance may be considered beginning at 32 0/7 to 34 0/7 weeks of gestation. Absent other indications, antenatal fetal surveillance is not required for mild idiopathic polyhydramnios.

• #34 Polyhydramnios Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/404856-overview

  The incidence of detection of polyhydramnios varies with the technique used. […] The incidence of polyhydramnios can vary with the technique used. A single deep pocket more than 8 cm is diagnostic of polyhydramnios. With the single-pocket technique, the incidence is 0.7% (1.1% for oligohydramnios). With the 2-diameter pocket, the rate is 3% (30% for oligohydramnios), and with the AFI method, the rate is 0% (8% for oligohydramnios). Therefore, the single-deep-pocket method is the best technique because it classifies the least number of cases as being abnormal.

• #35

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  Monitoring of Pregnancies with Polyhydramnios: In view of the increased perinatal mortality and morbidity associated with pregnancies with polyhydramnios, careful monitoring is recommended. […] There are no prospective randomized studies comparing expectant management to active intervention in idiopathic polyhydramnios. […] Polyhydramnios diagnosed on ultrasound requires further maternal and fetal diagnostic tests.

• #36 Treatment & Monitoring of Polyhydramnios: | Know Polyhydramnios

  https://polyhydramnios.org/learn-more-about-polyhydramnios/treatment-and-management-of-polyhydramnios/

  There is no treatment for Polyhydramnios, but there are ways to manage the condition. […] Monitoring and management methods include management of the underlying condition (when possible), fetal surveillance, reducing fluid, and creating an effective care plan. […] The ACOG recommends antenatal surveillance in all pregnancies at risk for stillbirth beginning at 32 weeks. However, the Society for Maternal-Fetal Medicine (SMFM) has stated that fetal surveillance is not required in cases of mild, idiopathic Polyhydramnios. […] Because Polyhydramnios is associated with a higher risk of stillbirth, we recommend fetal surveillance should be used in all pregnancies complicated by persistent Polyhydramnios in order to monitor for signs of fetal distress. […] Amnioreduction is considered safe to use in extreme circumstances.

• #37 Polyhydramnios – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/polyhydramnios

  Recommendations for prenatal monitoring depend on the severity of polyhydramnios, based on AFI: AFI 30 cm (which increases risk of fetal death): Prenatal monitoring should begin as early as 32 weeks or whenever it is diagnosed thereafter; it should include nonstress testing at least once a week. However, such monitoring has not been proved to decrease the fetal death rate. […] Polyhydramnios is excessive amniotic fluid; it can be caused by fetal malformations, multiple gestation, maternal diabetes, and various fetal disorders. It is associated with increased risk of preterm contractions, preterm labor, prelabor rupture of membranes, maternal respiratory compromise, fetal malposition or death, and various problems during labor and delivery. If polyhydramnios is suspected, do ultrasonography to determine amniotic fluid index or single deepest pocket, and test for possible causes (including a comprehensive ultrasonographic evaluation). Consider reducing amniotic fluid volume only if polyhydramnios causes severe maternal symptoms. Begin prenatal monitoring with weekly nonstress tests as early as 32 weeks in patients with an amniotic fluid index of 30 cm.

• #38 Treatment & Monitoring of Polyhydramnios: | Know Polyhydramnios

  https://polyhydramnios.org/learn-more-about-polyhydramnios/treatment-and-management-of-polyhydramnios/

  There is no treatment for Polyhydramnios, but there are ways to manage the condition. […] Monitoring and management methods include management of the underlying condition (when possible), fetal surveillance, reducing fluid, and creating an effective care plan. […] The ACOG recommends antenatal surveillance in all pregnancies at risk for stillbirth beginning at 32 weeks. However, the Society for Maternal-Fetal Medicine (SMFM) has stated that fetal surveillance is not required in cases of mild, idiopathic Polyhydramnios. […] Because Polyhydramnios is associated with a higher risk of stillbirth, we recommend fetal surveillance should be used in all pregnancies complicated by persistent Polyhydramnios in order to monitor for signs of fetal distress. […] Amnioreduction is considered safe to use in extreme circumstances.

• #39 Polyhydramnios — CREOGS Over Coffee

  https://creogsovercoffee.com/notes/2022/9/25/polyhydramnios

  Polyhydramnios […] Prevalence: can complicate 1-2% of singleton gestations, but it is more common in twin gestations, primarily due to complications of monochorionic placentation […] […] Most mild polyhydramnios is idiopathic or due to T2DM, and only 6-10% risk of fetal anomaly, with 1% of neonatal abnormality […] […] However, with severe poly, there is increased risk of fetal anomaly to as high as 20-40% and even risk of neonatal abnormality of 10% […] […] Therefore, those with severe poly should deliver at tertiary care center due to possibility for fetal anomaly […] […] Currently recommendation from SMFM is that antenatal fetal surveillance is not required for the sole indication of mild idiopathic poly […] […] Similarly, recommendation is that labor should be allowed to occur spontaneously at term for women with mild idiopathic poly, and that induction, if planned, should not occur at 39 weeks of gestation in the absence of other indications […] […] Most of delivery should be determined based on usual obstetric indications.

• #40 Polyhydramnios: Causes, Symptoms, Complications & Treatment

  https://my.clevelandclinic.org/health/diseases/17852-polyhydramnios

  People with polyhydramnios may be monitored more closely for the remainder of the pregnancy. You can expect more frequent appointments as well as more ultrasounds to measure amniotic fluid volume. […] Yes, most people will not have pregnancy complications from too much amniotic fluid and will have a healthy baby. […] Polyhydramnios is a complication of pregnancy that typically doesnt require treatment. Your provider will watch you closely and may recommend an induction. If youve been diagnosed with having too much amniotic fluid, its OK to be concerned. Talk to your pregnancy care provider about your concerns and ask any questions you have about the condition. Your provider is there to support you and make sure you and your baby are healthy. Most people with polyhydramnios have healthy babies without complications.

• #41 Polyhydramnios – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polyhydramnios/diagnosis-treatment/drc-20368494

  To find out if you have polyhydramnios, you’ll likely have a fetal ultrasound. This test uses high-frequency sound waves to make images of your unborn baby on a monitor. […] Health care professionals can check for polyhydramnios by measuring the single largest pocket of amniotic fluid around the baby. This is called the maximum vertical pocket (MVP). Or they might measure the fluid in the four quadrants of the uterus, also called the amniotic fluid index (AFI). Polyhydramnios is diagnosed if the MVP is 8 or greater, or the AFI is 24 or greater. […] Your health care team closely tracks your pregnancy if you have polyhydramnios. You may receive the following exams: […] Mild polyhydramnios rarely needs treatment. It may go away on its own. […] Otherwise, treatment for an underlying cause such as diabetes may help clear up polyhydramnios.

• #42 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Investigations: […] Detailed ultrasound examination. […] Invasive testing for karyotyping and array if there are fetal abnormalities or growth restriction. DNA testing for the myotonic dystrophy mutation if there is abnormal posturing of the extremities. […] Glucose tolerance test if there is associated macrosomia. […] TORCH test if there are fetal features suggestive of infection. […] Follow up: […] Ultrasound scans every 1-3 weeks to monitor fetal condition, amniotic fluid volume and cervical length. […] Prenatal therapy: […] Maternal diabetes mellitus: good glycemic control. […] Hydrops due to dysrhythmias: antiarrhythmic medication. […] Hydrops due to fetal anemia: intrauterine blood transfusion. […] Pulmonary cysts or pleural effusions: thoracoamniotic shunting.

