I.

INTRODUCTION
Objectives:

● Review the etiology of polyhydramnios.

● Outline the appropriate evaluation of polyhydramnios.

● Review the management options available for polyhydramnios.

TADEO
Polyhydramnios
- Is the excessive accumulation of amniotic fluid — the fluid that surrounds the
baby in the uterus during pregnancy. Polyhydramnios occurs in about 1 to 2
percent of pregnancies.
- Polyhydramnios is most common in the third trimester.
- A normal amniotic fluid index is 5 cm to 25 cm using the standard assessment
method. Less than 5 cm is considered oligohydramnios, and greater than 25 cm is
considered polyhydramnios.
ELAD
Polyhydramnios is an increase in amniotic fluid in pregnancy associated with
increased maternal and neonatal morbidity and mortality. The severity of this disease
process varies, but up to 20% of neonates affected by this condition are born with a
congenital anomaly. - The most common severe birth defects are heart defects, neural
tube defects and Down syndrome. Although birth defects may be the result of one or
more genetic, infectious, nutritional or environmental factors, it is often difficult to identify
the exact causes.
TADEO
Types on basis of Degree
Mild (common) AFI (amniotic fluid index) = 25-30 cm
Moderate AFI = 30-35 cm
Severe AFI = > 35 cm

ELAD
Type on basis of Onset
 Acute (rare) Sudden, takes few days to begin
Chronic (common) Gradual, takes few weeks to begin

II. PATHOPHYSIOLOGY AND MANAGEMENT

a. Diagram
Risk Factors
Predisposing Risk Factors Precipitating Risk Factors Aggravating Risk Factors
 Hereditary (Diabetes  Smoking  Fetal Factor
in Mother)  Alcoholism - Anencephaly
 Rhesus disease or - Cleft lip and cleft
other mother-baby palate
blood - Esophageal or
incompatibilities. duodenal atresia
 Idiopathic - Open spina bifida
- Rhesus
isoimmunization
- Presence of
infection during
pregnancy
 Maternal Factors
- Multiple pregnancy
- Cardiac or renal
disease
- Diabetes
 Placenta
- Chorioangioma of
the placenta

Explanation:
KATE
Predisposing Risk Factors
1. Hereditary – If the mother has diabetes, the baby can have hyperglycemia (high
blood glucose (blood sugar) in fetus and this may cause polyuria (Excessive Urine
Production) and feeders so more urine again may contribute in large amount of
amniotic fluid.
 2. Rhesus disease or other mother-baby blood incompatibilities. - Your blood
type depends on the genes you inherit from your parents. Whether you're RhD
positive or negative depends on how many copies of the RhD antigen you've
inherited. You can inherit one copy of the RhD antigen from your mother or father,
a copy from both of them, or none at all.
Rhesus disease is a condition where antibodies in a pregnant woman's blood
destroy her baby's blood cells. Rhesus disease doesn't harm the mother, but it can
cause the baby to become anaemic and develop jaundice.
3. Idiopathic - That is in majority of situation the exact reason is not known. Most
common cause.

Precipitating Risk Factors

1. Smoking – Women who repeatedly smoked prenatally were found to be at
increased risk for polyhydramnios.
2. Alcoholism – Even after alcohol leaves the fetal blood, it can linger in the amniotic
fluid. Alcohol can lower baby’s blood sugar, insulin levels, and thyroid levels.
These health problems can lead to low weight, birth defects, and even fetal death.
Birth defects are structural changes present at birth that can affect almost any part or
parts of the body (e.g., heart, brain, foot). They may affect how the body looks, works, or
both. Birth defects can vary from mild to severe.
Examples of Birth Defects.
Cleft lip or cleft palate.
Heart defects, such as missing or misshaped valves.
Abnormal limbs, such as a clubfoot.
Neural tube defects, such as spina bifida, and problems related to the growth and
development of the brain and spinal cord.

