Materiały źródłowe

• #1 Polyhydramnios – Symptoms and causes – Mayo Clinic

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

  Polyhydramnios, increased levels of amniotic fluid accumulates in the uterus during pregnancy. […] Polyhydramnios happens in about 1% to 2% of pregnancies. […] Some of the known causes of polyhydramnios include conditions that affect the baby’s digestive tract, central nervous system or certain other organs. […] Often, the cause of polyhydramnios isn’t clear, especially when the condition is mild. […] Greater health problems usually are linked with severe polyhydramnios.

• #2 Polyhydramnios (too much amniotic fluid)

  https://www.nhs.uk/conditions/polyhydramnios/

  Polyhydramnios is when there’s too much amniotic fluid (the fluid that surrounds the baby in the womb) during pregnancy. […] The cause of polyhydramnios (too much amniotic fluid) is often unknown. […] Some possible causes include: diabetes during pregnancy (gestational diabetes), being pregnant with more than 1 baby, an infection during pregnancy, a problem with your baby swallowing, your baby having a genetic condition. […] Polyhydramnios (too much amniotic fluid) usually does not need any treatment. […] If the polyhydramnios is caused by a condition such as gestational diabetes, you’ll be treated for the condition. […] Complications of polyhydramnios (too much amniotic fluid) are rare. […] Rarely, in more severe cases, complications can include: your waters breaking early, placental abruption, umbilical cord prolapse, your baby being born prematurely, your baby having a low birth weight.

• #3 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 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: […] Reduced fetal swallowing: due to brain abnormalities (e.g anencephaly, Dandy-Walker malformation), facial tumors, gastrointestinal obstruction (e.g. esophageal or duodenal atresia, small bowel obstruction), compressive pulmonary disorders (e.g. pleural effusions, diaphragmatic hernia, CPAM, CHAOS), narrow thoracic cage due to skeletal dysplasias), and fetal akinesia deformation sequence (due to neuromuscular impairment of fetal swallowing). […] Increased fetal urination: maternal diabetes mellitus and maternal uremia (increased glucose and urea cause osmotic diuresis), hyperdynamic fetal circulation due to fetal anemia (e.g. red blood cell isoimmunization or congenital infection), fetal and placental tumors (e.g. sacrococcygeal teratoma, placental chorioangioma), or twin-to-twin transfusion syndrome.

• #4 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. […] Polyhydramnios can be idiopathic or related to a variety of maternal and fetal disorders. Potential consequences include increased risks for preterm birth, fetal malposition, placental abruption, and cord prolapse. […] 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]).

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

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

  Polyhydramnios means theres too much amniotic fluid in your uterus during pregnancy. A mild case of polyhydramnios may not cause any symptoms or problems, but more severe forms may require treatment. […] Polyhydramnios is when you have too much amniotic fluid during pregnancy. Amniotic fluid plays a significant role in the fetus’s growth and development. […] This condition usually happens in the second half of pregnancy, but it may occur as early as 16 weeks into pregnancy. […] For most people (especially people with mild cases), the cause of polyhydramnios is unknown. […] Moderate to severe polyhydramnios could be caused by the following: The fetus cant swallow amniotic fluid due to a congenital disorder. […] Polyhydramnios is generally not treated if its a mild case or if youre at the end of your pregnancy.

• #6 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Polyhydramnios, or hydramnios, is defined as an excessive volume of amniotic fluid relative to the gestational age. Polyhydramnios may be acute or chronic. Acute polyhydramnios is usually a fulminant second-trimester process, with fluid accumulating rapidly over a period of a few days. Chronic polyhydramnios has a more gradual onset and course, often presenting in the third trimester. The incidence varies, depending on whether the diagnosis is clinical or sonographic. Overall, polyhydramnios complicates approximately 0.31.6% of all pregnancies. Chronic polyhydramnios is more frequent, exceeding the incidence of acute polyhydramnios by a 50: 1 ratio. […] Risk factors for polyhydramnios may be broadly divided into maternal, fetal, placental and idiopathic origins. Diabetes mellitus is the most common maternal factor, occurring in approximately 25% of cases. The exact mechanism for polyhydramnios with diabetes is unclear. It may represent fetal polyuria secondary to fetal hyperglycemia. However, van Otterlo and colleagues, measuring fetal urinary output by ultrasonography, found no increase in urine output in 12 of 13 diabetic pregnancies complicated by polyhydramnios. Alternatively, fetal glycosuria may lead to an increase in amniotic fluid osmolality, resulting in water transfer from the fetal compartment to maintain osmolar equilibrium.

• #7 Polyhydramnios – StatPearls – NCBI Bookshelf

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

  Polyhydramnios is a pathological condition characterized by an excess of amniotic fluid associated with increased rates of maternal and neonatal morbidity and mortality. This condition develops when the mechanisms regulating amniotic fluid volume are disrupted, most commonly due to excess fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] Polyhydramnios occurs when this equilibrium is disrupted, often due to increased fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] The pathophysiology of polyhydramnios is not fully understood. However, any imbalance in the complex regulatory mechanisms maintaining the amniotic fluid volume can result in polyhydramnios. […] Given that glucose readily crosses the placenta, maternal hyperglycemia leads to fetal hyperglycemia and osmotic diuresis. Fetal urine output also increases in high-output fetal cardiac states, such as severe anemia, arteriovenous shunts, and volume overload. Bartter syndrome is a rare autosomal recessive condition that affects fetal renal tubular function and results in sodium loss and polyuria, often leading to severe polyhydramnios.

• #8 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 primary sources of amniotic fluid are fetal urine production, fetal lung fluid and fetal oral and nasal secretions. The main routes of amniotic fluid removal are fetal swallowing and absorption via the intramembranous pathway. […] 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. […] Idiopathic polyhydramnios is a diagnosis of exclusion. […] At diagnosis, refer for anatomic survey and work up to rule out alloimmunization, congenital infection, diabetes and other causes. […] SMFM recommends against amnioreduction except in the presence of severe polyhydramnios. […] Indomethacin is not recommended for the sole purpose of decreasing amniotic fluid. […] Data to support higher risk for dysfunctional labor and cesarean section.

• #9 Polyhydramnios | Article | GLOWM

  https://www.glowm.com/article/heading/vol-10–common-obstetric-conditions–polyhydramnios/id/409583

  Polyhydramnios (which can be sometimes referred to as hydramnios) is an excessive accumulation of amniotic fluid. Polyhydramnios may be associated with an increased risk of adverse pregnancy outcomes, such as preterm birth, placental abruption and fetal anomalies. The incidence of polyhydramnios ranges between 0.2 and 1.6%, with differences in the reported rates due to variations in diagnostic criteria. Causes of polyhydramnios can be idiopathic (60%; where no fetal or maternal causes can be identified such as in cases of fetal macrosomia not associated with maternal diabetes) or due to maternal or fetal causes. […] The amniotic fluid volume depends on a balance between its production and its removal. In early pregnancy, there is little fetal contribution to the amniotic fluid. Later in pregnancy, the two primary sources of amniotic fluid are the fetal kidneys and lungs. The primary sources of amniotic fluid removal are fetal swallowing and absorption into the fetal blood perfusing the surface of the placenta. The relative contribution of each of these mechanisms varies markedly over the course of the pregnancy. For instance, a fetus close to term will produce between 500 and 1200 ml urine and swallow between 210 and 760 ml of amniotic fluid per day. Even small changes in this equilibrium can result in significant alterations in amniotic fluid volume at this stage which reflects the association between fetal gastrointestinal tract obstruction and severe cases of polyhydramnios.