• #43 Polyhydramnios – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polyhydramnios/diagnosis-treatment/drc-20368494

  You may need treatment in the hospital if you have severe polyhydramnios with symptoms such as shortness of breath, stomach pain or contractions. […] Polyhydramnios treatment may include: […] After treatment, your health care team likely will want to check your amniotic fluid level about every 1 to 3 weeks. […] If you have mild to moderate polyhydramnios, your care team probably will plan to have you deliver your baby at 39 or 40 weeks. If you have severe polyhydramnios, your team likely will talk about the right timing of delivery. The goal is to lower the chances of health problems for you and your baby.

• #44 Polyhydramnios – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polyhydramnios/diagnosis-treatment/drc-20368494

  You may need treatment in the hospital if you have severe polyhydramnios with symptoms such as shortness of breath, stomach pain or contractions. […] Polyhydramnios treatment may include: […] After treatment, your health care team likely will want to check your amniotic fluid level about every 1 to 3 weeks. […] If you have mild to moderate polyhydramnios, your care team probably will plan to have you deliver your baby at 39 or 40 weeks. If you have severe polyhydramnios, your team likely will talk about the right timing of delivery. The goal is to lower the chances of health problems for you and your baby.

• #45 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Twin-to-twin transfusion syndrome: laser occlusion of placental anastomoses. […] Fetal or placental tumors: laser occlusion of feeding vessels. […] Defects resulting in reduced fetal swallowing or severe idiopathic polyhydramnios: serial amniodrainages if there is cervical shortening. However, the procedure itself may precipitate premature labor. An alternative and effective method of treatment is maternal administration of indomethacin; however, this drug may cause fetal ductal constriction, and close monitoring by serial fetal echocardiographic studies is necessary. […] Delivery: […] Standard obstetric care and delivery in most cases. […] Fetal abnormalities: induction of labor at 38 weeks gestation in a hospital with neonatal intensive care and facilities for pediatric surgery.

• #46 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Twin-to-twin transfusion syndrome: laser occlusion of placental anastomoses. […] Fetal or placental tumors: laser occlusion of feeding vessels. […] Defects resulting in reduced fetal swallowing or severe idiopathic polyhydramnios: serial amniodrainages if there is cervical shortening. However, the procedure itself may precipitate premature labor. An alternative and effective method of treatment is maternal administration of indomethacin; however, this drug may cause fetal ductal constriction, and close monitoring by serial fetal echocardiographic studies is necessary. […] Delivery: […] Standard obstetric care and delivery in most cases. […] Fetal abnormalities: induction of labor at 38 weeks gestation in a hospital with neonatal intensive care and facilities for pediatric surgery.

• #47 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Twin-to-twin transfusion syndrome: laser occlusion of placental anastomoses. […] Fetal or placental tumors: laser occlusion of feeding vessels. […] Defects resulting in reduced fetal swallowing or severe idiopathic polyhydramnios: serial amniodrainages if there is cervical shortening. However, the procedure itself may precipitate premature labor. An alternative and effective method of treatment is maternal administration of indomethacin; however, this drug may cause fetal ductal constriction, and close monitoring by serial fetal echocardiographic studies is necessary. […] Delivery: […] Standard obstetric care and delivery in most cases. […] Fetal abnormalities: induction of labor at 38 weeks gestation in a hospital with neonatal intensive care and facilities for pediatric surgery.

• #48 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Twin-to-twin transfusion syndrome: laser occlusion of placental anastomoses. […] Fetal or placental tumors: laser occlusion of feeding vessels. […] Defects resulting in reduced fetal swallowing or severe idiopathic polyhydramnios: serial amniodrainages if there is cervical shortening. However, the procedure itself may precipitate premature labor. An alternative and effective method of treatment is maternal administration of indomethacin; however, this drug may cause fetal ductal constriction, and close monitoring by serial fetal echocardiographic studies is necessary. […] Delivery: […] Standard obstetric care and delivery in most cases. […] Fetal abnormalities: induction of labor at 38 weeks gestation in a hospital with neonatal intensive care and facilities for pediatric surgery.

• #49

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  Polyhydramnios is defined as a pathological increase of amniotic fluid volume in pregnancy and is associated with increased perinatal morbidity and mortality. […] The reported prevalence of polyhydramnios ranges from 0.2 to 1.6% of all pregnancies. […] The diagnosis is obtained by ultrasound. […] The prognosis of polyhydramnios depends on its cause and severity. […] Typical symptoms of polyhydramnios include maternal dyspnea, preterm labor, premature rupture of membranes (PPROM), abnormal fetal presentation, cord prolapse and postpartum hemorrhage. […] Due to its common etiology with gestational diabetes, polyhydramnios is often associated with fetal macrosomia. […] In the German Maternity Guidelines, assessment of amniotic fluid is a standard examination in prenatal care. Oligohydramnios and polyhydramnios are considered indicative of a developmental disorder.

• #50 Polyhydramnios – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562140/

  Polyhydramnios occurs in 1% to 2% of all pregnancies. Of patients with polyhydramnios, approximately 65% to 70% have mild disease, 20% have moderate disease, and less than 15% have severe disease. The condition is often identified incidentally in asymptomatic patients during ultrasonographic evaluation for other conditions in the third trimester. […] Chamberlin et al used ultrasonography to obtain qualitative amniotic fluid volumes to evaluate the perinatal mortality rate in 7562 patients with high-risk pregnancies. The perinatal mortality rate of patients with normal fluid volumes was 1.97 deaths per 1000 patients but increased more than 2-fold to 4.12 deaths per 1000 patients with polyhydramnios.

• #51 Polyhydramnios – MD Searchlight

  https://mdsearchlight.com/womens-health/polyhydramnios/

  Polyhydramnios is a condition where there is too much amniotic fluid during pregnancy. This condition can be risky for both the mother and the baby. It can lead to a higher chance of the baby dying in the womb, early labor, the waters breaking prematurely, the umbilical cord slipping out of the womb, the baby being unusually large, the baby lying feet first in the womb, cesarean birth, and the mother bleeding excessively after delivery. In pregnancies with polyhydramnios, about 20% can be traced back to a birth defect. However, in 60% to 70% of cases, there is no clear cause for the condition. […] Polyhydramnios, a condition where there’s too much amniotic fluid around the baby in the womb, occurs in 1% to 2% of all pregnancies. […] A study by Chamberlin used ultrasound to measure amniotic fluid volume in over 7,500 high-risk pregnancies. The study found that the perinatal mortality rate (the number of babies who die around the time of birth) for those with normal amounts of fluid was about 2 deaths per 1,000 pregnancies. But for those with polyhydramnios, this doubled to roughly 4 deaths per 1,000 pregnancies.

• #52

  https://journals.lww.com/obgynsurvey/Fulltext/2014/12000/Polyhydramnios_and_Adverse_Perinatal_Outcome__.1.aspx?generateEpub=Article%7Cobgynsurvey:2014:12000:00001%7C10.1097/ogx.0000000000000136%7C

  Polyhydramnios complicates 1% to 3% of all pregnancies, and approximately 50% to 60% of cases are idiopathic. […] Polyhydramnios is subdivided into mild (2430), moderate (30.135), and severe (AFI 35). […] A significantly increased rate of perinatal mortality was noted as AFI increased. […] The main finding of the study is the increased adverse perinatal outcome as AFI rises in a dose-response manner from AFI of greater than 20. […] The widely accepted cutoff for polyhydramnios is AFI of greater than 24, with established associations between polyhydramnios and adverse perinatal outcomes. […] The accepted definition of polyhydramnios as AFI of greater than 24 should be further reevaluated.

