Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Polyhydramnios”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed2002

Cephalocentesis with the modified Smellie's perforator.

A 37-year-old pregnant woman, gravida 2, para 0, was referred to Ramathibodi Hospital at 31 weeks of gestation with the diagnosis of hydrocephalus and polyhydramnios. Repeated ultrasound scans revealed hydrocephalus with macrocephaly (BPD=10.3 cm), polyhydramnios (AFI=31.5), and a suspected esophageal atresia. After counseling, both parents decided not to pursue the pregnancy and requested vaginal delivery. They decided against transabdominal, ultrasonic-guided cephalocentesis because of its invasiveness, patient's awareness, and pain. Skull decompression with the modified Smellie's perforator was performed after five 400-microg doses of misoprostol were applied to dilate the cervix. The post-partum condition was uneventful. Fetal skull decompression with the modified Smellie's perforator and misoprostol for cervix dilation is a useful, simple, and safe procedure that can be performed with no previous experience.

Abnormalities, Multiple↗
PubMed2006

Cardiotocographic and Doppler ultrasonographic findings in a fetus with brain death syndrome.

OBJECTIVE: The diagnosis of brain death syndrome by cardiotocography (CTG) and Doppler ultrasonography (US) is reported in a fetus at 35 weeks of gestation. CASE REPORT: A 23-year-old, gravida 2, para 0, woman was referred to our hospital because of the absence of fetal movements. CTG showed fixed fetal heart rate (FHR) pattern. A detailed Doppler US examination of the fetus showed extensive cystic lesions of both cerebral hemispheres, polyhydramnios, total absence of neuromuscular parameters of biophysical profile (BPP) and the cessation of cerebral blood flow. Umbilical cord artery blood gas analysis showed pH 7.3, PaO2 30 mmHg and PaCO2 35 mmHg. A floppy male infant weighing 2,450 g was delivered vaginally at 36 weeks of gestation and the Apgar scores were 1 and 1 at 5 and 10 minutes, respectively. The neonate died 2 days after delivery. Postmortem examination of the brain showed diffuse, anoxic changes with multicystic encephalomalacia in both hemispheres and the brain stem. No other maternal or placental abnormalities were seen. CONCLUSION: The possibility of intrauterine brain death should be considered in all cases of prolonged fixed FHR pattern, accompanied by absence of neuromuscular parameters of BPP, polyhydramnios and demonstrated cessation of cerebral blood flow by Doppler US. Increased awareness of this event may prevent unnecessary emergency cesarean section.

Adult↗
PubMedDate not supplied

Candida chorioamnionitis after serial therapeutic amniocenteses: a possible association.

BACKGROUND: Reduction amniocentesis is used in cases of severe polyhydramnios to decrease maternal discomfort and the risk of preterm labor. In a MEDLINE search (1966 to present, English language, keywords: amniocentesis, chorioamnionitis), no report of Candida chorioamnionitis after serial reduction amniocentesis exists. CASE: A 29-year-old primigravida with a history of four therapeutic amniocenteses for idiopathic polyhydramnios developed preterm labor at 30 and 5/7 weeks' gestation, rupture of membranes, and Candida albicans chorioamnionitis. Despite aggressive therapy with amphotericin B, the neonate succumbed to overwhelming systemic candidiasis. CONCLUSION: Serial amniocentesis may place patients at elevated risk for Candida chorioamnionitis and subsequent preterm delivery. Clinicians should consider early diagnostic amniocentesis in patients in preterm labor with a history of prior amniocentesis, and the routine Gram stain and culture of amniotic fluid.

Adult↗
PubMed2003

Perinatal outcome following amniotic septostomy in chronic TTTS is independent of placental angioarchitecture.

OBJECTIVES: To determine whether the vascular anatomy of monochorial placenta influences the success of amniotic septostomy for the treatment of chronic mid-trimester twin-twin transfusion syndrome, we report placental anastomoses and perinatal data of 13 pregnancies treated by amniotic septostomy in combination with amnioreduction (AR). The placental anastomoses were delineated postnatally by perfusion studies. Perinatal outcome was also evaluated in relation to umbilical artery Doppler waveform of the donor twin. RESULTS: The median gestational age at septostomy was 21 weeks (range 18 to 25.5 weeks). Amniotic septostomy in combination with single AR procedure successfully resolved polyhydramnios in all cases. The median gestational age at delivery and the septostomy to delivery interval were 27 weeks (range 20 to 34 weeks) and 4 weeks (range 0.3 to 13.6 weeks), respectively. Of the 26 fetuses, 10 died in utero and four died within a week of life, with a combined survival rate of 46%. There was no relation between the clinical outcome and angioarchitecture of the placenta. However, pregnancy loss was higher in the donor twin with absent end-diastolic flow umbilical artery Doppler waveform than those with end-diastolic flow (85 vs 17%; p < 0.001). CONCLUSION: This study suggests that although amniotic septostomy is a promising method for the correction of oligohydramnios and/or polyhydramnios, perinatal survival rate does not depend on angioarchitecture of the placenta. Instead, umbilical artery Doppler waveform of the donor twin may be a better marker for survival rate.