Aggravating Risk Factors

1. Fetal and Maternal factors also which contribute in this condition. First is
congenital defects which start develop developing in fetal life itself.
a. Anencephaly - Means where the brain and the skull part of the fetuses is not
develop well so when it is not develop well the what happen to the manager
are not there that cover whole brain and the cfs will leak in the amniotic sac
 and that will contribute to the amniotic fluid, along with that the swallowing
reflex is also not there or diminished in this fetus.
Cerebrospinal fluid (CSF, shown in blue) is made by tissue that lines the
ventricles (hollow spaces) in the brain. It flows in and around the brain and spinal
cord to help cushion them from injury and provide nutrients.
b. Gastrointestinal Defect (Cleft lip and cleft palate) – where a slit is forming in
the lip and the palate and that will interfere the swallowing of the amniotic fluid.
Amniotic fluid is recycled in every three hour so there are the factor of which
help in regulation because some factors produces this fluid some reabsorb this
fluid. That’s why this fluid is circulated or recycled in three hours duration.
ELAD
c. Esophageal or duodenal atresia - Interfere the swallowing because the
esophagus or dodal part is either completely absent or under developed or it is
narrow.
Esophageal Atresia (Blockage in the gut) or other birth defects – the baby
may have a birth defect which is affecting the central nervous system or
gastrointestinal tract
d. Open spina bifida – The managers become exposed and csf will leak into this
amniotic sac and that will contribute to the increase amount of amniotic fluid.
e. Rhesus isoimmunization - Where the mother is having Irish negative blood
group, so in this condition what happened when the fetal blood cell enter in the
fetal circulation, the mother develops antibody against them. These antibodies
travel along the fetal circulation and destroys the fetus rbcs. So to compensate
this loss and fulfill the oxygen demand of the fetus the placental tissues grows
more so there is a hyperplasia of placental tissue and this hyperplasia add in
more amount of amniotic fluid because there is an increased transformation of
fluid that filter across the fetal membrane and enter the amniotic sac so thereby
the fluid volume increases.
f. Presence of infection during pregnancy - Then this infection also causes
polyhydramnios. Such as Toxoplasmosis, Rubella, Syphilis.
Viral infection during pregnancy causes the release of cytokines and cause
oxidative stress and disrupts the placental functions and causes polyhydramnios

KATE
3. Maternal factors
a. Multiple pregnancies – where 2 or more fetuses are growing at the same time
in a womb then more fetuses means more urine because these all are
contributing in the amniotic fluid volume because the fetal urine is the main
 contributor in amniotic fluid volume at term. So more fetuses means more urine.
But in multiple pregnancies the polyhydramnios usually appear in monozygotic
twins where there is one rare complication appears, that is ttts twin twin
transfusion syndrome – both fetuses shares a common placenta but there are not
equally received the same amount of nutrient at the same time, so the recipient
fetus which receives more develops the hydramnios, and the one which receives
less may have oligohydramnios, but suppose if the woman is having
b. cardiac or renal diseases then to compensate the oxygen demand for the fetus,
again there is a hyperplasia of the blood vessels of placenta and that may filter
more fluid across the fetal membrane and that may enter in the amniotic sac so
thereby the fluid volume is increases,
ELAD
c. and if the woman is having diabetes, where the blood glucose level is more so
what happened these high glucose level enter in the fetal circulation as well so
there is a hyperglycemia (high blood glucose (blood sugar) in fetus and this
may cause polyuria Polyuria (Excessive Urine Production) and feeders so more
urine again may contribute in large amount of amniotic fluid
4. Where the benign tumor is formed in the placental tissues so benign tissues means
there is a hypoplasia (Hypoplasia refers to a lack of cells in an organ or tissue.) of
blood vessels and when it takes place then what happen again there is a more
translation of fluid across the membrane and that will enter in the amniotic sac.
KATE
DISEASE PROCESS
Polyhydramnios is a condition which affects the uterus of a pregnant woman. In this
condition, too much amniotic fluid (the liquid that surrounds the baby in the womb) collects
in the uterus. When this happens, the uterus becomes larger than normal.
What is the main reason babies swallow amniotic fluid in the womb?
Keeps a steady temperature around your baby. Helps your baby's lungs grow and
develop because your baby breathes in the fluid. Helps your baby's digestive system
develop because your baby swallows the fluid. Helps your baby's muscles and bones
develop because your baby can move around in the fluid.
KATE
SIGNS AND SYMPTOMS
Signs and Symptoms
 Abdominal girth is more
 Fundal height is more than the weeks of gestation
 Dyspnea
 Palpitation
 Edema & Varicosities in the legs, hemorrhoids
 Skin tense, shiny, & large striae
 Unstable lie malpresentation, fetal parts not defined – breech position
 FHS not auscultate by stethoscope
 Globular uterus (Enlargement of uterus)
 Abdominal Pain
 Constipation
 Uterine Contraction which may lead to preterm labor.

