seminar on: Polyhydramnios

COMPILED BY: MR. ASHISH ROY

1. SEMINAR ON
POLYHYDRAMNIOS
Complied By -
AshishHenjaliRoy
B.ScNursing 4th year student
College of Nursing
S.G.P.G.I.M.S,
Lucknow.

2. CONTENT
Short video session on polyhydroamnios
Definitions
Sign and Symptoms
Causes
Complications (mother and fetus)
Laboratory and Diagnostic
Treatment
Nursing Diagnosis
References

3. SHORT VIDEO SESSION

4. PHYSIOLOGY OF AMNIOTIC FLUID
Early pregnancy: composition of AF
(amniotic fluid) similar to ECF (Early
conception factor). Transfer of water across
amnion and through fetal skin.
By second trimester: fetus begins to urinate
swallow, and inspire AF During last 2/3 of
pregnancy, AF is principally comprised of
fetal urine.

5. NORMAL AMNIOTIC FLUID
VOLUME

Weeks Gestation
Fetus Amniotic Fluid Placenta
(g) (ml) (g)
16
th
week
28
th
week
36
th
week
40
th
week
100 200
100
1000 1000
200
2500 900
400
3300 800
500

7. DEFINITION:
POLYHYDRAMNIOS
Amedicalconditiondescribingexcessofamnioticfluidin
theamnioticsac.
or
Apathologicalincreaseofamnioticfluidvolumein
pregnancyandassociatedwithincreasedperinatalmorbidity
andmortality.(2000ccamnioticfluid).
or
“Itisadiagnosedifthedeepestverticalpoolismorethan
8cmsoramnioticfluidismorethan95
th
percentileforthe
correspondinggestationalage”.
AmnioticFluidIndex=largestvertical
pocketin4quadrants
polyhydramniosgreaterthan()24cm.

8. SHORT VIDEO ON -Amniotic fluid index
measurements during pregnancy

9. FIGURE OF POLYHYDROAMNIOS

11. ETIOLOGY OF
POLYHYDRAMNIOS
Idiopathic (unknown cause)
Fetal genetic Anomalies/malformation
Diabetes
Immune/Non-immune hydrops
Fetal infection(eg-viral
,rubella,syphilis,parvovirus
B19,neuromuscular,bartter syndrome.
Fetal anemia
Placental haemangiomas

12. Hemangiomas are noncancerous growths
that form on your skin or liver. Most people
develop them in the womb, and they’re
usually harmless
Skeletal dwafism

13. MULTIFETAL GESTATION OR
MULTIPLE PREGNANCIES

14. Chromosomal abnormalitis such as Down’s syndrome
and Edwards Syndrome(often associated with GI
abnormalitis
EDWARD’S SYNDROME BARRETT’S ESOPHAGUS
SYNDROME

15. Etiology of Polyhydramnios:
Fetal Anomalies
•Problems with swallowing
and GI absorption
•Increased transudation of
fluid: anencephaly, spina
bifida
•Increased urination:
anencephaly (lack of ADH,
stimulation of urination
centers)
•Decreased inspiration

16. SYMPTOMS
Abdominalpain
Contractionspretermlabor
DecreasedPerceptionofFetalMovements
Polyhydramniossymptomsresultfrompressurebeingexerted
withintheuterusandonnearbyorgans.
Mildpolyhydramniosmaycausefew—ifany—signsorsymptoms.Severe
polyhydramniosmaycause:
DyspneaorShortnessofbreathortheinabilitytobreathe
Swellinginthelowerextremitiesandabdominalwall
Uterinediscomfortorcontractions
Fetalmalposition,suchasbreechpresentation
Yourhealthcareprovidermayalsosuspectpolyhydramniosifyour
uterusisexcessivelyenlargedandheorshehastroublefeeling
thebaby.

17. Venous stasis or DVT

18. DIAGNOSIS
Fundal height >
gestational age
Difficulty palpating
fetal parts/hearing
heart tones
Tense uterine wall
Ultrasonography
Intrauterine infection
Diabetes mellitus
Rh incompatibilty

19. COMPLICATIONS
Polyhydramniosis associated with:
Premature birth
Premature rupture of membranes —when your water breaks early
Placental abruption —when the placenta peels away from the inner
wall of the uterus before delivery
Umbilical cord prolapse —when the umbilical cord drops into the
vagina ahead of the baby
C-section delivery
Stillbirth
Heavy bleeding due to lack of uterine muscle tone after delivery
The earlier that polyhydramniosoccurs in pregnancy and the greater
the amount of excess amniotic fluid, the higher the risk of
complications.

20. ASSOCIATED
CONDITIONS
Fetuses with polyhyrdoamnios are at risk
for a number of other problems including
cord prolapse, placental
abruption,premature birth and perinatal
death. At delivery the baby should be
checked for congenital abnormalitis.

21. IN FETUS
Fetal prognosis
worsens with more
severe hydramnios
and congenital
anomalies
15-20% fetal
malformations
Preterm delivery
Suspect diabetes
Prolapse of cord
Abruption

22. IN MOTHER
Dyspnea
Venous Stasis or Vericos
vein
Placental abruption
Uterine dysfunction
Post-partum
hemorrhage
Abnormal presentation -
C/S

23. TREATMENT
 For a woman with symptomatic polyhydroamnios
 Mild to moderate hydramnios;rarely requires
treatment
 Hospitalization and bed rest
 Amniocentesis
 Non-steroidal anti-inflammatory analgesia
 Blood sugar control
 No data support dietary restriction of the salt and
fluid.
 Antacids may be prescribed to relieve heartburn
and nausea.

24. TREATMENT
Delivery.
Amniocentesis.

26. Nursing Diagnosis
Deficient fluid volume & imbalance nutrition
less than the body requirements to meet
metabolic demand (nausea/vomiting).
Fatigue related to the disease condition.
Anemia due to the disease conditon.
Fever due to the disease condition.
Pain related to the disease condition.

27. NURSING MANAGEMENT
PROVIDE CLIENT AND FAMILY
TEACHING/COUNCELLING
As per the doctor order give medication on
time.
Provide healthy diet and nutrition
Measure vital signs regularly

28. ASSIGNMENT
Writeanassignmenton:
Q.Definepolyhydroamnios?
Writethecauses,diagnosisandtheraphygivenin
polyhydroamnios.
DATE OF SUBMISSION: 18.01.2018.

29. QUESTIONS
WHAT ARE THE SYMPTOMS OF
POLYHYDROAMNIOS?
WHAT ARE THE COMPLICATIONS?
WHAT ARE THE TREATMENTS
WHICH COULD BE DONE IN
HYDROAMNIONS ?

30. Thankyouso much for listening
& paying attention!!
IF ANY QUERY regarding the topic
KINDLY ASK..

31. REFERENCES
BOOKS:
1.Basanthappa BT, Essentials of midwifery & ObstecticalNursing.NewDelhi
:JaypeePublication
2.Konar Hiralal(1985),DC Dutta’sTextbook of Obstetrics.
3.Marshall Jayne(2014),Myle’sTextbook for midwives
INTERNET SOURCES:
http://www.google.com/wikipedia.com/polyhydroamnios/
http://www.youtube.com/What is Polyhydramnios_ _ Mothercare/
http://www.instagram.com/@the_roy_photography/
http://www.nurseslab.com<polyhydroaminos/