• #53 Indications for Outpatient Antenatal Fetal Surveillance | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/06/indications-for-outpatient-antenatal-fetal-surveillance

  The degree of polyhydramnios is frequently categorized as mild, moderate, or severe, based on a deepest vertical pocket of 8-11 cm, 12-15 cm, or 16 cm or greater, or an amniotic fluid index of 24.0-29.9 cm, 30.0-34.9 cm, and 35 cm or greater, respectively. The increased risk of fetal mortality associated with polyhydramnios has been attributed to higher incidence of fetal anomalies. However, a retrospective cohort study of nonanomalous births found that the risk of stillbirth in pregnancies complicated by polyhydramnios is 1.14 per 1,000 at 32 weeks, 1.34 per 1,000 at 34 weeks, 1.64 per 1,000 at 36 weeks, and 2.91 per 1,000 at 39 weeks. When adjusted for multiple confounding variables, polyhydramnios remained associated with increased odds of stillbirth (aOR 5.5; 95% CI, 4.1-7.6). The significance persisted after excluding pregnancies with pregestational or gestational diabetes mellitus. The authors concluded that polyhydramnios may warrant increased antenatal surveillance, particularly in the last weeks of pregnancy. For patients with moderate or severe polyhydramnios (deepest vertical pocket equal to or greater than 12 cm or amniotic fluid index equal to or greater than 30 cm), once or twice weekly antenatal fetal surveillance may be considered beginning at 32 0/7 to 34 0/7 weeks of gestation. Absent other indications, antenatal fetal surveillance is not required for mild idiopathic polyhydramnios.

• #54

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  The risk of the following obstetric complications is increased when polyhydramnios is present due to over-expansion of the uterus: maternal dyspnea, preterm labor, premature rupture of membranes, abnormal fetal presentation, umbilical cord prolapse, postpartum hemorrhage, fetal macrosomia due to maternal diabetes mellitus, hypertensive disorders of pregnancy, urinary tract infections. […] These risks vary depending on the severity and etiology of the polyhydramnios. […] A prospective longitudinal study of normal singleton pregnancies lists the following potential complications: higher rates of cesarean sections for fetal indications, higher rates of admission to neonatal intensive care units, higher birth weight, lower 5-minute Apgar scores. […] In a large study of 85000 pregnancies, of which 3900 pregnancies had an increased AFI, it was found that polyhydramnios was an independent risk factor for perinatal mortality.

• #55 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #56 Polyhydramnios – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/polyhydramnios

  Polyhydramnios is excessive amniotic fluid; it is associated with maternal and fetal complications. Diagnosis is by ultrasonographic measurement of amniotic fluid volume. Management is by treating maternal disorders contributing to polyhydramnios. If symptoms are severe or if painful preterm contractions occur, treatment may also include manual reduction of amniotic fluid volume. […] With polyhydramnios, risk of the following complications is increased: Preterm contractions and possibly prelabor rupture of membranes (sometimes followed by placental abruption) or preterm labor, Fetal malposition, Maternal respiratory compromise, Umbilical cord prolapse, Uterine atony, Postpartum hemorrhage, Fetal death (risk is increased even when polyhydramnios is idiopathic). […] Polyhydramnios is usually suspected based on ultrasonographic findings or uterine size that is larger than expected for dates. However, qualitative estimates of amniotic fluid volume tend to be subjective. So if polyhydramnios is suspected, amniotic fluid should be assessed quantitatively using the amniotic fluid index (AFI) or single deepest pocket (SDP).

• #57 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #58

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  The risk of the following obstetric complications is increased when polyhydramnios is present due to over-expansion of the uterus: maternal dyspnea, preterm labor, premature rupture of membranes, abnormal fetal presentation, umbilical cord prolapse, postpartum hemorrhage, fetal macrosomia due to maternal diabetes mellitus, hypertensive disorders of pregnancy, urinary tract infections. […] These risks vary depending on the severity and etiology of the polyhydramnios. […] A prospective longitudinal study of normal singleton pregnancies lists the following potential complications: higher rates of cesarean sections for fetal indications, higher rates of admission to neonatal intensive care units, higher birth weight, lower 5-minute Apgar scores. […] In a large study of 85000 pregnancies, of which 3900 pregnancies had an increased AFI, it was found that polyhydramnios was an independent risk factor for perinatal mortality.

• #59 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #60 Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2412-6

  In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes. […] We identified 305/18,640 (1.6%) cases of polyhydramnios. 229 (75%) cases were from the DRC, with an incidence of 10%. A higher percentage of women with polyhydramnios experienced obstructed labor (7% vs 4%) and fetal malposition (4% vs 2%). Neonatal death was more common when polyhydramnios was present (OR 2.43; CI 1.15, 5.13). […] Polyhydramnios occurred in these low and low-middle income countries at a rate similar to high-income countries except in the DRC where the incidence was 10%. Polyhydramnios was associated with obstructed labor, fetal malposition, and neonatal death.

• #61 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #62 The Interplay of Polyhydramnios and Birth Injuries in New Jersey

  https://pediatricmalpracticeguide.com/the-interplay-of-polyhydramnios-and-birth-injuries/

  Polyhydramnios is the condition referring to too much amniotic fluid that can cause permanent injury or death to either or both mother and fetus. […] Polyhydramnios can cause early contractions, long labor, and respiratory problems during childbirth, among other serious complications. One significant risk is early labor and premature birth. […] Polyhydramnios may also cause birth complications, such as breech birth, when the baby’s feet are closest to the birth canal. […] Another danger to the fetus during delivery is umbilical cord prolapse, when the umbilical cord is between the baby’s head and the vaginal opening, causing the cord to compress and cut off oxygen and nutrients to the baby. […] Polyhydramnios may result in the placenta detaching from the wall of the uterus, cutting off the fetus’s oxygen and nutrient supply.

• #63 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #64 The Interplay of Polyhydramnios and Birth Injuries in New Jersey

  https://pediatricmalpracticeguide.com/the-interplay-of-polyhydramnios-and-birth-injuries/

  When complications occur, the overseeing physician may need to perform an emergency cesarean section (C-section) to save the baby’s life. […] As mentioned, polyhydramnios can cause brain damage to the baby. […] Doctors diagnose polyhydramnios by calculating the fundal height to determine whether the uterus is too big for the gestational stage. […] When AFI or MVP suggests polyhydramnios, a healthcare provider may order specific tests to check for maternal and fetal conditions. […] Once diagnosed, a treating physician may simply monitor a mild case or treat the underlying causes, such as medications for diabetes or rapid fetal heart rate. […] A physician may commit malpractice by failing to note risk factors that lead to the condition. […] Among the ways that birth injury lawsuits arise from polyhydramnios, failing to treat excessive amniotic fluid occurs less often than failing to plan for, recognize, manage, prevent, and appropriately treat complications resulting from the condition.

