Polyhydramnios, Oligohydramnios,

Uterus smaller than date, Uterus

larger than date.
1.  Causes of uterus larger than date.
> Multiple gestation
> Polyhydramnios
> Macrosomic baby

2.  Causes of uterus smaller than date.

> Oligohydramnios
> SGA
> FGR

> IUD

3.  Causes of polyhydramnios and oligohydramnios.

Causes of Polyhydramnios:
> Maternal: GDM

> Placental: Chrioangioma, Arteriovenous fistula

> Fetal: Multiple gestation, Oesophageal atresia, Duodenal atresia,
Anencephaly
> Idiopathic (65%)

Causes of Oliohydramnios:
PPROM, Renal agenesis, Multicystic kidneys, Fetal growth restriction,
placental insufficiency, Drug (NSAIDS)

4.  Risks or complications of polyhydramnios and oligohydramnios.

Complications of Polyhydramnios:

> Pulmonary hypoplasia

> Limb deformity

> Potter’s face

Complications of Oligohydramnios

 Maternal discomfort

 Cord prolapsed

 Abruptio placenta

 Malpresentation

 Preterm labour

 PPROM

 PPH

 Uterine involution

5.  Investigations to rule out possible causes of polyhydramnios and

oligohydramnios.

> MOGTT/ BSP: TRO GDM

> Ultrasound scan: To determine number of fetus, fetal viability, to

evaluate fetal growth and fetal anomaly, amount of liquor

> Umbilical artery doppler: To evaluate placental sufficiency

6.  Management of polyhydramnios and oligohydramnios

Management of polyhydramnios:

Mild and moderate: no treatment acquired

Severe: Hospitalization, consider amniocentesis, Indomethacin (stop

before 32 weeks)

Management of oligohydramnios:
If evident of fetal distress on ultrasound, immediate delivery via
caesarean section.

If no evidence of fetal distress, do induction of labour and delivered via

vaginal delivery.