Amnion↗
PubMed2002

Alcoholization: the choice of intrauterine treatment for chorioangioma.

Chorioangioma is a vascular tumor of the placenta. Most are small and asymptomatic, whereas the large tumors are clinically significant and often associated with polyhydramnios and fetal heart failure. To prevent fetal loss from these complications, many interventions have been proposed, including intrauterine transfusion in anemic cases and fetoscopic surgery to ablate the feeding vessels. The case presented herein had large chorioangiomas, 8 and 4cm in diameter, associated with polyhydramnios and early signs of hydrops fetalis, diagnosed at 27 weeks gestation. After extensive counseling, we performed alcohol ablation of the feeding vessel of the larger tumor. Signs of fetal heart failure and hydrops fetalis disappeared dramatically. The pregnancy was extended for 2 weeks, followed by premature rupture of the membranes and spontaneous labor at 32 weeks gestation and a surviving female baby, weighing 1360g, was delivered uneventfully. This preliminary experience suggests that alcoholization may be one of the best choices for this condition due to its high efficacy, simplicity, safety and very low cost. To our knowledge, this is the first report using alcoholization for the treatment of hydrops fetalis secondary to chorioangioma.

Adult↗
PubMed1997

Intra-amniotic debris identified at ultrasound scanning: a feature of congenital ichthyosis.

A case is described in which intra-amniotic debris was identified during an ultrasound scan in a woman with polyhydramnios at 33 weeks' gestation. At delivery the neonate was found to have severe ichthyosis involving the whole of her head, trunk and limbs, with large plaques of hyperkeratotic skin on the palms of her hands and the soles of her feet. The finding of excessive debris in association with polyhydramnios should raise the possibility of an exfoliative skin disorder.

Adult↗
PubMed2001

Prenatal diagnosis of esophageal atresia using sonography and magnetic resonance imaging.

BACKGROUND: The diagnosis of esophageal atresia may be suspected on prenatal ultrasound scan in fetuses with a small or absent stomach or unexplained polyhydramnios. However, these findings are thought to have a low positive predictive value and clinical decisions affecting timing or site of delivery may be made erroneously. The authors evaluated the accuracy of fetal sonography followed by magnetic resonance imaging (MRI) for the diagnosis of this lesion. METHODS: Fetuses considered to be at risk for esophageal atresia based on detailed obstetric sonography underwent fetal MRI using a single-shot rapid-acquisition technique, and the T(2)-weighted images were evaluated prospectively. Scans were considered to be positive if the proximal esophagus was dilated, and the distal esophagus was not seen and negative if the esophagus was visualized throughout its length. RESULTS: Ten fetuses underwent MRI scanning. All had a small or absent stomach bubble with unexplained polyhydramnios. Four scans were considered to be negative for esophageal atresia; all 4 were found to have a normal esophagus after delivery. Six scans were considered to be positive; 5 had esophageal atresia (2 with tracheoesophageal fistula and 3 without), and one had a neurologic syndrome with a normal esophagus. CONCLUSIONS: Magnetic resonance imaging appears to be accurate for establishing or ruling out a prenatal diagnosis of esophageal atresia, and should be considered in fetuses who are at high risk based on ultrasound findings.

Esophageal Atresia↗
PubMed1990

[Prenatal diagnosis of Pena-Shokeir syndrome in the 27th week of pregnancy].

We report on the prenatal diagnosis of a Pena-Shokeir syndrome sporadic case of the 27th week of pregnancy. Typical sonographical features are polyhydramnios, hypoplasia of lungs, foetal akinesia, reduced length of proximal and distal extremities and a striking discrepancy between biparietal and abdominal diameter. Differential diagnosis of polyhydramnios caused by foetal neuromuscular disorders is discussed.

Abnormalities, Multiple↗
PubMed1987

[Acute hydramnios in the 2d half of pregnancy].

95 patients were prospectively examined from 1982-1986 in a diagnostic programme. These patients showed a clinically and ultrasonically established acute hydramnios during the second half of their pregnancy period. Possible important causes of an acute hydramnios can be confirmed or excluded via on-target sonography; at the same time, a diabetic condition must be excluded and the amniotic fluid must be examined to exclude acute viral or specific bacterial infections. In 8 cases (8%) we found that the mother had diabetes mellitus requiring insulin, the hydramnios being the main pointer towards the metabolic disturbance. Gestation diabetes was confirmed in 23 patients (25%) on the basis of the polyhydramnios. Chromosomal anomalies were seen in 12 eucyeses (13%) and in 2 polycyeses. In 8 pregnancies (8%) we found a pattern of non-immunological hydrops fetalis with pleural effusions and ascites. In three patients (3%) there was an immunological hydrops fetalis with polyserositis within an Rh incompatibility pattern. Severe foetal malformations associated with a normal karyotype were sonographically found in 12 pregnancies--encyeses and twins--(12%). Cardiac disturbances (tachyarrhythmia) resulted in polyhydramnios in 8 cases of eucyesis (8%). Finally, 10 cases only remained unclarified (11%). 14 cases (15%) had twin pregnancy. In this connection we observed on the average an earlier onset of acute hydramnios (27 weeks) compared with the eucyeses (on the average during the 30th week). Timely and adequate treatment may become possible if we know the aetiology of the acute hydramnios, especially in cases of diabetes mellitus and gestation diabetes, as well as in certain foetal malfunctions, such as e.g. pleural effusions and generalised hydrops fetalis and disturbances of cardiac rhythm.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed2001

Fetal esophageal ligation induces expression of vascular endothelial growth factor messenger ribonucleic acid in fetal membranes.

