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PubMed1984

Fetal polyuria and hydramnios associated with Bartter's syndrome.

The case of a woman with recurrent hydramnios in three pregnancies, from which the only surviving infant was later found to have Bartter's syndrome, is described. Analysis of electrolytes, renin activity, and aldosterone levels in amniotic fluid from this pregnancy are presented. The finding of maternal hydramnios in the present and 12 other reported cases of Bartter's syndrome suggests that increased fetal voiding is the most likely causative factor in the development of increased amniotic fluid volume. Early onset hydramnios might signify Bartter's syndrome in the offspring in families with an index case. In cases of hydramnios of unknown etiology, appropriate investigations might lead to early diagnosis and treatment of Bartter's syndrome.

Adult↗
PubMedDate not supplied

Intrapartum hydramnios at term and perinatal outcome.

The objective of this study was to compare the intrapartum outcome among laboring patients with hydramnios (amniotic fluid index > or = 24.0 cm) versus those with adequate fluid (amniotic fluid index > 5.0 and < 24.0 cm). Prospectively, during a 2-year period, 341 patients in early labor underwent four-quadrant measurement of amniotic fluid volume. Forty-two patients had intrapartum oligohydramnios (amniotic fluid index < or = 5.0 cm) and were excluded from further analysis. The study compares the outcome between 277 subjects with adequate fluid and 22 with hydramnios. The intrapartum amniotic fluid index, birth weight, incidence of macrosomia (birth weight > or = 4000 gm), shoulder dystocia, cesarean section for fetal distress or cephalopelvic disproportion, Apgar score, and neonatal malformations were noted in each of the 299 subjects. Umbilical arterial blood gas was analyzed in 189 patients. In this study, 22 women with hydramnios had a significantly higher risk of delivering a macrosomic fetus than the 277 patients with a normal index (36.3% vs 13.7%; p = 0.01). There was no significant difference in the incidence of shoulder dystocia, cesarean section for cephalopelvic disproportion, or fetal distress, Apgar scores < 7 at 1 and 5 minutes, fetal acidosis, or neonatal anomalies. We conclude that hydramnios during the intrapartum period in patients at term is significantly associated with delivery of a macrosomic fetus, but not with delivery of a compromised neonate.

Adult↗
PubMed1987

Does fetal gut obstruction cause hydramnios and growth retardation?

In order to study the effects of impaired fetal intestinal absorption of amniotic fluid, two series of neonates (551 from Liverpool and 172 from Rome) with different types of congenital gut obstruction were divided into two groups and compared. Group A consisted of patients with complete obstruction at or above the proximal jejunum (within 15 cm of the ligament of Treitz). Patients of group B had either incomplete obstruction at group A level or either incomplete or complete obstruction at a lower level. Maternal hydramnios and fetal growth retardation rates were found to be significantly higher in group A than in group B. Maternal hydramnios was associated with an increased prematurity rate (P less than .001). Fetal growth retardation was not related to the presence of additional anomalies. In group A growth retardation was more frequent in babies born after 37 weeks of gestation (P less than .05). No differences were found between the Liverpool and Rome series of patients. These findings suggest that fetal gut function not only contributes to the control of amniotic fluid volume but also, in the final stages of pregnancy, to normal fetal growth. Maternal hydramnios may be the cause of premature delivery of fetuses with upper gut obstructions.

Birth Weight↗
PubMed2001

Gestational diabetes complicated by hydramnios was not associated with increased risk of perinatal morbidity and mortality.

OBJECTIVE: To determine whether gestational diabetes (GDM) complicated with hydramnios is associated with higher rates of perinatal morbidity and mortality than those with normal amniotic fluid (AFI). STUDY DESIGN: A case control study of 368 pregnant women with GDM was conducted between January 1995 and December 1996. The study group consisted of 184 women with hydramnios (AFI>25 cm) that were matched for maternal age, parity, and gestational age to 184 women with gestational diabetes and normal AFI. A Student's t-test, McNemar test and logistic regression test were used to compare the two groups. RESULTS: Both groups were under strict metabolic control; mean glucose levels of 5.2+/-2.4 mmol/l in the study group and 5.5+/-2.4 mmol/l in the controls (P>0.05). There were no significant differences between groups in the rates of severe preeclampsia, premature rupture of membranes (PROM), cesarean section rate, intrauterine growth restriction (IUGR), antepartum fetal death, fetal distress, prolapse of umbilical cord and placenta abruption. Even though the prevalence of large for gestational age (LGA) and birth weight were significantly higher in the study group (31 versus 19% and 3441+/-477 versus 3232+/-554 g, respectively), the prevalence of neonatal trauma was the same in both groups (2.6%). There was no significant difference in the Apgar scores (1 and 5 min), newborn hypoglycemia, metabolic acidosis and hyperbilirubinemia. CONCLUSIONS: Hydramnios in women with GDM was not associated with increased risk of perinatal morbidity and mortality.