• #10 Polyhydramnios | Article | GLOWM

  https://www.glowm.com/article/heading/vol-10–common-obstetric-conditions–polyhydramnios/id/409583

  Polyhydramnios (which can be sometimes referred to as hydramnios) is an excessive accumulation of amniotic fluid. Polyhydramnios may be associated with an increased risk of adverse pregnancy outcomes, such as preterm birth, placental abruption and fetal anomalies. The incidence of polyhydramnios ranges between 0.2 and 1.6%, with differences in the reported rates due to variations in diagnostic criteria. Causes of polyhydramnios can be idiopathic (60%; where no fetal or maternal causes can be identified such as in cases of fetal macrosomia not associated with maternal diabetes) or due to maternal or fetal causes. […] The amniotic fluid volume depends on a balance between its production and its removal. In early pregnancy, there is little fetal contribution to the amniotic fluid. Later in pregnancy, the two primary sources of amniotic fluid are the fetal kidneys and lungs. The primary sources of amniotic fluid removal are fetal swallowing and absorption into the fetal blood perfusing the surface of the placenta. The relative contribution of each of these mechanisms varies markedly over the course of the pregnancy. For instance, a fetus close to term will produce between 500 and 1200 ml urine and swallow between 210 and 760 ml of amniotic fluid per day. Even small changes in this equilibrium can result in significant alterations in amniotic fluid volume at this stage which reflects the association between fetal gastrointestinal tract obstruction and severe cases of polyhydramnios.

• #11 Polyhydramnios – StatPearls – NCBI Bookshelf

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

  Polyhydramnios is a pathological condition characterized by an excess of amniotic fluid associated with increased rates of maternal and neonatal morbidity and mortality. This condition develops when the mechanisms regulating amniotic fluid volume are disrupted, most commonly due to excess fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] Polyhydramnios occurs when this equilibrium is disrupted, often due to increased fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] The pathophysiology of polyhydramnios is not fully understood. However, any imbalance in the complex regulatory mechanisms maintaining the amniotic fluid volume can result in polyhydramnios. […] Given that glucose readily crosses the placenta, maternal hyperglycemia leads to fetal hyperglycemia and osmotic diuresis. Fetal urine output also increases in high-output fetal cardiac states, such as severe anemia, arteriovenous shunts, and volume overload. Bartter syndrome is a rare autosomal recessive condition that affects fetal renal tubular function and results in sodium loss and polyuria, often leading to severe polyhydramnios.

• #12 Polyhydramnios – StatPearls – NCBI Bookshelf

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

  Polyhydramnios is a pathological condition characterized by an excess of amniotic fluid associated with increased rates of maternal and neonatal morbidity and mortality. This condition develops when the mechanisms regulating amniotic fluid volume are disrupted, most commonly due to excess fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] Polyhydramnios occurs when this equilibrium is disrupted, often due to increased fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] The pathophysiology of polyhydramnios is not fully understood. However, any imbalance in the complex regulatory mechanisms maintaining the amniotic fluid volume can result in polyhydramnios. […] Given that glucose readily crosses the placenta, maternal hyperglycemia leads to fetal hyperglycemia and osmotic diuresis. Fetal urine output also increases in high-output fetal cardiac states, such as severe anemia, arteriovenous shunts, and volume overload. Bartter syndrome is a rare autosomal recessive condition that affects fetal renal tubular function and results in sodium loss and polyuria, often leading to severe polyhydramnios.

• #13

  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. Common causes of polyhydramnios include gestational diabetes, fetal anomalies with disturbed fetal swallowing of amniotic fluid, fetal infections and other, rarer causes. […] A disturbed equilibrium can be the result of compromised swallowing function or increased urination and can lead to polyhydramnios. […] Poorly managed gestational diabetes is associated with fetal macrosomia and polyhydramnios but the pathogenesis has not been elucidated yet. One possible explanation is fetal hyperglycemia resulting in increased osmotic diuresis which subsequently leads to polyuria. […] 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.

• #14

  https://www.today.com/parents/too-much-amniotic-fluid-pregnancy-polyhydramnios-causes-t221310

  Polyhydramnios is the presence of excess amniotic fluid the protective liquid that surrounds an unborn baby in the uterus during pregnancy. It occurs in roughly 1 to 2% of pregnancies, according to the Mayo Clinic. […] Polyhydramnios is often associated with gestational diabetes. […] When a mothers blood sugar is high, shell pee more and then the baby will pee more, Columbo said, noting that amniotic fluid after 20 weeks of pregnancy is mostly baby urine. […] If gestational diabetes is ruled out, your doctor will look for other causes such as chromosomal abnormalities and obstructions. […] Children who have an obstruction between the mouth and the stomach will have extra fluid because they cant drink and the fluid doesnt get absorbed, Colombo explained. […] Sometimes structural abnormalities can cause polyhydramnios. […] New antibodies in the blood and viral infections can cause the fluid to be high. […] Theres really a whole list of things that we look for.

• #15 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Polyhydramnios, or hydramnios, is defined as an excessive volume of amniotic fluid relative to the gestational age. Polyhydramnios may be acute or chronic. Acute polyhydramnios is usually a fulminant second-trimester process, with fluid accumulating rapidly over a period of a few days. Chronic polyhydramnios has a more gradual onset and course, often presenting in the third trimester. The incidence varies, depending on whether the diagnosis is clinical or sonographic. Overall, polyhydramnios complicates approximately 0.31.6% of all pregnancies. Chronic polyhydramnios is more frequent, exceeding the incidence of acute polyhydramnios by a 50: 1 ratio. […] Risk factors for polyhydramnios may be broadly divided into maternal, fetal, placental and idiopathic origins. Diabetes mellitus is the most common maternal factor, occurring in approximately 25% of cases. The exact mechanism for polyhydramnios with diabetes is unclear. It may represent fetal polyuria secondary to fetal hyperglycemia. However, van Otterlo and colleagues, measuring fetal urinary output by ultrasonography, found no increase in urine output in 12 of 13 diabetic pregnancies complicated by polyhydramnios. Alternatively, fetal glycosuria may lead to an increase in amniotic fluid osmolality, resulting in water transfer from the fetal compartment to maintain osmolar equilibrium.

• #16 Polyhydramnios – StatPearls – NCBI Bookshelf

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

  Polyhydramnios is a pathological condition characterized by an excess of amniotic fluid associated with increased rates of maternal and neonatal morbidity and mortality. This condition develops when the mechanisms regulating amniotic fluid volume are disrupted, most commonly due to excess fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] Polyhydramnios occurs when this equilibrium is disrupted, often due to increased fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] The pathophysiology of polyhydramnios is not fully understood. However, any imbalance in the complex regulatory mechanisms maintaining the amniotic fluid volume can result in polyhydramnios. […] Given that glucose readily crosses the placenta, maternal hyperglycemia leads to fetal hyperglycemia and osmotic diuresis. Fetal urine output also increases in high-output fetal cardiac states, such as severe anemia, arteriovenous shunts, and volume overload. Bartter syndrome is a rare autosomal recessive condition that affects fetal renal tubular function and results in sodium loss and polyuria, often leading to severe polyhydramnios.

• #17 Polyhydramnios – StatPearls – NCBI Bookshelf

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

  Swallowing requires complex coordination between cerebral and brainstem pathways, oral and pharyngeal sensorimotor function, and respiratory activity. Many central nervous system and neuromuscular disorders and infections may prevent the fetus from swallowing effectively, decreasing amniotic fluid resorption and leading to polyhydramnios. In addition, the gastrointestinal tract must be patent and functional for the fluid to be reabsorbed by the fetal vasculature. Therefore, polyhydramnios can also develop due to conditions that prevent the swallowed fluid from reaching the intestines, such as esophageal or duodenal atresia or gastrointestinal compression due to a neck or thoracic mass. Common aneuploidies such as trisomies 21, 18, and 13 can also be associated with polyhydramnios.