• #65 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #66

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  The risk of the following obstetric complications is increased when polyhydramnios is present due to over-expansion of the uterus: maternal dyspnea, preterm labor, premature rupture of membranes, abnormal fetal presentation, umbilical cord prolapse, postpartum hemorrhage, fetal macrosomia due to maternal diabetes mellitus, hypertensive disorders of pregnancy, urinary tract infections. […] These risks vary depending on the severity and etiology of the polyhydramnios. […] A prospective longitudinal study of normal singleton pregnancies lists the following potential complications: higher rates of cesarean sections for fetal indications, higher rates of admission to neonatal intensive care units, higher birth weight, lower 5-minute Apgar scores. […] In a large study of 85000 pregnancies, of which 3900 pregnancies had an increased AFI, it was found that polyhydramnios was an independent risk factor for perinatal mortality.

• #67 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #68 Polyhydramnios – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/polyhydramnios

  Polyhydramnios is excessive amniotic fluid; it is associated with maternal and fetal complications. Diagnosis is by ultrasonographic measurement of amniotic fluid volume. Management is by treating maternal disorders contributing to polyhydramnios. If symptoms are severe or if painful preterm contractions occur, treatment may also include manual reduction of amniotic fluid volume. […] With polyhydramnios, risk of the following complications is increased: Preterm contractions and possibly prelabor rupture of membranes (sometimes followed by placental abruption) or preterm labor, Fetal malposition, Maternal respiratory compromise, Umbilical cord prolapse, Uterine atony, Postpartum hemorrhage, Fetal death (risk is increased even when polyhydramnios is idiopathic). […] Polyhydramnios is usually suspected based on ultrasonographic findings or uterine size that is larger than expected for dates. However, qualitative estimates of amniotic fluid volume tend to be subjective. So if polyhydramnios is suspected, amniotic fluid should be assessed quantitatively using the amniotic fluid index (AFI) or single deepest pocket (SDP).

• #69 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #70

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  The risk of the following obstetric complications is increased when polyhydramnios is present due to over-expansion of the uterus: maternal dyspnea, preterm labor, premature rupture of membranes, abnormal fetal presentation, umbilical cord prolapse, postpartum hemorrhage, fetal macrosomia due to maternal diabetes mellitus, hypertensive disorders of pregnancy, urinary tract infections. […] These risks vary depending on the severity and etiology of the polyhydramnios. […] A prospective longitudinal study of normal singleton pregnancies lists the following potential complications: higher rates of cesarean sections for fetal indications, higher rates of admission to neonatal intensive care units, higher birth weight, lower 5-minute Apgar scores. […] In a large study of 85000 pregnancies, of which 3900 pregnancies had an increased AFI, it was found that polyhydramnios was an independent risk factor for perinatal mortality.

• #71 Obstetric and neonatal outcomes in pregnant women with idiopathic polyhydramnios: a systematic review and meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-024-54840-0

  The findings of this meta-analysis suggest that pregnant women with idiopathic polyhydramnios may be at increased risk of perinatal complications including preterm delivery, labour induction, placental abruption, shoulder dystocia, delivery via caesarean section, and postpartum haemorrhage. Additionally, our analysis showed that idiopathic polyhydramnios may potentially increase the risk of adverse perinatal outcomes including low 1-min and 5-min APGAR scores, stillbirth and perinatal mortality. These results should be interpreted with caution due to the high heterogeneity observed in the majority of studied outcomes affecting the overall quality of evidence. […] The findings of this meta-analysis suggest that pregnant women with idiopathic polyhydramnios may be at increased risk of perinatal complications and adverse neonatal outcomes. However, the quality of evidence for the majority of the studied outcomes ranged from very low to low; as such, the data remain inconclusive.

• #72 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #73

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  Polyhydramnios is defined as a pathological increase of amniotic fluid volume in pregnancy and is associated with increased perinatal morbidity and mortality. […] The reported prevalence of polyhydramnios ranges from 0.2 to 1.6% of all pregnancies. […] The diagnosis is obtained by ultrasound. […] The prognosis of polyhydramnios depends on its cause and severity. […] Typical symptoms of polyhydramnios include maternal dyspnea, preterm labor, premature rupture of membranes (PPROM), abnormal fetal presentation, cord prolapse and postpartum hemorrhage. […] Due to its common etiology with gestational diabetes, polyhydramnios is often associated with fetal macrosomia. […] In the German Maternity Guidelines, assessment of amniotic fluid is a standard examination in prenatal care. Oligohydramnios and polyhydramnios are considered indicative of a developmental disorder.

• #74 Polyhydramnios | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/polyhydramnios

  Polyhydramnios happens when there is too much amniotic fluid around your baby during pregnancy. […] Having too much fluid can affect how your baby develops. […] Your health care provider may notice this condition during an ultrasound. […] Polyhydramnios may increase the risk of these problems during pregnancy: Preterm birth Birth before 37 weeks of pregnancy, Premature rupture of the membranes (PROM) When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts, Placental abruption When the placenta partially or completely peels away from the wall of the uterus before birth, Stillbirth When a baby dies in the womb after 20 weeks of pregnancy, Postpartum hemorrhage Heavy bleeding after having a baby, Fetal malposition When a baby is not in a head-down position and may need to be born via Cesarean section, Severe breathing problems during pregnancy, Uterine atony When the uterus becomes stretched out and can’t contract normally, Bleeding after delivery, Prolapsed umbilical cord When the umbilical cord comes out of the vagina before the baby, Macrosomia When the baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth, Shoulder dystocia A birth injury that happens when one or both of a baby’s shoulders get stuck inside the pelvis during labor, Birth defects, including problems with the baby’s bones and genetic conditions.

• #75

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  The risk of the following obstetric complications is increased when polyhydramnios is present due to over-expansion of the uterus: maternal dyspnea, preterm labor, premature rupture of membranes, abnormal fetal presentation, umbilical cord prolapse, postpartum hemorrhage, fetal macrosomia due to maternal diabetes mellitus, hypertensive disorders of pregnancy, urinary tract infections. […] These risks vary depending on the severity and etiology of the polyhydramnios. […] A prospective longitudinal study of normal singleton pregnancies lists the following potential complications: higher rates of cesarean sections for fetal indications, higher rates of admission to neonatal intensive care units, higher birth weight, lower 5-minute Apgar scores. […] In a large study of 85000 pregnancies, of which 3900 pregnancies had an increased AFI, it was found that polyhydramnios was an independent risk factor for perinatal mortality.

• #76 Obstetric and neonatal outcomes in pregnant women with idiopathic polyhydramnios: a systematic review and meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-024-54840-0

  The findings of this meta-analysis suggest that pregnant women with idiopathic polyhydramnios may be at increased risk of perinatal complications including preterm delivery, labour induction, placental abruption, shoulder dystocia, delivery via caesarean section, and postpartum haemorrhage. Additionally, our analysis showed that idiopathic polyhydramnios may potentially increase the risk of adverse perinatal outcomes including low 1-min and 5-min APGAR scores, stillbirth and perinatal mortality. These results should be interpreted with caution due to the high heterogeneity observed in the majority of studied outcomes affecting the overall quality of evidence. […] The findings of this meta-analysis suggest that pregnant women with idiopathic polyhydramnios may be at increased risk of perinatal complications and adverse neonatal outcomes. However, the quality of evidence for the majority of the studied outcomes ranged from very low to low; as such, the data remain inconclusive.

