gynecology and obstetrics
Risk Factors for Complications During Pregnancy
Polyhydramnios (Hydramnios) and Oligohydramnios
 Polyhydramnios None Uncontrolled maternal diabetes Multifetal pregnancy Isoimmunization Fetal malformations (eg, esophageal atresia, anencephaly, spina bifida) Oligohydramnios None Polyhydramnios or oligohydramnios is suspected if uterine size does not correspond to gestational date or may be discovered incidentally via ultrasonography, which is diagnostic. In symptomatic patients (shortness of breath and/or abdominal discomfort), amniocentesis to remove excess amniotic fluid (amnioreduction) should be considered. Rarely, when maternal symptoms are severe, corticosteroids and preterm delivery should be considered. Amnioreduction relieves maternal symptoms, but amniotic fluid may reaccumulate rapidly and require repeat procedures. In patients with mild to moderate polyhydramnios, elective delivery at 39 weeks (or earlier, as indicated by symptoms) may be advisable; in making this decision, clinicians should also consider degree of cervical dilation and risk of premature rupture of membranes and umbilical cord prolapse. 