• #18 Polyhydramnios – StatPearls – NCBI Bookshelf

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

  Swallowing requires complex coordination between cerebral and brainstem pathways, oral and pharyngeal sensorimotor function, and respiratory activity. Many central nervous system and neuromuscular disorders and infections may prevent the fetus from swallowing effectively, decreasing amniotic fluid resorption and leading to polyhydramnios. In addition, the gastrointestinal tract must be patent and functional for the fluid to be reabsorbed by the fetal vasculature. Therefore, polyhydramnios can also develop due to conditions that prevent the swallowed fluid from reaching the intestines, such as esophageal or duodenal atresia or gastrointestinal compression due to a neck or thoracic mass. Common aneuploidies such as trisomies 21, 18, and 13 can also be associated with polyhydramnios.

• #19 Polyhydramnios and Oligohydramnios: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/975821-overview

  Polyhydramnios may occur in the recipient twin, and oligohydramnios may occur in the donor. […] Polyhydramnios appears to increase the risk of prolonged first stage of labor, nonvertex presentation, and cesarean delivery. […] Studies show that as the severity of polyhydramnios increases, the likelihood of determining the etiology increases.

• #20 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Polyhydramnios not associated with an identifiable cause is labeled idiopathic and accounts for 3060% of cases. Further research is necessary to identify other as yet undetermined causes. One such possibility is a disorder of intra-amniotic prolactin regulation by the chorion and decidua. Under normal circumstances, prolactin may be partially responsible for control of water homeostasis in the intra-amniotic environment. In vitro studies on human amnion have shown reduced diffusion of water in response to ovine prolactin administered on the fetal side of the membrane. Hence, an overproduction of decidual prolactin may impair diffusional flow of water away from the amniotic compartment, leading to polyhydramnios. […] The maternal signs and symptoms of polyhydramnios are usually caused by the overdistended uterus and its compressing effect on intrathoracic and intra-abdominal organs. Elevation of the diaphragm can result in dyspnea and occasionally respiratory distress. Back and abdominal discomfort are also frequent complaints, as are nausea and vomiting. Edema of the lower extremities may result from compression of the inferior vena cava.

• #21 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 primary sources of amniotic fluid are fetal urine production, fetal lung fluid and fetal oral and nasal secretions. The main routes of amniotic fluid removal are fetal swallowing and absorption via the intramembranous pathway. […] 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. […] Idiopathic polyhydramnios is a diagnosis of exclusion. […] At diagnosis, refer for anatomic survey and work up to rule out alloimmunization, congenital infection, diabetes and other causes. […] SMFM recommends against amnioreduction except in the presence of severe polyhydramnios. […] Indomethacin is not recommended for the sole purpose of decreasing amniotic fluid. […] Data to support higher risk for dysfunctional labor and cesarean section.

• #22 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Polyhydramnios not associated with an identifiable cause is labeled idiopathic and accounts for 3060% of cases. Further research is necessary to identify other as yet undetermined causes. One such possibility is a disorder of intra-amniotic prolactin regulation by the chorion and decidua. Under normal circumstances, prolactin may be partially responsible for control of water homeostasis in the intra-amniotic environment. In vitro studies on human amnion have shown reduced diffusion of water in response to ovine prolactin administered on the fetal side of the membrane. Hence, an overproduction of decidual prolactin may impair diffusional flow of water away from the amniotic compartment, leading to polyhydramnios. […] The maternal signs and symptoms of polyhydramnios are usually caused by the overdistended uterus and its compressing effect on intrathoracic and intra-abdominal organs. Elevation of the diaphragm can result in dyspnea and occasionally respiratory distress. Back and abdominal discomfort are also frequent complaints, as are nausea and vomiting. Edema of the lower extremities may result from compression of the inferior vena cava.

• #23 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Polyhydramnios, or hydramnios, is defined as an excessive volume of amniotic fluid relative to the gestational age. Polyhydramnios may be acute or chronic. Acute polyhydramnios is usually a fulminant second-trimester process, with fluid accumulating rapidly over a period of a few days. Chronic polyhydramnios has a more gradual onset and course, often presenting in the third trimester. The incidence varies, depending on whether the diagnosis is clinical or sonographic. Overall, polyhydramnios complicates approximately 0.31.6% of all pregnancies. Chronic polyhydramnios is more frequent, exceeding the incidence of acute polyhydramnios by a 50: 1 ratio. […] Risk factors for polyhydramnios may be broadly divided into maternal, fetal, placental and idiopathic origins. Diabetes mellitus is the most common maternal factor, occurring in approximately 25% of cases. The exact mechanism for polyhydramnios with diabetes is unclear. It may represent fetal polyuria secondary to fetal hyperglycemia. However, van Otterlo and colleagues, measuring fetal urinary output by ultrasonography, found no increase in urine output in 12 of 13 diabetic pregnancies complicated by polyhydramnios. Alternatively, fetal glycosuria may lead to an increase in amniotic fluid osmolality, resulting in water transfer from the fetal compartment to maintain osmolar equilibrium.

• #24 Polyhydramnios & Oligohydramnios – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/polyhydramnios-oligohydramnios

  Polyhydramnios refers to an excess of amniotic fluid during pregnancy and manifests as a uterus that is larger than expected for the given gestational age. This condition arises from either reduced swallowing of amniotic fluid by the fetus or increased fetal urination. GI obstructions such as duodenal atresia and tracheoesophageal fistula, as well as neural tube defects like anencephaly, which affects the swallowing center of the brain, can impair fetal swallowing and cause polyhydramnios. […] Polyhydramnios associated with increased fetal urination can result due to either a fetal high-output state or maternal hyperglycemia. For example, fetal anemia can elevate cardiac output and enhance renal blood flow, thereby promoting greater urination. Similarly, maternal hyperglycemia can lead to an excess transfer of glucose to the fetus and fetal hyperglycemia, which induces osmotic diuresis and increases renal blood flow, also increasing fetal urination.

• #25 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Isoimmunization is another, albeit decreasing, cause of polyhydramnios. The proposed inciting mechanism is extramedullary hematopoiesis in response to fetal anemia, which results in portal hypertension and hypoalbuminemia. The decrease in colloid oncotic pressure, as well as hydrostatic venous engorgement, leads to extravasation of fluid into the interstitium of the placenta. How this extravascular fluid results in hydramnios is unclear. […] Fetal conditions have been observed in approximately 20% of polyhydramnios cases. Fetal malformations of the central nervous system (CNS) comprise almost 50% of fetal anomalies, with anencephaly being the most common. The postulated mechanisms for polyhydramnios due to CNS malformations include centrally-mediated reduction in fetal swallowing, fetal polyuria resulting from insufficient production of vasopressin from the fetal pituitary, and transudation of fluid across the uncovered meninges. Gastrointestinal anomalies constitute the second leading structural fetal cause. Any gastrointestinal obstruction proximal to the ligament of Treitz, such as duodenal or esophageal atresia, may interfere with the effective removal of amniotic fluid by the alimentary tract.

• #26 What Causes Polyhydramnios and the Birth Defects Associated with it? | Know Polyhydramnios

  https://polyhydramnios.org/learn-more-about-polyhydramnios/what-causes-polyhydramnios/

  At the time of delivery, the majority of cases of Polyhydramnios are considered idiopathic. […] The most common known cause of Polyhydramnios is genetic anomaly, followed by infection, blood incompatibility, fetal anemia, complications of multiples, and gestational diabetes. […] Of that 61% of idiopathic cases, up to 1/3 of those babies will be diagnosed with a genetic anomaly before their first birthday. […] Maternal Hashimoto’s Disease is an autoimmune disorder that damages the thyroid and is the most common cause of hypothyroidism. […] Untreated hypothyroidism during early pregnancy has been linked to birth defects that can cause Polyhydramnios, including problems with the heart, kidneys, and central nervous system. […] Maternal Uremia is a dangerous condition in which the kidneys are no longer able to function properly causing a dangerous build-up of toxins in the blood.