• #77

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  The risk of the following obstetric complications is increased when polyhydramnios is present due to over-expansion of the uterus: maternal dyspnea, preterm labor, premature rupture of membranes, abnormal fetal presentation, umbilical cord prolapse, postpartum hemorrhage, fetal macrosomia due to maternal diabetes mellitus, hypertensive disorders of pregnancy, urinary tract infections. […] These risks vary depending on the severity and etiology of the polyhydramnios. […] A prospective longitudinal study of normal singleton pregnancies lists the following potential complications: higher rates of cesarean sections for fetal indications, higher rates of admission to neonatal intensive care units, higher birth weight, lower 5-minute Apgar scores. […] In a large study of 85000 pregnancies, of which 3900 pregnancies had an increased AFI, it was found that polyhydramnios was an independent risk factor for perinatal mortality.

• #78 Too Much Amniotic Fluid: Should I Be Concerned About Polyhydramnios?

  https://www.healthline.com/health/pregnancy/too-much-amniotic-fluid

  Polyhydramnios is a condition where a woman simply has too much amniotic fluid during her pregnancy. […] Polyhydramnios is estimated to occur in only about 1 to 2 percent of pregnancies. […] Fetal abnormalities are the most worrisome causes of polyhydramnios, but luckily, theyre also the least common. […] You should also keep in mind that even with ultrasound testing, 100 percent accurate diagnosis may not be completely possible. There are associations between an elevated AFI and poor outcomes for your baby. These can include: increased risk for preterm delivery, increased risk for admission to the neonatal intensive care unit (NICU). […] The risks of polyhydramnios will vary based on how far along you are in your pregnancy and how severe the condition is. In general, the more severe the polyhydramnios, the higher the risk of complications during pregnancy or delivery.

• #79 Obstetric and neonatal outcomes in pregnant women with idiopathic polyhydramnios: a systematic review and meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-024-54840-0

  The findings of this meta-analysis suggest that pregnant women with idiopathic polyhydramnios may be at increased risk of perinatal complications including preterm delivery, labour induction, placental abruption, shoulder dystocia, delivery via caesarean section, and postpartum haemorrhage. Additionally, our analysis showed that idiopathic polyhydramnios may potentially increase the risk of adverse perinatal outcomes including low 1-min and 5-min APGAR scores, stillbirth and perinatal mortality. These results should be interpreted with caution due to the high heterogeneity observed in the majority of studied outcomes affecting the overall quality of evidence. […] The findings of this meta-analysis suggest that pregnant women with idiopathic polyhydramnios may be at increased risk of perinatal complications and adverse neonatal outcomes. However, the quality of evidence for the majority of the studied outcomes ranged from very low to low; as such, the data remain inconclusive.

• #80 Obstetric and neonatal outcomes in pregnant women with idiopathic polyhydramnios: a systematic review and meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-024-54840-0

  The findings of this meta-analysis suggest that pregnant women with idiopathic polyhydramnios may be at increased risk of perinatal complications including preterm delivery, labour induction, placental abruption, shoulder dystocia, delivery via caesarean section, and postpartum haemorrhage. Additionally, our analysis showed that idiopathic polyhydramnios may potentially increase the risk of adverse perinatal outcomes including low 1-min and 5-min APGAR scores, stillbirth and perinatal mortality. These results should be interpreted with caution due to the high heterogeneity observed in the majority of studied outcomes affecting the overall quality of evidence. […] The findings of this meta-analysis suggest that pregnant women with idiopathic polyhydramnios may be at increased risk of perinatal complications and adverse neonatal outcomes. However, the quality of evidence for the majority of the studied outcomes ranged from very low to low; as such, the data remain inconclusive.

• #81 Amniotic Fluid Volume in Fetal Health and Disease | Article | GLOWM

  https://www.glowm.com/article/heading/vol-18–ultrasound-in-obstetrics–amniotic-fluid-volume-in-fetal-health-and-disease/id/419193

  The prevalence of polyhydramnios is 12% with 5060% of those cases being idiopathic. Idiopathic polyhydramnios has been linked in a review of cases between 1950 and 2007 with macrosomia and 25-fold increase in the risk of perinatal mortality. A more recent systematic review and meta-analysis compared 2392 women with idiopathic polyhydramnios with 160,135 controls. The pregnancies with idiopathic polyhydramnios had higher odd ratios (OR) of neonatal death (OR 8.68; 95% CI 2.9125.87), intrauterine fetal demise (OR 7.64; 95% CI 2.5023.38), newborn intensive care unit admission (OR 1.94; 95% CI 1.452.59), 5 minute Apgar score 7 (OR 2.21; 95% CI 1.343.62), macrosomia (OR 2.93; 95%CI 2.393.59), and cesarean delivery (OR 2.31; 95% CI 1.792.99). […] Treatment of polyhydramnios is not typically pursued. This may be related to a lack of treatment options that demonstrate long-term benefit and low risk. Amnioreduction is currently the only known way to acutely decrease the amount of amniotic fluid, but it is associated with risks of preterm labor, preterm delivery, placental abruption, preterm prelabor rupture of membranes, chorioamnionitis, and IUFD. Additionally, around 50% of patients need multiple treatments, potentially increasing these risks.

• #82 Polyhydramnios in Pregnancy: Too Much Amniotic Fluid in the Third Trimester | Know Polyhydramnios

  https://polyhydramnios.org/learn-more-about-polyhydramnios/polyhydramnios-in-pregnancy/

  61% of cases are considered idiopathic at the time of delivery. […] Pediatric support should be made available to every baby affected by a Polyhydramnios pregnancy, even if there has not been an antenatal diagnosis of a genetic anomaly. The risk of finding a previously undiagnosed anomaly in these babies is 9% during the immediate neonatal period, and as high as 28% up to one year later.

• #83 Evaluation and management of polyhydramnios

  https://www.contemporaryobgyn.net/view/evaluation-and-management-polyhydramnios

  Idiopathic polyhydramnios is a diagnosis of exclusion. While the cause may be unexplained during pregnancy, the underlying risk that a structural or genetic abnormality is identified after birth in a pregnancy associated with apparently idiopathic polyhydramnios is 9% in the neonatal period to as high as 28% when infants were followed up to age 1 year. […] Likelihood of an underlying fetal abnormality is significantly higher with greater degrees of polyhydramnios, and progression of the condition is suggestive of an underlying etiology. In pregnancies with an identified underlying etiology, the degree of polyhydramnios is associated with an increased likelihood of preterm birth (PTB), a small-for-gestational age infant, macrosomia, and perinatal mortality. […] Rates of PTB are not generally increased with idiopathic polyhydramnios (which is usually mild) but PTB is associated with more severe polyhydramnios. […] Planning for care of the neonate is necessary in cases of polyhydramnios. As noted previously, there is an increased rate of structural abnormalities or genetic syndromes in the neonate following a gestation complicated by polyhydramnios.

• #84 Polyhydramnios in Pregnancy: Too Much Amniotic Fluid in the Third Trimester | Know Polyhydramnios

  https://polyhydramnios.org/learn-more-about-polyhydramnios/polyhydramnios-in-pregnancy/

  61% of cases are considered idiopathic at the time of delivery. […] Pediatric support should be made available to every baby affected by a Polyhydramnios pregnancy, even if there has not been an antenatal diagnosis of a genetic anomaly. The risk of finding a previously undiagnosed anomaly in these babies is 9% during the immediate neonatal period, and as high as 28% up to one year later.

