gynecology and obstetrics
Polyhydramnios
Key Points
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, premature 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 preterm labor occurs or if polyhydramnios causes severe symptoms. Begin prenatal monitoring with weekly nonstress tests as early as 32 weeks in patients with an amniotic fluid index of ≥ 30 cm. 