• #27 What Causes Polyhydramnios and the Birth Defects Associated with it? | Know Polyhydramnios

  https://polyhydramnios.org/learn-more-about-polyhydramnios/what-causes-polyhydramnios/

  Pregnancy in a uremic mother undergoing dialysis is associated with a higher risk of spontaneous abortion, hypertension, preeclampsia, polyhydramnios, preterm labor, and premature birth. […] Placental chorioangiomas can often be detected by an alpha-fetoprotein blood test or by ultrasound. […] Some small chorioangiomas do not cause any problems, but larger ones have been associated with Polyhydramnios, fetal hydrops, fetal anemia, thrombocytopenia, IUGR, and IUFD. […] Twin to Twin Transfusion Syndrome (TTTS) is a rare complication affecting monochorionic identical twins or other higher-order multiples who share the same placenta and the network of blood vessels needed for development inside the womb. […] In TTTS, the network of blood vessels is unevenly distributed resulting in not enough blood supply in one baby and too much in the other. This can cause low urine output, oligohydramnios, IUGR, and fetal death in the donor twin and excessive urine output, polyhydramnios, and heart failure in the recipient twin.

• #28 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Isoimmunization is another, albeit decreasing, cause of polyhydramnios. The proposed inciting mechanism is extramedullary hematopoiesis in response to fetal anemia, which results in portal hypertension and hypoalbuminemia. The decrease in colloid oncotic pressure, as well as hydrostatic venous engorgement, leads to extravasation of fluid into the interstitium of the placenta. How this extravascular fluid results in hydramnios is unclear. […] Fetal conditions have been observed in approximately 20% of polyhydramnios cases. Fetal malformations of the central nervous system (CNS) comprise almost 50% of fetal anomalies, with anencephaly being the most common. The postulated mechanisms for polyhydramnios due to CNS malformations include centrally-mediated reduction in fetal swallowing, fetal polyuria resulting from insufficient production of vasopressin from the fetal pituitary, and transudation of fluid across the uncovered meninges. Gastrointestinal anomalies constitute the second leading structural fetal cause. Any gastrointestinal obstruction proximal to the ligament of Treitz, such as duodenal or esophageal atresia, may interfere with the effective removal of amniotic fluid by the alimentary tract.

• #29 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Isoimmunization is another, albeit decreasing, cause of polyhydramnios. The proposed inciting mechanism is extramedullary hematopoiesis in response to fetal anemia, which results in portal hypertension and hypoalbuminemia. The decrease in colloid oncotic pressure, as well as hydrostatic venous engorgement, leads to extravasation of fluid into the interstitium of the placenta. How this extravascular fluid results in hydramnios is unclear. […] Fetal conditions have been observed in approximately 20% of polyhydramnios cases. Fetal malformations of the central nervous system (CNS) comprise almost 50% of fetal anomalies, with anencephaly being the most common. The postulated mechanisms for polyhydramnios due to CNS malformations include centrally-mediated reduction in fetal swallowing, fetal polyuria resulting from insufficient production of vasopressin from the fetal pituitary, and transudation of fluid across the uncovered meninges. Gastrointestinal anomalies constitute the second leading structural fetal cause. Any gastrointestinal obstruction proximal to the ligament of Treitz, such as duodenal or esophageal atresia, may interfere with the effective removal of amniotic fluid by the alimentary tract.

• #30 Polyhydramnios – StatPearls – NCBI Bookshelf

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

  Swallowing requires complex coordination between cerebral and brainstem pathways, oral and pharyngeal sensorimotor function, and respiratory activity. Many central nervous system and neuromuscular disorders and infections may prevent the fetus from swallowing effectively, decreasing amniotic fluid resorption and leading to polyhydramnios. In addition, the gastrointestinal tract must be patent and functional for the fluid to be reabsorbed by the fetal vasculature. Therefore, polyhydramnios can also develop due to conditions that prevent the swallowed fluid from reaching the intestines, such as esophageal or duodenal atresia or gastrointestinal compression due to a neck or thoracic mass. Common aneuploidies such as trisomies 21, 18, and 13 can also be associated with polyhydramnios.

• #31 Polyhydramnios | Article | GLOWM

  https://www.glowm.com/article/heading/vol-10–common-obstetric-conditions–polyhydramnios/id/409583

  Polyhydramnios can be caused by fetal anomalies in most organ systems. The most common structural anomalies associated with polyhydramnios are those that interfere with fetal swallowing and/or the absorption of amniotic fluid. Decreased swallowing may be due to a primary gastrointestinal obstruction (e.g. duodenal, esophageal, or intestinal atresia), neuromuscular disorders (e.g. anencephaly), or due to secondary gastrointestinal tract obstruction as in cases of massive unilateral dysplastic kidneys that may cause fetal bowel obstruction. Also, increased amniotic fluid may be attributed to increased urine production due to decreased gastrointestinal absorption secondary to bowel compression, or tumor secretion of prostaglandins leading to hypercalcemia-induced polyuria. […] Increased urine production may occur in high fetal cardiac output states (e.g. fetal anemia due to alloimmunization, parvovirus infection, fetomaternal hemorrhage, and hemolysis) or, rarely in syndromes such as fetal Bartter syndrome. In monochorionic multiple gestation, polyhydramnios/oligohydramnios sequence is diagnostic of twin-twin transfusion syndrome (TTTS). The mechanism for polyhydramnios in pregnancies complicated by maternal diabetes is unclear, but theoretically may be owing to fetal osmotic diuresis secondary to fetal hyperglycemia.

• #32 Polyhydramnios | Article | GLOWM

  https://www.glowm.com/article/heading/vol-10–common-obstetric-conditions–polyhydramnios/id/409583

  Polyhydramnios can be caused by fetal anomalies in most organ systems. The most common structural anomalies associated with polyhydramnios are those that interfere with fetal swallowing and/or the absorption of amniotic fluid. Decreased swallowing may be due to a primary gastrointestinal obstruction (e.g. duodenal, esophageal, or intestinal atresia), neuromuscular disorders (e.g. anencephaly), or due to secondary gastrointestinal tract obstruction as in cases of massive unilateral dysplastic kidneys that may cause fetal bowel obstruction. Also, increased amniotic fluid may be attributed to increased urine production due to decreased gastrointestinal absorption secondary to bowel compression, or tumor secretion of prostaglandins leading to hypercalcemia-induced polyuria. […] Increased urine production may occur in high fetal cardiac output states (e.g. fetal anemia due to alloimmunization, parvovirus infection, fetomaternal hemorrhage, and hemolysis) or, rarely in syndromes such as fetal Bartter syndrome. In monochorionic multiple gestation, polyhydramnios/oligohydramnios sequence is diagnostic of twin-twin transfusion syndrome (TTTS). The mechanism for polyhydramnios in pregnancies complicated by maternal diabetes is unclear, but theoretically may be owing to fetal osmotic diuresis secondary to fetal hyperglycemia.

• #33 What Causes Polyhydramnios and the Birth Defects Associated with it? | Know Polyhydramnios

  https://polyhydramnios.org/learn-more-about-polyhydramnios/what-causes-polyhydramnios/

  Pregnancy in a uremic mother undergoing dialysis is associated with a higher risk of spontaneous abortion, hypertension, preeclampsia, polyhydramnios, preterm labor, and premature birth. […] Placental chorioangiomas can often be detected by an alpha-fetoprotein blood test or by ultrasound. […] Some small chorioangiomas do not cause any problems, but larger ones have been associated with Polyhydramnios, fetal hydrops, fetal anemia, thrombocytopenia, IUGR, and IUFD. […] Twin to Twin Transfusion Syndrome (TTTS) is a rare complication affecting monochorionic identical twins or other higher-order multiples who share the same placenta and the network of blood vessels needed for development inside the womb. […] In TTTS, the network of blood vessels is unevenly distributed resulting in not enough blood supply in one baby and too much in the other. This can cause low urine output, oligohydramnios, IUGR, and fetal death in the donor twin and excessive urine output, polyhydramnios, and heart failure in the recipient twin.