1. Abdominal girth is more – it is the increasing more and more in comparison to the
normal pregnancy because the fluid volume is more so when the girt is increasing
more along with
Diagnosis – Abdominal girth measurement - locate the upper hip bone and the top
of the right iliac crest. Place a measuring tape in a horizontal plane around the
abdomen at the level of the iliac crest.
Surgical Management – Ultrasound
Nursing Management - Maintain bed rest with sedation to make the situation
endurable.

2. Fundal height is more than the weeks of gestation – the fundus height is also
more, which is not correspond with the week of the station, suppose the week of
gestation is 24 but we are receiving 28-30 cm. Why? Because the height goes up
with this large amount of amniotic fluid, so it does not correspond or correlate with
the week of gestation and that may cause
Diagnosis – Fundal height measurement
A fundal height measurement is typically done to determine if a baby is small for its
gestational age. The measurement is generally defined as the distance in centimeters
from the pubic bone to the top of the uterus.
Nursing Management - Maintain bed rest with sedation to make the situation
endurable.
3. Dyspnea – because the height goes up and that will displaced diaphragm up and
that may cause difficulty in breathing in a woman, then it will again cause
Diagnosis – Chest X-rays and Computed Tomography (CT) Images,
Electrocardiogram (ECG)
Doctors may use chest X-rays and computed tomography (CT) images to make a
more specific diagnosis of dyspnea and evaluate the health of the person's heart,
lungs, and related systems. An electrocardiogram (ECG) may help to show any
signs of a heart attack or other electrical problem in the heart.
Nursing Management - Elevate the patients head. Keep your head and shoulders
propped up when you are lying down. This position will help you breathe deeply
and prevent shortness of breath.

4. Palpitation – when the size of the abdomen is more that may compress the blood
vessels of woman as well, so this compress vessels may cause
Diagnosis – Physical exam and listen to your heart using a stethoscope.
To diagnose palpitations, a health care provider will do a physical exam and listen
to your heart using a stethoscope. The exam may include looking for signs of
medical conditions that can cause heart palpitations, such as a swollen thyroid
gland. You will likely be asked questions about your medical history.
Nursing Management - Monitor maternal vital signs and fetal heart rate
frequently; report changes immediately.

ELAD
5. Edema & Varicosities in the legs, hemorrhoids – edema of the lower limb as well
as varicosities in the lower limb or may cause hemorrhoids as well, and along with
that
Diagnosis – Physical Exam, Doppler ultrasound,
Bleeding (you may notice blood when you wipe after a bowel movement)
Painful bowel movements.
A raised area of skin near your anus.
Itching.
Burning.
Swelling.
Your doctor can tell whether you have edema by examining you. The skin over the
swollen area may be stretched and shiny. Pushing gently on the swollen area for
about 15 seconds will leave a dimple.
To diagnose varicose veins, a health care provider might recommend a test called a
venous Doppler ultrasound of the leg. A Doppler ultrasound is a noninvasive test
that uses sound waves to look at blood flow through the valves in the veins. A leg
ultrasound can help detect a blood clot.
 Surgical Management – Vein ligation and stripping, surgical hemorrhoidectomy
Pharmacological Management - Medication. Your health care provider may
prescribe the oral medication - indomethacin (Indocin) to help reduce fetal urine
production and amniotic fluid volume. Indomethacin isn't recommended beyond 31
weeks of pregnancy. Due to the risk of fetal heart problems, your baby's heart may
need to be monitored with a fetal echocardiogram and Doppler ultrasound. Other
side effects may include nausea, vomiting, acid reflux and inflammation of the
lining of the stomach (gastritis).
Vein ligation and stripping is a surgical treatment for varicose veins. One or more
cuts are made over the vein, and the vein is tied off (ligated) in two places. All or
part of the vein between the teed off areas is usually removed (stripped). You'll need
general or spinal anesthesia for this surgery.
A hemorrhoidectomy is surgery to remove internal or external hemorrhoids that are
extensive or severe. Surgical hemorrhoidectomy is the most effective treatment for
hemorrhoids, though it is associated with the greatest rate of complications.
Nursing Management – Instruct patient and/or family in comfort measures to use
with the presence of hemorrhoids. Use of rubber donuts remove pressure directly
placed on the hemorrhoid. Warm sits baths or suppositories containing anesthetic
agents can help to alleviate pain temporarily.
These include elevating and supporting your legs throughout the day, avoiding high
heels, and wearing graduated compression stockings. Regular exercise and not
standing or sitting for long periods of time can also help.

