Polyhydramnios
As Polyhydramnios or polyhydramnios , short mostly hydramnios , commonly known as amniotic fluid addiction is, in the prenatal an exceptionally large amount of amniotic fluid with an amniotic fluid index ( AFI ) from and over 20 cm or with a large amniotic fluid about 8 cm (the date is more than two liters).
Frequency and possible causes
Polyhydramnios occurs in about 1% of all pregnancies . Increased occurrence is observed in the presence of diabetes mellitus in pregnant women ( gestational diabetes ).
In addition, amniotic fluid can build up if the growing child drinks little or nothing of it.
In some cases with hydramnios, there are peculiarities in the unborn child. A polyhydramnios is considered a sonographic soft marker for:
- Achondroplasia (most common form of disproportionate short stature )
- Anencephaly
- antenatal bartter syndrome
- Beckwith-Wiedemann syndrome
- Accompanying symptom of hydrops fetalis and prenatal infection
- Chorangion (benign vascular tumor of the placenta )
- Down syndrome (trisomy 21)
- Noonan syndrome (heart defect) / (short stature)
- Duodenal stenosis (narrowing of the duodenum )
- Fallot tetralogy ( heart defect consisting of four specific malformations)
- Fetofetal transfusion syndrome (polyhydramnios in the acceptor / larger twin )
- Fryns Syndrome
- Esophageal stenosis or esophageal atresia (narrowing or occlusion of the esophagus / polyhydramnios may develop due to an accompanying difficulty swallowing)
- Jejunal stenosis (narrowing of the jejunum )
- Congenital syphilis (infection of the pregnant woman with the spirochete Treponema pallidum / syphilis pathogen leads to the disease of the unborn child)
- congenital chickenpox / varicella ( varicella zoster virus infection in pregnant women; the risk of infection for the unborn child is less than 5%)
- Cleft lip and palate (polyhydramnios may develop due to an accompanying difficulty swallowing)
- Majewski syndrome ( short rib polydactyly syndrome type II / hydramnios can be identified from the second trimester)
- Mediastinal displacement (displacement of the middle layer )
- Meconium peritonitis (intestinal perforation )
- Multiple pterygia syndromes
- Neu Laxova syndrome
- Patau syndrome (trisomy 13)
- Pena Shokeir Syndrome (Pseudo Trisomy 18)
- Peters Plus Syndrome
- Prader-Willi Syndrome
- Pyloric atresia
- Rhesus incompatibility (haemolyticus fetalis disease)
- Rubella (infection of the pregnant woman with the Parvo-B-19 virus / polyhydramnios can be determined in severe cases)
- Swallowing disorders (muscular or central)
- Coccyx teratoma ( teratoma / germ cell tumor in the sacrococcygeal region )
- Thanatophoric dysplasia
- Teratomas / germ cell tumors in the brain with cystic and solid areas (hydramnios may develop due to an accompanying swallowing disorder)
- Trisomy 14
- Toxoplasmosis - infection of pregnant women, which is transmitted via the placenta ( transplacentally ) to the unborn child and causes serious illnesses in around 10% of cases
- VACTERL association
- Enlargement of the thyroid gland in the unborn child ( fetal goiter , usually due to hypothyroidism / in 70% of children in whom the pregnant woman has Graves' disease )
- Diaphragmatic hernia (breakthrough of the diaphragm )
- Cystic fibrosis ( cystic fibrosis )
A recent study differentiated between moderate and severe polyhydramnios and showed that Apgar scores less than 7, perinatal mortality, and structural malformations occurred only in women with severe polyhydramnios. In another study, all patients with polyhydramnios who had a sonographically normal fetus showed no chromosomal abnormalities.
treatment
If the polyhydramnios does not resolve on its own, the possibility of an amniotic fluid puncture can be considered. The amniotic sac is punctured with a hollow needle and the excess amniotic fluid is drained through an inserted catheter .
See also
Individual evidence
- ↑ Sandra L. Hagen-Ansert: Textbook of Diagnostic Sonography. 2012, ISBN 978-0-323-07301-1 , p. 1254.
- ^ A. Bundgaard, BR Andersen, L. Rode, M. Lebech, A. Tabor: Prevalence of polyhydramnios at a Danish hospital - a population-based study. In: Acta Obstet Gynecol Scand. 86 (12), 2007, pp. 1427-1431.
- ^ Y. Barnhard, I. Bar-Hava, MY Divon: Is polyhydramnios in an ultrasonographically normal fetus an indication for genetic evaluation? In: Obstet Gynecol. 173 (5), Nov 1995, pp. 1523-1527.