Adult↗
PubMed1984

Hydramnios and maternal renal failure: relief with fetal therapy.

Hydramnios and maternal renal compromise are described in a singleton pregnancy with a large fetal abdominal cystic mass. Both the hydramnios and the renal failure resolved after percutaneous drainage of the fetal cyst. Rapid reaccumulation of the mass resulted in redrainage and placement of an indwelling cyst/amniotic cavity diversion shunt. Successful continuous decompression and uneventful continuation of the pregnancy were observed for four weeks. The relationship between fetal abdominal masses and hydramnios is discussed.

Abdomen↗
PubMed1995

Fetal pseudohypoaldosteronism: another cause of hydramnios.

Pseudohypoaldosteronism (PHA) is a rare hereditary salt-wasting syndrome which is caused by decreased renal tubular responsiveness to aldosterone. The syndrome consists of hyponatremia, hyperkalemia, dehydration, failure to thrive and increased urinary salt loss. A case of PHA was previously described where fetal polyuria was the probable cause of hydramnios. We present four new cases of PHA, from two families, who were born after pregnancies complicated by severe hydramnios and premature labor. We suggest that PHA should be included in the differential diagnosis of hydramnios, since appropriate investigations might lead to the early diagnosis and treatment of a life-threatening disease.

Adult↗
PubMed1993

Hydramnios in singleton pregnancy: sonographic prevalence and etiology.

One hundred and forty-nine cases of hydramnios were detected among 13,750 parturients undergoing 25,000 routine ultrasonographic examinations. The prevalence of hydramnios was 1.08%. Ninety-seven patients (65.1%) had no apparent cause for the increased amount of fluid volume. Twenty-eight newborns (18.8%) were congenitally malformed, and 22 (14.8%) patients had diabetes mellitus. Rh incompatibility accounted for only 1.3% of the cases. It seems that with the improvement of modern obstetrics, mainly improving the antenatal management of diabetes and Rh incompatibility, there is a decrease in the relative incidence of these two conditions as etiological factors of hydramnios.

Congenital Abnormalities↗
PubMed1982

Hydramnios and observations in Bartter's syndrome.

A boy was born after a pregnancy complicated by a hydramnios. He appeared to suffer from Bartter's syndrome, a disease characterized by hyperreninemia, hyperaldosteronism and excess prostaglandin production resulting in hypokalemia, normotension, impaired urine concentration ability, polyuria and renal sodium loss. Other children with Bartter's syndrome, and also a different syndrome characterized by polyuria and hydramnios, are reviewed. In the evaluation of gross hydramnios of unknown etiology, Bartter's syndrome might also be considered.

Adult↗
PubMedDate not supplied

Indomethacin therapy in hydramnios.

AIM: The use of indomethacin in treatment of hydramnios was evaluated. SUBJECTS & METHODS: Twelve patients with symptomatic hydramnios were treated with indomethacin (2.2- 3.0 mg/kg body weight/day). RESULTS: The treatment was started at a gestational age of 31.17-/+7.94 weeks and continued for 3.74-/+2.3 weeks. Eleven patients responded to the therapy both subjectively and objectively and pregnancies were prolonged by 4.6-/+3.1 weeks (range 0.1-10 weeks). Five women had term deliveries. Six patients had a favourable perinatal outcome. Four patients who had a known congenital anomaly in the foetus, delivered stillborn babies or had an early neonatal death. One patient who did not follow up after commencing therapy delivered a full-term stillbirth. One patient delivered within 1 day of starting therapy. Indomethacin therapy caused no maternal complications. CONCLUSION: Indomethacin was effective in the management of hydramnios and preventing it's complications.

Adult↗
PubMed1986

An overview of hydramnios.

Hydramnios, defined as a volume of amniotic fluid in excess of 2,000 mL, is frequently diagnosed in contemporary obstetric practice by ultrasound. A pocket of amniotic fluid in excess of 8 cm X 1 cm is a satisfactory upper limit of normal volume using ultrasound. The etiology of hydramnios is not clear cut, but there is a significant 20% association with fetal anomaly. Maternal complications are rare, while fetal complications are usually related to an underlying anomaly or preterm birth. There is no specific treatment for hydramnios apart from drainage, which should be performed if maternal symptoms are sufficiently distressing. Perinatal outcome is generally determined by gestation at delivery or fetal anomaly.

Female↗
PubMed1995

[An unusual etiology of hydramnios: prenatal cerebral vascular accident. Five cases].