• #34 Polyhydramnios & Oligohydramnios – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/polyhydramnios-oligohydramnios

  Maternal diabetes can be a contributing factor to polyhydramnios. Excessive glucose from the mother crosses the placenta, leading to fetal hyperglycemia. This leads to fetal polyuria, resulting in an accumulation of excessive amniotic fluid in the uterus. […] Anencephaly, a neural tube defect, can cause polyhydramnios due to a defect in the swallowing center in the brain, leading to decreased swallowing of amniotic fluid by the fetus. This results in an accumulation of excessive amniotic fluid in the uterus, manifesting as polyhydramnios.

• #35 Polyhydramnios Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/polyhydramnios

  Polyhydramnios occurs when too much amniotic fluid builds up during pregnancy. […] Polyhydramnios can occur if the baby does not swallow and absorb amniotic fluid in normal amounts. This can happen if the baby has certain health problems, including gastrointestinal disorders, such as duodenal atresia, esophageal atresia, gastroschisis, and diaphragmatic hernia. […] Polyhydramnios also may occur if too much fluid is produced. This may be due to certain lung disorders in the baby, multiple pregnancy (for example, twins or triplets), or hydrops fetalis in the baby. […] Sometimes, no specific cause is found.

• #36 Polyhydramnios – Causes – Management – Prognosis – TeachMeObGyn

  https://teachmeobgyn.com/pregnancy/fetal-abnormality/polyhydramnios/

  Polyhydramnios refers to an abnormally large level of amniotic fluid during pregnancy. It is defined by an amniotic fluid index that is above the 95th centile for gestational age. The volume of amniotic fluid increases steadily until 33 weeks of gestation. It plateaus from 33-38 weeks, and then declines with the volume of amniotic fluid at term approximately 500ml. It is predominantly comprised of the fetal urine output, with small contributions from the placenta and some fetal secretions (e.g. respiratory, oral). The fetus breathes and swallows the amniotic fluid. It gets processed, fills the bladder and is voided, and the cycle repeats. Problems with any of the structures in this pathway can lead to either too much or too little fluid. Polyhydramnios is idiopathic in 50-60% of cases. Where an underlying abnormality can be identified, the most common causes include: Any condition that prevents the fetus from swallowing e.g. oesophageal atresia, CNS abnormalities, muscular dystrophies, congenital diaphragmatic hernia obstructing the oesophagus. Severe and persistently unexplained polyhydramnios is associated with increased perinatal mortality. This is largely due to two factors: The likely presence of an underlying abnormality or congenital malformation. The increased incidence of preterm labour (due to over-distension of the uterus).

• #37 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 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: […] Reduced fetal swallowing: due to brain abnormalities (e.g anencephaly, Dandy-Walker malformation), facial tumors, gastrointestinal obstruction (e.g. esophageal or duodenal atresia, small bowel obstruction), compressive pulmonary disorders (e.g. pleural effusions, diaphragmatic hernia, CPAM, CHAOS), narrow thoracic cage due to skeletal dysplasias), and fetal akinesia deformation sequence (due to neuromuscular impairment of fetal swallowing). […] Increased fetal urination: maternal diabetes mellitus and maternal uremia (increased glucose and urea cause osmotic diuresis), hyperdynamic fetal circulation due to fetal anemia (e.g. red blood cell isoimmunization or congenital infection), fetal and placental tumors (e.g. sacrococcygeal teratoma, placental chorioangioma), or twin-to-twin transfusion syndrome.

• #38 Polyhydramnios & Oligohydramnios – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/polyhydramnios-oligohydramnios

  Maternal diabetes can be a contributing factor to polyhydramnios. Excessive glucose from the mother crosses the placenta, leading to fetal hyperglycemia. This leads to fetal polyuria, resulting in an accumulation of excessive amniotic fluid in the uterus. […] Anencephaly, a neural tube defect, can cause polyhydramnios due to a defect in the swallowing center in the brain, leading to decreased swallowing of amniotic fluid by the fetus. This results in an accumulation of excessive amniotic fluid in the uterus, manifesting as polyhydramnios.

• #39 Polyhydramnios & Oligohydramnios – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/polyhydramnios-oligohydramnios

  Polyhydramnios refers to an excess of amniotic fluid during pregnancy and manifests as a uterus that is larger than expected for the given gestational age. This condition arises from either reduced swallowing of amniotic fluid by the fetus or increased fetal urination. GI obstructions such as duodenal atresia and tracheoesophageal fistula, as well as neural tube defects like anencephaly, which affects the swallowing center of the brain, can impair fetal swallowing and cause polyhydramnios. […] Polyhydramnios associated with increased fetal urination can result due to either a fetal high-output state or maternal hyperglycemia. For example, fetal anemia can elevate cardiac output and enhance renal blood flow, thereby promoting greater urination. Similarly, maternal hyperglycemia can lead to an excess transfer of glucose to the fetus and fetal hyperglycemia, which induces osmotic diuresis and increases renal blood flow, also increasing fetal urination.

• #40 Polyhydramnios & Oligohydramnios – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/polyhydramnios-oligohydramnios

  Polyhydramnios refers to an excess of amniotic fluid during pregnancy and manifests as a uterus that is larger than expected for the given gestational age. This condition arises from either reduced swallowing of amniotic fluid by the fetus or increased fetal urination. GI obstructions such as duodenal atresia and tracheoesophageal fistula, as well as neural tube defects like anencephaly, which affects the swallowing center of the brain, can impair fetal swallowing and cause polyhydramnios. […] Polyhydramnios associated with increased fetal urination can result due to either a fetal high-output state or maternal hyperglycemia. For example, fetal anemia can elevate cardiac output and enhance renal blood flow, thereby promoting greater urination. Similarly, maternal hyperglycemia can lead to an excess transfer of glucose to the fetus and fetal hyperglycemia, which induces osmotic diuresis and increases renal blood flow, also increasing fetal urination.

• #41

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

  Treatment consists of reducing the volume of amniotic fluid to improve maternal well-being and prolong the pregnancy. The following methods are used to reduce amniotic fluid volumes: amnioreduction (therapeutic amniocentesis) and pharmacological treatment. […] Prostaglandin synthetase inhibitors stimulate fetal secretion of arginine vasopressin, resulting in vasopressin-induced antidiuresis. […] As fetal urine production constitutes the main source of amniotic fluid and changes in urine production can significantly change the dynamics of amniotic fluid volumes, the effect of intra-amniotic administration of arginine vasopressin was investigated.

• #42 Polyhydramnios – StatPearls – NCBI Bookshelf

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

  Polyhydramnios is a pathological condition characterized by an excess of amniotic fluid associated with increased rates of maternal and neonatal morbidity and mortality. This condition develops when the mechanisms regulating amniotic fluid volume are disrupted, most commonly due to excess fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] Polyhydramnios occurs when this equilibrium is disrupted, often due to increased fetal urine production, impaired swallowing, or gastrointestinal obstruction. […] The pathophysiology of polyhydramnios is not fully understood. However, any imbalance in the complex regulatory mechanisms maintaining the amniotic fluid volume can result in polyhydramnios. […] Given that glucose readily crosses the placenta, maternal hyperglycemia leads to fetal hyperglycemia and osmotic diuresis. Fetal urine output also increases in high-output fetal cardiac states, such as severe anemia, arteriovenous shunts, and volume overload. Bartter syndrome is a rare autosomal recessive condition that affects fetal renal tubular function and results in sodium loss and polyuria, often leading to severe polyhydramnios.