• #85 Evaluation and management of polyhydramnios

  https://www.contemporaryobgyn.net/view/evaluation-and-management-polyhydramnios

  Idiopathic polyhydramnios is a diagnosis of exclusion. While the cause may be unexplained during pregnancy, the underlying risk that a structural or genetic abnormality is identified after birth in a pregnancy associated with apparently idiopathic polyhydramnios is 9% in the neonatal period to as high as 28% when infants were followed up to age 1 year. […] Likelihood of an underlying fetal abnormality is significantly higher with greater degrees of polyhydramnios, and progression of the condition is suggestive of an underlying etiology. In pregnancies with an identified underlying etiology, the degree of polyhydramnios is associated with an increased likelihood of preterm birth (PTB), a small-for-gestational age infant, macrosomia, and perinatal mortality. […] Rates of PTB are not generally increased with idiopathic polyhydramnios (which is usually mild) but PTB is associated with more severe polyhydramnios. […] Planning for care of the neonate is necessary in cases of polyhydramnios. As noted previously, there is an increased rate of structural abnormalities or genetic syndromes in the neonate following a gestation complicated by polyhydramnios.

• #86 Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2412-6

  In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes. […] We identified 305/18,640 (1.6%) cases of polyhydramnios. 229 (75%) cases were from the DRC, with an incidence of 10%. A higher percentage of women with polyhydramnios experienced obstructed labor (7% vs 4%) and fetal malposition (4% vs 2%). Neonatal death was more common when polyhydramnios was present (OR 2.43; CI 1.15, 5.13). […] Polyhydramnios occurred in these low and low-middle income countries at a rate similar to high-income countries except in the DRC where the incidence was 10%. Polyhydramnios was associated with obstructed labor, fetal malposition, and neonatal death.

• #87 Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2412-6

  In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes. […] We identified 305/18,640 (1.6%) cases of polyhydramnios. 229 (75%) cases were from the DRC, with an incidence of 10%. A higher percentage of women with polyhydramnios experienced obstructed labor (7% vs 4%) and fetal malposition (4% vs 2%). Neonatal death was more common when polyhydramnios was present (OR 2.43; CI 1.15, 5.13). […] Polyhydramnios occurred in these low and low-middle income countries at a rate similar to high-income countries except in the DRC where the incidence was 10%. Polyhydramnios was associated with obstructed labor, fetal malposition, and neonatal death.

• #88 Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2412-6

  The incidence of polyhydramnios ranged from 0.3% in Guatemala to 10% in DRC. Of the women identified with polyhydramnios, 229 (75%) were from the DRC. […] In a multivariable regression model, adjusting for age, parity, previous live birth and controlling for cluster level effects, the odds ratio for neonatal death in pregnancies that were complicated by polyhydramnios was 2.43 (1.15, 5.13). […] Polyhydramnios was associated with a higher mean birthweight at delivery (3082g vs 2979g), although this was not significant in the final model. […] By demonstrating a high incidence of polyhydramnios in the DRC, we identify a critical gap in knowledge about the etiology of polyhydramnios and the site specific risk factors that contribute. Also, given the high rate of polyhydramnios, and the association with fetal malposition and obstructed labor, this represents an important public health problem. […] This study identified the incidence of polyhydramnios in LMICs, and confirmed its association with adverse pregnancy outcomes and neonatal mortality. We identified a high incidence of polyhydramnios in the DRC compared to other LMICs.

• #89 Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2412-6

  In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes. […] We identified 305/18,640 (1.6%) cases of polyhydramnios. 229 (75%) cases were from the DRC, with an incidence of 10%. A higher percentage of women with polyhydramnios experienced obstructed labor (7% vs 4%) and fetal malposition (4% vs 2%). Neonatal death was more common when polyhydramnios was present (OR 2.43; CI 1.15, 5.13). […] Polyhydramnios occurred in these low and low-middle income countries at a rate similar to high-income countries except in the DRC where the incidence was 10%. Polyhydramnios was associated with obstructed labor, fetal malposition, and neonatal death.

• #90 Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2412-6

  The incidence of polyhydramnios ranged from 0.3% in Guatemala to 10% in DRC. Of the women identified with polyhydramnios, 229 (75%) were from the DRC. […] In a multivariable regression model, adjusting for age, parity, previous live birth and controlling for cluster level effects, the odds ratio for neonatal death in pregnancies that were complicated by polyhydramnios was 2.43 (1.15, 5.13). […] Polyhydramnios was associated with a higher mean birthweight at delivery (3082g vs 2979g), although this was not significant in the final model. […] By demonstrating a high incidence of polyhydramnios in the DRC, we identify a critical gap in knowledge about the etiology of polyhydramnios and the site specific risk factors that contribute. Also, given the high rate of polyhydramnios, and the association with fetal malposition and obstructed labor, this represents an important public health problem. […] This study identified the incidence of polyhydramnios in LMICs, and confirmed its association with adverse pregnancy outcomes and neonatal mortality. We identified a high incidence of polyhydramnios in the DRC compared to other LMICs.

• #91

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  Monitoring of Pregnancies with Polyhydramnios: In view of the increased perinatal mortality and morbidity associated with pregnancies with polyhydramnios, careful monitoring is recommended. […] There are no prospective randomized studies comparing expectant management to active intervention in idiopathic polyhydramnios. […] Polyhydramnios diagnosed on ultrasound requires further maternal and fetal diagnostic tests.

• #92 Polyhydramnios – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/polyhydramnios/

  Refer patients with polyhydramnios to maternal-fetal medicine for further evaluation and management, which may include the following: Evaluation for causes of polyhydramnios and fetal complications of polyhydramnios. […] Management is individualized based on the severity of polyhydramnios, underlying cause, and any associated complications. […] Fetal complications include intrauterine fetal demise, intrauterine growth restriction, and macrosomia.

• #93 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Investigations: […] Detailed ultrasound examination. […] Invasive testing for karyotyping and array if there are fetal abnormalities or growth restriction. DNA testing for the myotonic dystrophy mutation if there is abnormal posturing of the extremities. […] Glucose tolerance test if there is associated macrosomia. […] TORCH test if there are fetal features suggestive of infection. […] Follow up: […] Ultrasound scans every 1-3 weeks to monitor fetal condition, amniotic fluid volume and cervical length. […] Prenatal therapy: […] Maternal diabetes mellitus: good glycemic control. […] Hydrops due to dysrhythmias: antiarrhythmic medication. […] Hydrops due to fetal anemia: intrauterine blood transfusion. […] Pulmonary cysts or pleural effusions: thoracoamniotic shunting.

• #94 Polyhydramnios – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/polyhydramnios/

  Refer patients with polyhydramnios to maternal-fetal medicine for further evaluation and management, which may include the following: Evaluation for causes of polyhydramnios and fetal complications of polyhydramnios. […] Management is individualized based on the severity of polyhydramnios, underlying cause, and any associated complications. […] Fetal complications include intrauterine fetal demise, intrauterine growth restriction, and macrosomia.

• #95 polyhydramnios Archives – The ObG Project

  https://www.obgproject.com/tag/polyhydramnios/

  The term polyhydramnios, also known as hydramnios, refers to an excessive amount of amniotic fluid. The overall incidence is 0.2-2.0 % of pregnancies […] More common in twins, likely due to complications of monochorionic placentation. Idiopathic polyhydramnios will occur in approximately 1% of pregnancies. Causes of polyhydramnios are many and account for varying percentages of cases: Idiopathic polyhydramnios (50-60%) […] Congenital anomalies and genetic disorders (8-45%) […] Maternal diabetes (5-26%) […] Multiple gestation (8-10%) […] Fetal anemia (1-11%). Increasing severity of polyhydramnios correlates with an increased risk of perinatal mortality and congenital abnormalities. SMFM suggests that “antenatal fetal surveillance is not required for the sole indication of mild idiopathic polyhydramnios” (GRADE 2C).