6. Skin tense, shiny, & large striae– the skin of the uterus become tense, it become
tense, it become thin, shiny because it is stretching with this large amount of
amniotic fluid, and the straits, the linear stretch marks which appear on the abdomen
is also become enlarged. They become enlarge, become thick. So striates are also
more prominent in these women’s. Then when we talked about the fetal status, then
it is completely disturbed because with the increasing week of gestation diaphragm,
the fluid volume is usually decreases, but here the fluid volume is not decreasing so
that’s why the fetal status that is the fetal lie position is not stable this is all
disturbed,
Diagnosis – Physical Examination
Nursing Management –
1. Control your weight
One of the most helpful things you can do to prevent stretch marks, whether you’re
pregnant or not, is to maintain a healthy weight.
2. Stay hydrated
Drinking enough water may help keep your skin hydrated and soft. Soft skin
doesn’t tend to develop stretch marks as much as dry skin does.
 3. Eat a nutrient-rich diet
Stretch marks may also occur if you lack nutrition in certain areas. Eating foods that
boost skin health may help. Make sure your diet includes foods rich in:
Vitamin C
Vitamin D
Vitamin E
Zinc
Protein
4. Include vitamin C in your diet
Collagen plays a role in keeping your skin strong and elastic. It helps reduce the
appearance of wrinkles, but it may also be important for preventing stretch marks.
Vitamin C is an important nutrient for the development of collagen. Vitamin C can
be found in many fruits and vegetables. Citrus fruits, such as oranges and lemons,
are especially good sources of vitamin C.
5. Soak up some vitamin D
More research is needed, but results suggest that maintaining healthy levels of
vitamin D may reduce your risk of stretch marks. The easiest way to get vitamin D
is through exposure to the sun. The vitamin is also commonly added to bread,
cereal, and dairy products like milk or yogurt.
6. Eat foods rich in zinc
Zinc is an important nutrient for skin health. It helps reduce inflammation and plays
a role in the wound healing process.
7. Treat fresh stretch marks when they appear
If you can’t totally prevent stretch marks on your skin, you can work to minimize
their appearance so they aren’t as noticeable in the long run. Make an appointment
with your doctor or a dermatologist to discuss your options if you have fresh stretch
marks. Your doctor can help determine what is causing your marks, and they may
be able to suggest treatment options that work best on new stretch marks.

7. Unstable lie malpresentation, Fetal parts not defined – because of this fluid thrill
what happened the lie become disturbed so there is an unstable line, there is a mild
presentation, fetal body part of parts are not palpable easily, and if we are not able
to palpate the body parts then we will not be able to auscultate the fetal heart sound
as well
Diagnosis – Biophysical profile. This test uses an ultrasound to provide more
information about your baby's breathing, tone and movement, as well as the volume
of amniotic fluid in your uterus. It may be combined with a nonstress test.
Surgical Management – Ultrasound, Cesarean Section
Nursing Management - Monitor the patient for signs and symptoms of premature
labor.
8. FHS not auscultate by stethoscope - This all difficulties maybe arises with this
hydramnios but at this time fetal heart rate is easily measured by ultrasonography
but it is tough to measure by ordinary stethoscope.
Diagnosis – Fetal Nonstress test. This test checks how your baby's heart rate reacts
when your baby moves. During the test, you'll wear a special device on your
abdomen to measure the baby's heart rate. You may be asked to eat or drink
something to make the baby active. A buzzer-like device also may be used to wake
the baby and encourage movement.
Surgical Management – Ultrasound
Nursing Management - Monitor the patient for signs and symptoms of premature
labor.

9. Globular uterus - So by this all fluid thrill as well as the increased abdominal girth
where the height of the uterus is also increasing this all makes the uterus a globe
shaped structure.
The uterus takes on a more globular shape and becomes firmer. This occurs as the
placenta descends into the lower segment and the body of the uterus continues to
retract. This change may be clinically difficult to appreciate. The uterus rises in the
abdomen.
Diagnosis – Ultrasound, MRI
Pelvic imaging such as ultrasound and MRI can detect signs of adenomyosis, but
the only way to confirm it is to examine the uterus after hysterectomy.
Surgical Management – Drainage of excess amniotic fluid. Your health care
provider may use amniocentesis to drain excess amniotic fluid from your uterus.
This procedure carries a small risk of complications, including preterm labor,
placental abruption and premature rupture of the membranes.
Delivery may be recommended if your baby is close to full term.
Nursing Management - Hospitalization if symptoms are severe dyspnea,
abdominal pain and difficult ambulation.
MEDICAL MANAGEMENT
Diagnostic Evaluation Pharmacological Surgical Intervention
Treatment
 Fetal Ultrasound  Close Monitoring  Drainage of excess
 Measurement of the  Biophysical profile amniotic fluid
amniotic fluid  Nonstress Test
volume (AFV)  Indomethacin
 Measurement of the (Indocin)
amniotic fluid index  Treatment of
(AFI) underlying medical
 Blood Test condition.
 Amniocentesis