• #43

  https://www.today.com/parents/too-much-amniotic-fluid-pregnancy-polyhydramnios-causes-t221310

  Polyhydramnios is the presence of excess amniotic fluid the protective liquid that surrounds an unborn baby in the uterus during pregnancy. It occurs in roughly 1 to 2% of pregnancies, according to the Mayo Clinic. […] Polyhydramnios is often associated with gestational diabetes. […] When a mothers blood sugar is high, shell pee more and then the baby will pee more, Columbo said, noting that amniotic fluid after 20 weeks of pregnancy is mostly baby urine. […] If gestational diabetes is ruled out, your doctor will look for other causes such as chromosomal abnormalities and obstructions. […] Children who have an obstruction between the mouth and the stomach will have extra fluid because they cant drink and the fluid doesnt get absorbed, Colombo explained. […] Sometimes structural abnormalities can cause polyhydramnios. […] New antibodies in the blood and viral infections can cause the fluid to be high. […] Theres really a whole list of things that we look for.

• #44 Too much amniotic fluid (polyhydramnios)

  https://www.babycenter.com/pregnancy/health-and-safety/excessive-amniotic-fluid-polyhydramnios_1200199

  Polyhydramnios (also called hydramnios) means you have too much amniotic fluid. Most cases are mild and not dangerous, but in some cases polyhydramnios can put you at increased risk for complications. […] Experts don’t know what causes many cases of polyhydramnios, particularly mild ones. The most common causes of polyhydramnios are: […] You can end up with high fluid levels if you have diabetes and you’re having trouble managing it properly. That’s because you’re probably carrying a large baby as a result of your diabetes. Polyhydramnios is diagnosed in about 10 percent of pregnant diabetics, usually in the third trimester. […] You’re at risk for high fluid levels if you’re carrying twins or multiples because, again, they will produce more fluid than a single baby. Polyhydramnios is especially likely in the case of twin-to-twin transfusion syndrome, in which one twin has too little amniotic fluid while the other has too much.

• #45 Polyhydramnios & Oligohydramnios – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/polyhydramnios-oligohydramnios

  Maternal diabetes can be a contributing factor to polyhydramnios. Excessive glucose from the mother crosses the placenta, leading to fetal hyperglycemia. This leads to fetal polyuria, resulting in an accumulation of excessive amniotic fluid in the uterus. […] Anencephaly, a neural tube defect, can cause polyhydramnios due to a defect in the swallowing center in the brain, leading to decreased swallowing of amniotic fluid by the fetus. This results in an accumulation of excessive amniotic fluid in the uterus, manifesting as polyhydramnios.

• #46 Polyhydramnios Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/polyhydramnios

  Polyhydramnios occurs when too much amniotic fluid builds up during pregnancy. […] Polyhydramnios can occur if the baby does not swallow and absorb amniotic fluid in normal amounts. This can happen if the baby has certain health problems, including gastrointestinal disorders, such as duodenal atresia, esophageal atresia, gastroschisis, and diaphragmatic hernia. […] Polyhydramnios also may occur if too much fluid is produced. This may be due to certain lung disorders in the baby, multiple pregnancy (for example, twins or triplets), or hydrops fetalis in the baby. […] Sometimes, no specific cause is found.

• #47 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 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: […] Reduced fetal swallowing: due to brain abnormalities (e.g anencephaly, Dandy-Walker malformation), facial tumors, gastrointestinal obstruction (e.g. esophageal or duodenal atresia, small bowel obstruction), compressive pulmonary disorders (e.g. pleural effusions, diaphragmatic hernia, CPAM, CHAOS), narrow thoracic cage due to skeletal dysplasias), and fetal akinesia deformation sequence (due to neuromuscular impairment of fetal swallowing). […] Increased fetal urination: maternal diabetes mellitus and maternal uremia (increased glucose and urea cause osmotic diuresis), hyperdynamic fetal circulation due to fetal anemia (e.g. red blood cell isoimmunization or congenital infection), fetal and placental tumors (e.g. sacrococcygeal teratoma, placental chorioangioma), or twin-to-twin transfusion syndrome.

• #48 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. […] Management is by treating maternal disorders contributing to polyhydramnios. […] Causes of polyhydramnios include the following: Idiopathic, Fetal malformations (eg, gastrointestinal or urinary tract obstruction), Multiple gestation, Maternal diabetes, Fetal anemia, including hemolytic anemia due to hemolytic disease of the fetus and newborn, Other fetal disorders (eg, infections) or genetic abnormalities. […] Risk of complications tends to be proportional to the degree of fluid accumulation and vary with the cause. […] Polyhydramnios is usually suspected based on ultrasonographic findings or uterine size that is larger than expected for dates. […] If polyhydramnios is present, further testing is recommended to determine the cause. […] Reducing amniotic fluid volume (eg, by amnioreduction) or reducing its production should be considered only if polyhydramnios causes severe maternal discomfort. […] Disorders that could be contributing to polyhydramnios (eg, maternal diabetes) should be controlled.

• #49 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  The increased perinatal morbidity and mortality associated with polyhydramnios are due to both an increase in congenital/genetic anomalies and preterm births. Perinatal mortality used to approach 100% with acute polyhydramnios; however, with aggressive repetitive amniocentesis, survivors have been reported. Chronic polyhydramnios tends to have a better prognosis, especially if idiopathic in origin. […] Treatment of polyhydramnios may be medical or surgical or both. The method chosen will depend on the etiology, severity, clinical symptoms, and gestational age at diagnosis, as well as the presence and type of associated anomalies. If the diagnosis is made on the basis of ultrasonographic findings, an attempt should be made to establish the cause. In cases that are not acute or severe and are not associated with a fetal malformation, patients should be rescanned periodically to assess the progression or improvement of the fluid volume. Some reports have documented gradual resolution of polyhydramnios, either spontaneously or as a result of treating the underlying cause (e.g., control of hyperglycemia, intrauterine transfusion of the anemic fetus). […] In the absence of rapidly progressive polyhydramnios or maternal symptoms, management is expectant. If a patient experiences increasing dyspnea, back pain, or preterm labor, hospitalization for possible tocolysis and amniocentesis should be considered.

• #50 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Polyhydramnios not associated with an identifiable cause is labeled idiopathic and accounts for 3060% of cases. Further research is necessary to identify other as yet undetermined causes. One such possibility is a disorder of intra-amniotic prolactin regulation by the chorion and decidua. Under normal circumstances, prolactin may be partially responsible for control of water homeostasis in the intra-amniotic environment. In vitro studies on human amnion have shown reduced diffusion of water in response to ovine prolactin administered on the fetal side of the membrane. Hence, an overproduction of decidual prolactin may impair diffusional flow of water away from the amniotic compartment, leading to polyhydramnios. […] The maternal signs and symptoms of polyhydramnios are usually caused by the overdistended uterus and its compressing effect on intrathoracic and intra-abdominal organs. Elevation of the diaphragm can result in dyspnea and occasionally respiratory distress. Back and abdominal discomfort are also frequent complaints, as are nausea and vomiting. Edema of the lower extremities may result from compression of the inferior vena cava.

• #51 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Polyhydramnios not associated with an identifiable cause is labeled idiopathic and accounts for 3060% of cases. Further research is necessary to identify other as yet undetermined causes. One such possibility is a disorder of intra-amniotic prolactin regulation by the chorion and decidua. Under normal circumstances, prolactin may be partially responsible for control of water homeostasis in the intra-amniotic environment. In vitro studies on human amnion have shown reduced diffusion of water in response to ovine prolactin administered on the fetal side of the membrane. Hence, an overproduction of decidual prolactin may impair diffusional flow of water away from the amniotic compartment, leading to polyhydramnios. […] The maternal signs and symptoms of polyhydramnios are usually caused by the overdistended uterus and its compressing effect on intrathoracic and intra-abdominal organs. Elevation of the diaphragm can result in dyspnea and occasionally respiratory distress. Back and abdominal discomfort are also frequent complaints, as are nausea and vomiting. Edema of the lower extremities may result from compression of the inferior vena cava.