• #96 Indications for Outpatient Antenatal Fetal Surveillance | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/06/indications-for-outpatient-antenatal-fetal-surveillance

  The degree of polyhydramnios is frequently categorized as mild, moderate, or severe, based on a deepest vertical pocket of 8-11 cm, 12-15 cm, or 16 cm or greater, or an amniotic fluid index of 24.0-29.9 cm, 30.0-34.9 cm, and 35 cm or greater, respectively. The increased risk of fetal mortality associated with polyhydramnios has been attributed to higher incidence of fetal anomalies. However, a retrospective cohort study of nonanomalous births found that the risk of stillbirth in pregnancies complicated by polyhydramnios is 1.14 per 1,000 at 32 weeks, 1.34 per 1,000 at 34 weeks, 1.64 per 1,000 at 36 weeks, and 2.91 per 1,000 at 39 weeks. When adjusted for multiple confounding variables, polyhydramnios remained associated with increased odds of stillbirth (aOR 5.5; 95% CI, 4.1-7.6). The significance persisted after excluding pregnancies with pregestational or gestational diabetes mellitus. The authors concluded that polyhydramnios may warrant increased antenatal surveillance, particularly in the last weeks of pregnancy. For patients with moderate or severe polyhydramnios (deepest vertical pocket equal to or greater than 12 cm or amniotic fluid index equal to or greater than 30 cm), once or twice weekly antenatal fetal surveillance may be considered beginning at 32 0/7 to 34 0/7 weeks of gestation. Absent other indications, antenatal fetal surveillance is not required for mild idiopathic polyhydramnios.

• #97 Polyhydramnios — CREOGS Over Coffee

  https://creogsovercoffee.com/notes/2022/9/25/polyhydramnios

  Polyhydramnios […] Prevalence: can complicate 1-2% of singleton gestations, but it is more common in twin gestations, primarily due to complications of monochorionic placentation […] […] Most mild polyhydramnios is idiopathic or due to T2DM, and only 6-10% risk of fetal anomaly, with 1% of neonatal abnormality […] […] However, with severe poly, there is increased risk of fetal anomaly to as high as 20-40% and even risk of neonatal abnormality of 10% […] […] Therefore, those with severe poly should deliver at tertiary care center due to possibility for fetal anomaly […] […] Currently recommendation from SMFM is that antenatal fetal surveillance is not required for the sole indication of mild idiopathic poly […] […] Similarly, recommendation is that labor should be allowed to occur spontaneously at term for women with mild idiopathic poly, and that induction, if planned, should not occur at 39 weeks of gestation in the absence of other indications […] […] Most of delivery should be determined based on usual obstetric indications.

• #98 Indications for Outpatient Antenatal Fetal Surveillance | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/06/indications-for-outpatient-antenatal-fetal-surveillance

  The degree of polyhydramnios is frequently categorized as mild, moderate, or severe, based on a deepest vertical pocket of 8-11 cm, 12-15 cm, or 16 cm or greater, or an amniotic fluid index of 24.0-29.9 cm, 30.0-34.9 cm, and 35 cm or greater, respectively. The increased risk of fetal mortality associated with polyhydramnios has been attributed to higher incidence of fetal anomalies. However, a retrospective cohort study of nonanomalous births found that the risk of stillbirth in pregnancies complicated by polyhydramnios is 1.14 per 1,000 at 32 weeks, 1.34 per 1,000 at 34 weeks, 1.64 per 1,000 at 36 weeks, and 2.91 per 1,000 at 39 weeks. When adjusted for multiple confounding variables, polyhydramnios remained associated with increased odds of stillbirth (aOR 5.5; 95% CI, 4.1-7.6). The significance persisted after excluding pregnancies with pregestational or gestational diabetes mellitus. The authors concluded that polyhydramnios may warrant increased antenatal surveillance, particularly in the last weeks of pregnancy. For patients with moderate or severe polyhydramnios (deepest vertical pocket equal to or greater than 12 cm or amniotic fluid index equal to or greater than 30 cm), once or twice weekly antenatal fetal surveillance may be considered beginning at 32 0/7 to 34 0/7 weeks of gestation. Absent other indications, antenatal fetal surveillance is not required for mild idiopathic polyhydramnios.

• #99

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3964358/

  Polyhydramnios is defined as a pathological increase of amniotic fluid volume in pregnancy and is associated with increased perinatal morbidity and mortality. […] The reported prevalence of polyhydramnios ranges from 0.2 to 1.6% of all pregnancies. […] The diagnosis is obtained by ultrasound. […] The prognosis of polyhydramnios depends on its cause and severity. […] Typical symptoms of polyhydramnios include maternal dyspnea, preterm labor, premature rupture of membranes (PPROM), abnormal fetal presentation, cord prolapse and postpartum hemorrhage. […] Due to its common etiology with gestational diabetes, polyhydramnios is often associated with fetal macrosomia. […] In the German Maternity Guidelines, assessment of amniotic fluid is a standard examination in prenatal care. Oligohydramnios and polyhydramnios are considered indicative of a developmental disorder.

• #100 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/amniotic-fluid/polyhydramnios

  Investigations: […] Detailed ultrasound examination. […] Invasive testing for karyotyping and array if there are fetal abnormalities or growth restriction. DNA testing for the myotonic dystrophy mutation if there is abnormal posturing of the extremities. […] Glucose tolerance test if there is associated macrosomia. […] TORCH test if there are fetal features suggestive of infection. […] Follow up: […] Ultrasound scans every 1-3 weeks to monitor fetal condition, amniotic fluid volume and cervical length. […] Prenatal therapy: […] Maternal diabetes mellitus: good glycemic control. […] Hydrops due to dysrhythmias: antiarrhythmic medication. […] Hydrops due to fetal anemia: intrauterine blood transfusion. […] Pulmonary cysts or pleural effusions: thoracoamniotic shunting.

• #101 Medical Science Monitor | Abnormal amniotic fluid volume as a screening test prior to targeted ultrasound – Article abstract #13391

  https://medscimonit.com/abstract/index/idArt/13391

  Background:The purpose of this study was to examine (1) the association between amniotic fluid volume (AFV) and sonographically detected fetal structural anomalies, and (2) the effectiveness of using abnormal AFV as a screening test prior to patient referral for a targeted ultrasound. […] Results:15,959 (92.0%) of patients had normal amniotic fluid volume, 537 (3.1%) decreased, 544 (3.1%) increased, 167 (1.0%) oligohydramnios, and 141 (0.8%) polyhydramnios. […] Anomalies were significantly more frequent in all categories of abnormal fluid: decreased (3.2%, OR 1.74, 95% CI 1.062.86), increased (5.7%, OR 3.22, 95% CI 2.24.71), oligohydramnios (9.0%, OR 5.26, 95% CI 3.099.05), and polyhydramnios (5.7%, OR 3.21, 95% CI 1.566.6). […] Referral for targeted ultrasound based on any abnormal AFV volume compared to only oligohydramnios or polyhydramnios increased the overall anomaly detection rate by nearly three-fold (19.5% vs. 6.3%), with minimal changes in the number of referrals per anomaly detected (13.4 vs. 19.6). […] Conclusions:Referral for targeted ultrasound in the presence of even minor abnormalities of amniotic fluid would significantly improve anomaly detection with minimal increase in referrals.

