The fetus develops in the water area, which is surrounded by a shell of water or amnion. Amniotic fluid play an important role in the development and future of the child. They provide him freedom of movement, protection against infectious agents and external factors (injuries, blows in the stomach), and also contribute to the functioning of the excretory system of the fetus and the metabolism. But under the influence of unfavorable factors of the volume of amniotic fluid may increase, leading to high water or fall (oligohydramnios). Polyhydramnios adverse impact on women's health and the condition of the fetus and complicates the course of pregnancy and childbirth.
What is polyhydramnios
About hydramnion say, when the amount of amniotic fluid is much higher than normal. The amount of amniotic fluid changes throughout pregnancy. Thus, when the term of ten weeks the amount of water is 30 ml, and by the end of pregnancy is 1-1, 5 liters. Increased amniotic fluid in pregnancy 38-40 weeks to two liters evidence of polyhydramnios.
The reasons that lead to the development of polyhydramnios, diverse and currently not fully understood. The main factors that cause polyhydramnios are:
- bacterial and viral infections during pregnancy or before conception (especially rubella);
- diseases associated with metabolism
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(diabetes, the pathological processes of the urinary and biliary systems);
- diseases of the cardiovascular system;
- congenital malformations of the fetus (abnormalities of the central nervous system, digestive tract, chromosomal and genetic disorders);
- immunological incompatibility between mother and fetus (Rh-conflict pregnancy);
- multiple pregnancy (often accompanied by polyhydramnios one fruit and another oligohydramnios).
Clinical manifestations of polyhydramnios
Polyhydramnios classified according to the severity of symptoms (mild, moderate and severe) and course (acute and chronic).
Develops quickly and is accompanied by a sharp increase in amniotic fluid for several hours. Acute polyhydramnios usually occurs in the second trimester of pregnancy (in terms of 16-24 weeks of pregnancy) and is accompanied by pronounced symptoms.
The current long-term chronic polyhydramnios, amniotic fluid volume increases gradually, the clinical manifestations are expressed moderately. Chronic polyhydramnios often occurs in later stages of pregnancy (33-35 weeks).
The main symptoms of polyhydramnios include increasing the size of the stomach, and their gestational age discrepancy (increased waist circumference and height of standing uterus) often observed bulging of navel. Palpation Uterus tense tugoelastichnoy consistency. Also, there are pains in the abdomen
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and lower back due to the increased load on the spine. Overstretched uterus puts pressure on adjacent organs and lifts up the diaphragm, which is accompanied by the appearance of shortness of breath and blood circulation disorders (tachycardia, palpitations, fatigue). Furthermore, as a result of impaired blood flow increases the load on the veins of the lower extremities and perineum, which leads to the development of varicose veins. The pressure of the uterus on the intestines and bladder
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It causes frequent urination and bowel function disorders.
On palpation the abdomen is determined by distinct gurgle of the fruit palpated with difficulty, muffled or dull heartbeat. Due to the increase of the space intrauterine fetus it is often in the wrong position (breech, transverse) and often it changes. With the development of infection in the mother at high risk of intrauterine infection of the fetus, and, accordingly, the development of fetal malformations. In turn, intrauterine fetal abnormalities often lead to polyhydramnios. If polyhydramnios develops in the rhesus, is evidence of the deterioration of the fruit.
One-third of women in polyhydramnios marked vomiting and threatened miscarriage. Due to the large belly appear on the skin striae (stretch marks of pregnancy). Most pregnancies with polyhydramnios ends in miscarriage or premature birth
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Polyhydramnios Treatment depends on the cause. Women with acute or severe polyhydramnios admitted to hospital. Appointed by means of improving placental blood flow (pentoxifylline, piracetam), antispasmodics (no-spa, papaverine), tocolytics (partusisten, ginipral), vitamins. In severe cases, amniocentesis (fetal bladder puncture and evacuation of the amniotic fluid).
- polyhydramnios during pregnancy