• #52 Amniotic Fluid: Physiology and Assessment | GLOWM

  https://www.glowm.com/section-view/heading/Amniotic%20Fluid:%20Physiology%20and%20Assessment/item/208

  Polyhydramnios not associated with an identifiable cause is labeled idiopathic and accounts for 3060% of cases. Further research is necessary to identify other as yet undetermined causes. One such possibility is a disorder of intra-amniotic prolactin regulation by the chorion and decidua. Under normal circumstances, prolactin may be partially responsible for control of water homeostasis in the intra-amniotic environment. In vitro studies on human amnion have shown reduced diffusion of water in response to ovine prolactin administered on the fetal side of the membrane. Hence, an overproduction of decidual prolactin may impair diffusional flow of water away from the amniotic compartment, leading to polyhydramnios. […] The maternal signs and symptoms of polyhydramnios are usually caused by the overdistended uterus and its compressing effect on intrathoracic and intra-abdominal organs. Elevation of the diaphragm can result in dyspnea and occasionally respiratory distress. Back and abdominal discomfort are also frequent complaints, as are nausea and vomiting. Edema of the lower extremities may result from compression of the inferior vena cava.

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

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

  Treatment may be needed if you have severe polyhydramnios. […] Too much amniotic fluid in your uterus puts pressure on your nearby organs and causes pregnancy complications. […] The condition is usually more serious if it occurs early in pregnancy because theres more time for amniotic fluid to continue to build up. […] Other complications of too much amniotic fluid include: Early labor. […] Severe cases of polyhydramnios may lead to premature labor and your baby being born early. […] Most people with polyhydramnios have healthy babies without complications.

• #54 Polyhydramnios (too much amniotic fluid)

  https://www.nhs.uk/conditions/polyhydramnios/

  Polyhydramnios is when there’s too much amniotic fluid (the fluid that surrounds the baby in the womb) during pregnancy. […] The cause of polyhydramnios (too much amniotic fluid) is often unknown. […] Some possible causes include: diabetes during pregnancy (gestational diabetes), being pregnant with more than 1 baby, an infection during pregnancy, a problem with your baby swallowing, your baby having a genetic condition. […] Polyhydramnios (too much amniotic fluid) usually does not need any treatment. […] If the polyhydramnios is caused by a condition such as gestational diabetes, you’ll be treated for the condition. […] Complications of polyhydramnios (too much amniotic fluid) are rare. […] Rarely, in more severe cases, complications can include: your waters breaking early, placental abruption, umbilical cord prolapse, your baby being born prematurely, your baby having a low birth weight.

• #55

  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. Common causes of polyhydramnios include gestational diabetes, fetal anomalies with disturbed fetal swallowing of amniotic fluid, fetal infections and other, rarer causes. […] A disturbed equilibrium can be the result of compromised swallowing function or increased urination and can lead to polyhydramnios. […] Poorly managed gestational diabetes is associated with fetal macrosomia and polyhydramnios but the pathogenesis has not been elucidated yet. One possible explanation is fetal hyperglycemia resulting in increased osmotic diuresis which subsequently leads to polyuria. […] 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.

• #56 High Amniotic Fluid During Pregnancy | American Pregnancy Association

  https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/polyhydramnios-high-amniotic-fluid/

  Maternal diabetes – Elevated blood glucose levels can lead to an excessive buildup of amniotic fluid. […] Twin To Twin Transfusion Syndrome (TTTS) – If you are carrying identical twins, it’s possible that you could have a complication in which one twin is getting too much blood, and the other is getting too little. […] A problem with the baby’s heart rate – This includes anything from fetal arrhythmia, a faintness of heartbeat due to a large amount of amniotic fluid or a congenital heart defect. […] As mentioned earlier, mild polyhydramnios usually does not cause complications. But in severe cases, there are certain risks, including: Pre-term Labor, Premature Birth, Excess fetal growth, Placental abruption (the placenta detaching from the wall of the uterus before you give birth), Postpartum hemorrhage, Umbilical cord prolapse (the cord falling out of the vagina before the baby), Fetal malposition, Stillbirth.

• #57 High Amniotic Fluid During Pregnancy | American Pregnancy Association

  https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/polyhydramnios-high-amniotic-fluid/

  Maternal diabetes – Elevated blood glucose levels can lead to an excessive buildup of amniotic fluid. […] Twin To Twin Transfusion Syndrome (TTTS) – If you are carrying identical twins, it’s possible that you could have a complication in which one twin is getting too much blood, and the other is getting too little. […] A problem with the baby’s heart rate – This includes anything from fetal arrhythmia, a faintness of heartbeat due to a large amount of amniotic fluid or a congenital heart defect. […] As mentioned earlier, mild polyhydramnios usually does not cause complications. But in severe cases, there are certain risks, including: Pre-term Labor, Premature Birth, Excess fetal growth, Placental abruption (the placenta detaching from the wall of the uterus before you give birth), Postpartum hemorrhage, Umbilical cord prolapse (the cord falling out of the vagina before the baby), Fetal malposition, Stillbirth.

• #58 High Amniotic Fluid During Pregnancy | American Pregnancy Association

  https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/polyhydramnios-high-amniotic-fluid/

  Maternal diabetes – Elevated blood glucose levels can lead to an excessive buildup of amniotic fluid. […] Twin To Twin Transfusion Syndrome (TTTS) – If you are carrying identical twins, it’s possible that you could have a complication in which one twin is getting too much blood, and the other is getting too little. […] A problem with the baby’s heart rate – This includes anything from fetal arrhythmia, a faintness of heartbeat due to a large amount of amniotic fluid or a congenital heart defect. […] As mentioned earlier, mild polyhydramnios usually does not cause complications. But in severe cases, there are certain risks, including: Pre-term Labor, Premature Birth, Excess fetal growth, Placental abruption (the placenta detaching from the wall of the uterus before you give birth), Postpartum hemorrhage, Umbilical cord prolapse (the cord falling out of the vagina before the baby), Fetal malposition, Stillbirth.

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

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

  Treatment may be needed if you have severe polyhydramnios. […] Too much amniotic fluid in your uterus puts pressure on your nearby organs and causes pregnancy complications. […] The condition is usually more serious if it occurs early in pregnancy because theres more time for amniotic fluid to continue to build up. […] Other complications of too much amniotic fluid include: Early labor. […] Severe cases of polyhydramnios may lead to premature labor and your baby being born early. […] Most people with polyhydramnios have healthy babies without complications.

• #60 High Amniotic Fluid During Pregnancy | American Pregnancy Association

  https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/polyhydramnios-high-amniotic-fluid/

  Maternal diabetes – Elevated blood glucose levels can lead to an excessive buildup of amniotic fluid. […] Twin To Twin Transfusion Syndrome (TTTS) – If you are carrying identical twins, it’s possible that you could have a complication in which one twin is getting too much blood, and the other is getting too little. […] A problem with the baby’s heart rate – This includes anything from fetal arrhythmia, a faintness of heartbeat due to a large amount of amniotic fluid or a congenital heart defect. […] As mentioned earlier, mild polyhydramnios usually does not cause complications. But in severe cases, there are certain risks, including: Pre-term Labor, Premature Birth, Excess fetal growth, Placental abruption (the placenta detaching from the wall of the uterus before you give birth), Postpartum hemorrhage, Umbilical cord prolapse (the cord falling out of the vagina before the baby), Fetal malposition, Stillbirth.