• #102 Polyhydramnios – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polyhydramnios/symptoms-causes/syc-20368493

  Polyhydramnios happens in about 1% to 2% of pregnancies. […] Most of the time, the condition is mild. It’s often found during the middle or later stages of pregnancy. […] If you learn that you have polyhydramnios, your health care team carefully tracks your pregnancy to help prevent health problems. […] Risk factors for polyhydramnios include certain conditions that develop during pregnancy, such as gestational diabetes. […] Greater health problems usually are linked with severe polyhydramnios.

• #103 Polyhydramnios: Etiology, diagnosis, and management in singleton gestations – UpToDate

  https://www.uptodate.com/contents/polyhydramnios-etiology-diagnosis-and-management

  Polyhydramnios (also known as hydramnios) refers to an excessive volume of amniotic fluid. It should be suspected clinically when uterine size is large for gestational age (fundal height [cm] that exceeds the weeks of gestation by >3). Prenatal diagnosis is based upon documentation of excessive amniotic fluid volume (AFV) by a quantitative ultrasound technique, such as amniotic fluid index (AFI) ≥24 cm or single deepest pocket (SDP) ≥8 cm. […] The incidence of polyhydramnios in a general obstetric population generally ranges from 1 to 2 percent. Reported rates are highly influenced by the gestational age at the time of the ultrasound examination (higher preterm, lower postterm), the population studied (low or high risk, screening or indicated ultrasound examination, antepartum or intrapartum), and variations in diagnostic criteria (use of amniotic fluid index [AFI] versus single deepest pocket [SDP]). […] In a series including over 93,000 singleton pregnancies over six years at a single hospital, polyhydramnios was diagnosed during prenatal sonography in 0.7 percent and was described as mild, moderate, or severe in 66, 22, and 12 percent of cases, respectively.

• #104 What Can I Do About High Amniotic Fluid Levels? | ParentData by Emily Osterframe_1-svgframe_2-svgframe_3-svg

  https://parentdata.org/what-can-i-do-about-high-amniotic-fluid-levels/

  Polyhydramnios is a condition in which there is excess amniotic fluid (in contrast to oligohydramnios, which is not enough fluid). Polyhydramnios is generally classified as mild, moderate, or severe. The overall incidence is 1% to 2%. […] In about 40% of cases, the condition is idiopathic, basically meaning it seems to occur without any other reason. In the other 60%, it is associated with another fetal condition — for example, a genetic disorder (trisomy 18 or 21) or a fetal abnormality that impedes swallowing — or with a maternal condition (often, diabetes). […] For idiopathic cases, there are some elevated risks, both to you and the baby. This includes preterm birth and neonatal complications like a low Apgar score. Although it’s very rare, stillbirth risk is elevated.

• #105 Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2412-6

  The incidence of polyhydramnios ranged from 0.3% in Guatemala to 10% in DRC. Of the women identified with polyhydramnios, 229 (75%) were from the DRC. […] In a multivariable regression model, adjusting for age, parity, previous live birth and controlling for cluster level effects, the odds ratio for neonatal death in pregnancies that were complicated by polyhydramnios was 2.43 (1.15, 5.13). […] Polyhydramnios was associated with a higher mean birthweight at delivery (3082g vs 2979g), although this was not significant in the final model. […] By demonstrating a high incidence of polyhydramnios in the DRC, we identify a critical gap in knowledge about the etiology of polyhydramnios and the site specific risk factors that contribute. Also, given the high rate of polyhydramnios, and the association with fetal malposition and obstructed labor, this represents an important public health problem. […] This study identified the incidence of polyhydramnios in LMICs, and confirmed its association with adverse pregnancy outcomes and neonatal mortality. We identified a high incidence of polyhydramnios in the DRC compared to other LMICs.

• #106 Amniotic fluid volume: When and how to take action

  https://www.contemporaryobgyn.net/view/amniotic-fluid-volume-when-and-how-take-action

  The incidence of polyhydramnios ranges from 1% to 2%. Idiopathic polyhydramnios is most commonly mild (55%). Causes of polyhydramnios include uncontrolled maternal diabetes; large-for-gestational-age fetus or birth weight 90th percentile; movement disorders (neuromuscular disorders) that affect fetal amniotic fluid swallowing; and multiple gestations (most commonly in the context of twin-twin transfusion syndrome, associated with oligohydramnios in the co-twin). […] Polyhydramnios is associated with increased risk of adverse pregnancy outcomes (in addition to associated morphologic abnormalities): maternal respiratory compromise, preterm PROM, preterm delivery, preeclampsia (mirror syndrome), fetal malpresentation, macrosomia, umbilical cord prolapse, abruption upon rupture of membranes, postpartum uterine atony. These complications increase the risk of cesarean delivery and neonatal intensive care admission. Overall perinatal mortality in isolated polyhydramnios is increased 2- to 5-fold compared to pregnancies with normal AF.

• #107

  https://journals.lww.com/obgynsurvey/Fulltext/2014/12000/Polyhydramnios_and_Adverse_Perinatal_Outcome__.1.aspx?generateEpub=Article%7Cobgynsurvey:2014:12000:00001%7C10.1097/ogx.0000000000000136%7C

  Polyhydramnios complicates 1% to 3% of all pregnancies, and approximately 50% to 60% of cases are idiopathic. […] Polyhydramnios is subdivided into mild (2430), moderate (30.135), and severe (AFI 35). […] A significantly increased rate of perinatal mortality was noted as AFI increased. […] The main finding of the study is the increased adverse perinatal outcome as AFI rises in a dose-response manner from AFI of greater than 20. […] The widely accepted cutoff for polyhydramnios is AFI of greater than 24, with established associations between polyhydramnios and adverse perinatal outcomes. […] The accepted definition of polyhydramnios as AFI of greater than 24 should be further reevaluated.

• #108 Foods to Eat to Reduce Amniotic Fluid During Pregnancy | Tata AIG

  https://www.tataaig.com/knowledge-center/health-insurance/foods-to-reduce-amniotic-fluid-during-pregnancy

  Polyhydramnios, also known as hydramnios, arises when the amniotic fluid index falls within the 20 24 range, indicating an elevated level of amniotic fluid. This surplus fluid, although typically benign, marginally elevates the likelihood of pregnancy and delivery complications. […] Polyhydramnios can occur due to various reasons, including foetal anomalies (such as gastrointestinal obstructions or central nervous system disorders), maternal diabetes, twin pregnancies, or foetal anaemia. It is associated with an increased risk of complications in the baby, such as premature rupture of membranes, preterm labour, placental abruption, and postpartum haemorrhage. […] Diagnosing and managing abnormalities in amniotic fluid volume requires a multidisciplinary approach involving obstetricians, maternal-foetal medicine specialists, and neonatologists. Healthcare providers can assess for polyhydramnios by evaluating the largest single pocket of amniotic fluid surrounding the foetus, known as the maximum vertical pocket (MVP). Alternatively, they may conduct a measurement of amniotic fluid across the four quadrants of the uterus, known as the amniotic fluid index (AFI). […] Although most women with polyhydramnios experience an uneventful pregnancy and deliver a healthy baby, there is a slightly heightened risk of pregnancy and delivery complications.

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