Neurological anomalies of the fetus are classically reported as causes of hydramnios, but cerebral vascular events occurring in utero in the fetus are rarely mentioned. We observed five newborns with neurological complications during the neonatal period in which anomalies of cerebral vascularization were identified antenatally. The mothers had hydramnios during pregnancy. Several pathophysiological hypotheses have been proposed to explain the mechanism of hydramnios. Magnetic resonance imaging of the brain in the fetus has made it possible to identify such exceptional events with extremely poor prognosis and major sequelae.

Cerebrovascular Disorders↗
PubMed1994

Large-volume therapeutic amniocentesis in the treatment of hydramnios.

OBJECTIVE: To evaluate the safety and outcome of large-volume therapeutic amniocentesis in the treatment of hydramnios. METHODS: Therapeutic amniocentesis was defined as an attempt to remove enough amniotic fluid (AF) in pregnancies complicated by symptomatic hydramnios to leave a normal volume of AF (AF index less than 25 cm). This report includes all therapeutic amniocenteses that were performed at Good Samaritan Regional Medical Center in Phoenix, Arizona, from 1988-1993. RESULTS: Ninety-four patients had 200 therapeutic amniocenteses. The most common condition treated with therapeutic amniocentesis was twin-twin transfusion syndrome (36 patients). The mean volume of fluid removed was 1666 +/- 1245 mL (mean +/- standard deviation). The median volume of fluid removed was 1500 mL (range 350-10,000). The fluid was removed at a mean rate of 54 +/- 22 mL/minute. Complications were limited to one patient with ruptured membranes one day after therapeutic amniocentesis, one patient who developed chorioamnionitis, and one patient with an anencephalic fetus who had an abruption following removal of 10,200 mL of fluid. CONCLUSION: Large-volume therapeutic amniocentesis can be used to treat hydramnios, with a 1.5% complication rate.

Amniocentesis↗
PubMed1989

Twin with hydramnios: treating premature labor at source.

Six twin pregnancies complicated by hydramnios and premature labor were prospectively studied to determine whether indomethacin reduces amniotic fluid. Requirements for study entry included a gestational age less than 32 completed weeks and an amniotic fluid greater than 10 cm in one or both sacs. The amniotic fluid was measured using real-time ultrasonography before, during, and after treatment. Indomethacin treatment was initiated as a 100 mg rectal suppository and maintained thereafter by 50 mg orally every 6 hours. Treatment was discontinued after 32 completed weeks' gestation, if the patient was asymptomatic and the amniotic fluid was "normal" (less than 8 cm) or after the onset of oligohydramnios in one or both sacs (less than 2 cm). The interval from initiation of treatment to delivery ranged from 12 to 101 days. A coincidental reduction in amniotic fluid was observed in all seven treatment cycles. The time interval to obtain "normal" fluid ranged from 4 to 20 days (mean, 12.5 days). There were no perinatal complications attributable to indomethacin treatment. These data suggest that in selected pregnancies complicated by hydramnios, indomethacin may be of value not only in prolonging gestation but also in amniotic fluid reduction.

Delivery, Obstetric↗
PubMed1987

Prepartum diagnosis of limb-shortening defects with associated hydramnios.

Two cases of skeletal dysplasia with limb-shortening abnormalities are presented. In association with the skeletal abnormalities, gross hydramnios was noted. A review of the existing literature reveals that coexistent fetal skeletal dysplasia and hydramnios have an extremely poor prognosis, especially in the nonachondroplastic patient with singleton fetus. The two cases presented here and the accompanying review emphasize the importance of recognizing this association in providing appropriate counseling to parents.

Adult↗
PubMed1980

[The value of alpha-1-fetoprotein determinations in the amniotic-fluid of patients with hydramnios in the diagnosis of fetal anomalies (author's transl)].

Little is known about the influence of hydramnios on the alphafetoprotein (AFP)-concentration in the amniotic fluid. We therefore investigated in 19 patients with hydramnios the diagnostic value of the sonographic evidence and the AFP-concentration in the amniotic fluid in relation to prenatal diagnosis of fetal malformations in two independent series. An anlysis of the AFP-concentration in the amniotic fluid can corroborate the diagnosis of a malformation made by sonography and influence decisions concerning the management of pregnancy and delivery. If ultra-sonic tests show no anomalies, significantly increased AFP-concentrations in the amniotic fluid of patients with hydramnions can merely confirm a suspicious of an existing malformation and influence decisions on further diagnostic steps.

Amniotic Fluid↗
PubMed1978

Hydrops fetalis, hydramnios and hepatic vascular malformation associated with cutaneous hemangioma and chorioangioma.

A premature baby presented with severe hydrops fetalis due to a multifocal angiomatous malformation of the liver. There were two other small vascular tumors: hemangioma of the skin and chorioangioma. Hydramnios and placental edema were also present. The association of severe hydrops fetalis and hydramnios with angiomatous malformation of the liver was not found in reviewing the literature.

Adult↗