• #61

  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. Common causes of polyhydramnios include gestational diabetes, fetal anomalies with disturbed fetal swallowing of amniotic fluid, fetal infections and other, rarer causes. […] A disturbed equilibrium can be the result of compromised swallowing function or increased urination and can lead to polyhydramnios. […] Poorly managed gestational diabetes is associated with fetal macrosomia and polyhydramnios but the pathogenesis has not been elucidated yet. One possible explanation is fetal hyperglycemia resulting in increased osmotic diuresis which subsequently leads to polyuria. […] 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.

• #62 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

  Assessment of the amniotic fluid volume (AFV) in pregnancy is part of the surveillance of fetal wellbeing and polyhydramnios constitutes the abnormal increase in amniotic fluid volume. It is defined as the presence of a single deepest vertical pocket (DVP) of 8 cm or an amniotic fluid index (AFI) of 25 cm. Although polyhydramnios can be associated with chromosomal abnormalities, genetic syndromes, fetal structural malformations, anaemia, infections, placental abnormalities and maternal diabetes, in the majority of the cases (70%) no reason is identified and the polyhydramnios is classified as idiopathic. Idiopathic polyhydramnios is usually diagnosed in the third trimester of pregnancy and its impact on maternal and perinatal outcomes is a matter of debate. […] 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.

• #63 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

  Assessment of the amniotic fluid volume (AFV) in pregnancy is part of the surveillance of fetal wellbeing and polyhydramnios constitutes the abnormal increase in amniotic fluid volume. It is defined as the presence of a single deepest vertical pocket (DVP) of 8 cm or an amniotic fluid index (AFI) of 25 cm. Although polyhydramnios can be associated with chromosomal abnormalities, genetic syndromes, fetal structural malformations, anaemia, infections, placental abnormalities and maternal diabetes, in the majority of the cases (70%) no reason is identified and the polyhydramnios is classified as idiopathic. Idiopathic polyhydramnios is usually diagnosed in the third trimester of pregnancy and its impact on maternal and perinatal outcomes is a matter of debate. […] 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.

• #64 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

  Assessment of the amniotic fluid volume (AFV) in pregnancy is part of the surveillance of fetal wellbeing and polyhydramnios constitutes the abnormal increase in amniotic fluid volume. It is defined as the presence of a single deepest vertical pocket (DVP) of 8 cm or an amniotic fluid index (AFI) of 25 cm. Although polyhydramnios can be associated with chromosomal abnormalities, genetic syndromes, fetal structural malformations, anaemia, infections, placental abnormalities and maternal diabetes, in the majority of the cases (70%) no reason is identified and the polyhydramnios is classified as idiopathic. Idiopathic polyhydramnios is usually diagnosed in the third trimester of pregnancy and its impact on maternal and perinatal outcomes is a matter of debate. […] 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.

• #65 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

  Assessment of the amniotic fluid volume (AFV) in pregnancy is part of the surveillance of fetal wellbeing and polyhydramnios constitutes the abnormal increase in amniotic fluid volume. It is defined as the presence of a single deepest vertical pocket (DVP) of 8 cm or an amniotic fluid index (AFI) of 25 cm. Although polyhydramnios can be associated with chromosomal abnormalities, genetic syndromes, fetal structural malformations, anaemia, infections, placental abnormalities and maternal diabetes, in the majority of the cases (70%) no reason is identified and the polyhydramnios is classified as idiopathic. Idiopathic polyhydramnios is usually diagnosed in the third trimester of pregnancy and its impact on maternal and perinatal outcomes is a matter of debate. […] 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.

• #66 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

  From a pathophysiological point of view, increased AFV can cause uterine overdistention which can potentially explain the increased risk of preterm labour, placental abruption and PPH as the uterus becomes less responsive to oxytocin, leading to uterine atony. Uterine overdistention and increased intrauterine pressure could also lead to a degree of placental insufficiency and this could explain the altered feto-placental Doppler velocimetry seen in patients diagnosed with idiopathic polyhydramnios. This putative mechanism could represent a possible link between idiopathic polyhydramnios and adverse neonatal outcomes including low APGAR scores and perinatal mortality.

• #67 Polyhydramnios and Oligohydramnios: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/975821-overview

  Polyhydramnios may occur in the recipient twin, and oligohydramnios may occur in the donor. […] Polyhydramnios appears to increase the risk of prolonged first stage of labor, nonvertex presentation, and cesarean delivery. […] Studies show that as the severity of polyhydramnios increases, the likelihood of determining the etiology increases.

• #68 Polyhydramnios and Oligohydramnios: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/975821-overview

  Polyhydramnios may occur in the recipient twin, and oligohydramnios may occur in the donor. […] Polyhydramnios appears to increase the risk of prolonged first stage of labor, nonvertex presentation, and cesarean delivery. […] Studies show that as the severity of polyhydramnios increases, the likelihood of determining the etiology increases.

• #69 Polyhydramnios and Oligohydramnios: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/975821-overview

  Polyhydramnios may occur in the recipient twin, and oligohydramnios may occur in the donor. […] Polyhydramnios appears to increase the risk of prolonged first stage of labor, nonvertex presentation, and cesarean delivery. […] Studies show that as the severity of polyhydramnios increases, the likelihood of determining the etiology increases.

• #70 High Amniotic Fluid During Pregnancy | American Pregnancy Association

  https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/polyhydramnios-high-amniotic-fluid/

  Maternal diabetes – Elevated blood glucose levels can lead to an excessive buildup of amniotic fluid. […] Twin To Twin Transfusion Syndrome (TTTS) – If you are carrying identical twins, it’s possible that you could have a complication in which one twin is getting too much blood, and the other is getting too little. […] A problem with the baby’s heart rate – This includes anything from fetal arrhythmia, a faintness of heartbeat due to a large amount of amniotic fluid or a congenital heart defect. […] As mentioned earlier, mild polyhydramnios usually does not cause complications. But in severe cases, there are certain risks, including: Pre-term Labor, Premature Birth, Excess fetal growth, Placental abruption (the placenta detaching from the wall of the uterus before you give birth), Postpartum hemorrhage, Umbilical cord prolapse (the cord falling out of the vagina before the baby), Fetal malposition, Stillbirth.

• #71 High Amniotic Fluid During Pregnancy | American Pregnancy Association

  https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/polyhydramnios-high-amniotic-fluid/

  Maternal diabetes – Elevated blood glucose levels can lead to an excessive buildup of amniotic fluid. […] Twin To Twin Transfusion Syndrome (TTTS) – If you are carrying identical twins, it’s possible that you could have a complication in which one twin is getting too much blood, and the other is getting too little. […] A problem with the baby’s heart rate – This includes anything from fetal arrhythmia, a faintness of heartbeat due to a large amount of amniotic fluid or a congenital heart defect. […] As mentioned earlier, mild polyhydramnios usually does not cause complications. But in severe cases, there are certain risks, including: Pre-term Labor, Premature Birth, Excess fetal growth, Placental abruption (the placenta detaching from the wall of the uterus before you give birth), Postpartum hemorrhage, Umbilical cord prolapse (the cord falling out of the vagina before the baby), Fetal malposition, Stillbirth.

• #72 Polyhydramnios | Too Much Amniotic Fluid

  https://www.birthinjuryhelpcenter.org/birth-injuries/prenatal-problems/amniotic-fluid-excess/

  In cases of severe polyhydramnios, there is significant risk of serious pregnancy and childbirth complications. The most significant complications associated with polyhydramnios include: […] This study looked at the relationship between polyhydramnios and adverse pregnancy outcomes. The researchers found that polyhydramniotic mothers were associated with higher C-section, fetal distress, and NICU admission rates. They concluded that these effects necessitate close monitoring of polyhydramniotic pregnancies. […] They found that polyhydramnios increased the placental abruption risk.

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