Explanation:
Diagnostic Evaluation
Fetal ultrasound – to visualize the baby in utero through high-frequency sound waves
Measurement of the amniotic fluid volume (AFV) – to find the largest and deepest
pocket of fluid around the baby and measuring the volume of amniotic fluid in it;
polyhydramnios is confirmed if the AFV value is 8 centimeters or more; measuring the
AFV via ultrasound is a standard procedure in all pregnancies, regardless of the risk for
polyhydramnios
Measurement of the amniotic fluid index (AFI) – the sum of measurements of the largest
pockets in four areas of the uterus; polyhydramnios is confirmed if the AFI value is 25
centimeters or more
Blood tests – to check for any presence of infection as a complication of polyhydramnios
Amniocentesis – to collect a sample of amniotic fluid from the uterus to test for any fetal
abnormalities; involves the ultrasound-guided insertion of a thin, hollow needle into the
uterus through the abdominal wall.

Pharmacological Treatment
Close monitoring. Pregnant women with mild polyhydramnios may not require active
management as they usually resolve on their own. Instead, they will be closely monitored
for any worsening signs and symptoms. The monitoring may also include:
Biophysical profile – an ultrasound test that can be used to check the volume of amniotic
fluid in utero, as well as the breathing, movement, and tone of the baby
Non-stress test – to check the reaction of the baby’s heart rate when he/she moves
Medication. The physician may prescribe indomethacin therapy to facilitate the reduction
of the amniotic fluid volume and fetal urine production. This medication is usually not
prescribed for pregnant women above 31 weeks’ gestation.
Indomethacin is often prescribed to pregnant women presenting with preterm labor or
shortened cervix, which places them at risk for preterm labor and delivery. Indomethacin
has been used since the 1970s to prolong pregnancy by decreasing uterine contractions.
Treatment of underlying medical conditions. Effective management of maternal or
gestational diabetes may help in resolving polyhydramnios.

Surgical Intervention
Amniocentesis. Severe cases of polyhydramnios may require the drainage of excess
amniotic fluid through amniocentesis. This is also the treatment when preterm labor occurs
due to polyhydramnios. The healthcare team will have to monitor the patient every 1 to 3
weeks following treatment.
NURSING MANAGEMENT
Nursing Care Plans for Polyhydramnios
Nursing Care Plan 1
Nursing Diagnosis: Risk for Maternal and Fetal Injury related to polyhydramnios

Desired Outcome: The patient will maintain safety and participate in measures that will
protect self during pregnancy.

Interventions Rationale
Pregnant women with mild
polyhydramnios may not require active
management as they usually resolve on
Place the mother on close monitoring.
their own. Instead, they will be closely
monitored for any worsening signs and
symptoms.

Prepare the patient for biophysical profile Biophysical profile – an ultrasound test
and non-stress test. used to check the volume of amniotic
fluid in utero, as well as the breathing,
 movement, and tone of the baby Non-
stress test – to check the reaction of the
baby’s heart rate when he/she moves.

To allow the healthcare team to monitor

Prepare the patient for admission if there
the pregnant mother and her baby, and to
is any evidence of worsening maternal
provide prescribed treatments as deemed
and/or fetal health due to polyhydramnios.
necessary.

Severe cases of polyhydramnios may

require the drainage of excess amniotic
Obtain consent from the patient to
fluid through amniocentesis. This is also
perform amniocentesis after explaining
the treatment when preterm labor occurs
the procedure’s purpose, benefits, and
due to polyhydramnios. The healthcare
risks.
team will have to monitor the patient
every 1 to 3 weeks following treatment.

The physician may prescribe medication

to facilitate the reduction of the amniotic
Administer prescribed medications for the
fluid volume (AFV) and fetal urine
management of AFV and fetal urine
production. This medication is usually not
production.
prescribed for pregnant women above 31
weeks’ gestation.

Effective management of maternal or

Treat the underlying conditions related to
polyhydramnios, such as gestational/
maternal diabetes and rhesus disease.
gestational diabetes may help in resolving
polyhydramnios. Administration of anti-D
immunoglobulin injection to a pregnant
woman who is Rh D negative can prevent
rhesus disease which could cause
polyhydramnios.

Nursing Care Plan 2

Nursing Diagnosis: Acute Pain related to increased uterine pressure as evidenced by
pain score of 8 out of 10, verbalization of abdominal pain, swelling of the abdomen, and
enlargement of uterus as seen in the ultrasound, constipation, decreased appetite and
nausea

Desired Outcome: The patient will demonstrate relief of pain as evidenced by a pain
score of 0 out of 10, stable vital signs, and gaining a better appetite.
 Interventions Rationale

Severe cases of polyhydramnios may

Obtain consent from the patient to
perform amniocentesis after explaining
the procedure’s purpose, benefits, and
risks.
require the drainage of excess amniotic
fluid through amniocentesis. This
procedure will help reduce the pressure in
the uterine and abdominal walls, thus
alleviating the pain.

The physician may prescribe medication

Administer prescribed medications for the to facilitate the reduction of the amniotic
management of AFV and fetal urine fluid volume (AFV) and fetal urine
production for pregnant women on 31 production. With a decreased AFV, the
weeks’ gestation and below. pressure on the abdominal walls will be
reduced.

Administer pain medication and/or

To alleviate abdominal pain.
constipation medication as prescribed.

To monitor effectiveness of medical

Assess the patient’s vital signs and
treatment for the pain relief. The time of
characteristics of pain at least 30 minutes
monitoring of vital signs may depend on
after administration of medication.
the peak time of the drug administered.

Nursing Care Plan 3

Nursing Diagnosis: Activity Intolerance related to maternal discomfort and dyspnea
secondary to polyhydramnios as evidenced by fatigue, overwhelming lack of energy,
verbalization of tiredness, and acute abdominal pain

Desired Outcome: The patient will demonstrate alternate periods of desired activities
and rest/sleep.

Interventions Rationales

Assess the patient’s activities of daily To create a baseline of activity levels and
living, as well as actual and perceived mental status related to fatigue and
limitations to physical activity. Ask for activity intolerance.
any form of exercise that he/she used to
 do or wants to try. Ensure that the
exercise is safe to perform during the
patient’s current stage of pregnancy.

The mother with mild to moderate

polyhydramnios can still ambulate and
Alternate low impact activities and rest perform low impact daily activities to
periods. improve breathing and circulation.
However, it is important for her to get
plenty of rest to prevent fatigue.

When the mother experiences acute

abdominal pain or shortness of breath, To reserve energy and to gradually
encourage bed rest. Encourage increase the patient’s tolerance to physical
progressive activity through self-care and activity.
exercise as tolerated.

Help the mother feel more comfortable To allow the patient to relax while at rest
through the following interventions: and to facilitate effective stress
Teach deep breathing exercises and management. To allow enough
relaxation techniques. Provide adequate oxygenation in the room. To help the
ventilation in the room. Prop up the head patient breathe deeply and alleviate
of the mother on two or three pillows. shortness of breath.

Severe polyhydramnios may cause fatigue

Encourage the next of kin, relative, or
and exhaustion of the pregnant patient, so
carer of the mother to participate in her
it is best to have the partner or any carer
care, such as monitoring hydration and
beside her at all times and ensure her
diet, and activities of daily living where
safety and assist her to perform activities
the patient require a helping hand.
of daily living.

KATE
IF NOT TREATED
Complications
Polyhydramnios is associated with:
• Premature birth - is a birth that takes place more than three weeks before the baby's
estimated due date. In other words, a premature birth is one that occurs before the start of
the 37th week of pregnancy. Premature babies, especially those born very early, often have
complicated medical problems.
• 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

ELAD
• C-section delivery
• Stillbirth - is the death or loss of a baby before or during delivery. Both miscarriage and
stillbirth describe pregnancy loss, but they differ according to when the loss occurs.
• Heavy bleeding due to lack of uterine muscle tone after delivery
- Uterine atony is caused by the inability of the myometrium to contract sufficiently
in response to oxytocin, a hormone the body releases before and during childbirth to
stimulate uterine contractions.
PROGNOSIS
The earlier that polyhydramnios occurs in pregnancy and the greater the amount of excess
amniotic fluid, the higher the risk of complications.