OBJECTIVE: Obstruction of the fetal esophagus does not always produce the expected polyhydramnios. This is because of increased intramembranous absorption of amniotic fluid into the fetal circulation. A possible mediator for this increased absorption is vascular endothelial growth factor (VEGF). The present objective was to explore whether VEGF gene expression and action would be induced in fetal membranes and placentas of ovine fetuses after esophageal ligation. STUDY DESIGN: Five late-gestation fetal sheep underwent esophageal ligation and 5 served as control animals. On postoperative day 9, amnion, chorion, and placenta were collected for cellular localization and quantitation of VEGF messenger ribonucleic acid by in situ hybridization and Northern blot analysis. Reverse-transcription polymerase chain reaction was used to identify the VEGF molecular forms. Immunostaining with Ki-67 antibody was used to determine the proliferation of vascular endothelium in the fetal membranes and placentas. RESULTS: VEGF messenger ribonucleic acid was localized in amniotic epithelium, chorionic cytotrophoblast, and cytotrophoblast of the placenta. VEGF164 was the major transcript expressed in these tissues. The abundance of VEGF messenger ribonucleic acid in the amnion and chorion, but not in the placenta, was significantly increased in the ligated fetuses in comparison with the control fetuses. The proliferation of the intramembranous blood vessel endothelium was greater in the ligated fetuses than in the control fetuses. CONCLUSION: The levels of VEGF messenger ribonucleic acid and the proliferation of vascular endothelium in the amnion and chorion increased after fetal esophageal ligation. This provides a possible mechanism for the enhanced intramembranous absorption of amniotic fluid through increased vascularity and permeability of the fetal membranes, thus ameliorating the development of polyhydramnios. We speculate that the signal(s) that mediate the increase in VEGF expression is present in either the fetal urine or the fetal lung secretions, or both.

Amnion↗
PubMed1996

Does the amniotic fluid protein absorption contribute significantly to the fetal weight?

OBJECTIVE: This study was carried out to evaluate the significance of amniotic fluid protein ingestion and absorption on fetal growth. METHODOLOGY: Neonates with small bowel atresia during a 30 year period were studied retrospectively. RESULTS: There were 56 patients enlisted, 17 with duodenal atresia, 18 with jejunal atresia and 21 with ileal atresia. The percentage of mothers with polyhydramnios and the percentage of premature babies decreases as the intestinal atresia becomes more distal. The mean gestational age and the mean birthweight increase as the intestinal atresia becomes more distal. On the other hand, the percentage of the neonates with birthweight below the 50th and the 10th percentiles do not differ significantly as the intestinal atresia becomes more distal. CONCLUSIONS: It appears that the variation of birthweights in babies with different levels of small bowel atresia may be due to the difference in gestation caused by polyhydramnios. The effect of amniotic fluid protein absorption on fetal bodyweight could not be demonstrated clinically in this study.

Analysis of Variance↗
PubMed1989

Effect of amniotic fluid volume on umbilical cord length.

To study effect of amniotic fluid volume on umbilical cord length, 939 pregnant women at 24-41 weeks of gestation, including 10 twin cases, 51 preterm premature rupture of the membranes (PROM) and 70 premature delivery cases, were examined for their amniotic fluid volume within a week of delivery by the ultrasound procedure and these 949 newborns were also examined for umbilical cord length and incidence of fetal distress. In the polyhydramnios group (pocket size of more than 8 cm), 8 of 20 infants (40%) had longer cords and 6 infants (30%) had shorter cords, while only one of 49 infants (2%) with oligohydramnios (pocket size of less than 2 cm) had a longer cord and 36 infants (73.5%) had shorter cords than the mean cord length (+/- SD) of the normal group. The 20 twins had significantly shorter cords than those of the normal group (P less than 0.05) and the polyhydramnios group (P less than 0.01). The PROM group showed significantly higher incidence of oligohydramnios (P less than 0.05) and fetal distress (P less than 0.01), which suggests that intrauterine space availability is important for assuring fetal well-being.

Amniotic Fluid↗
PubMed2006

Comparison of maternal-fetal outcomes in gestational diabetes and lesser degrees of glucose intolerance.

AIM: To determine the relationships between maternal and fetal outcomes and gestational diabetes mellitus (GDM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), respectively. METHODS: A retrospective cohort study design was used with 149 patients with abnormal oral glucose tolerance test (OGTT) and 149 normal patients. Statistical analysis used was the chi-squared test, Fisher's exact test or the Student's t-test, as appropriate. P < 0.05 was considered significant. RESULTS: The level of hyperglycemia according to the OGTT (World Health Organization criteria) was associated with pre-eclampsia, polyhydramnios and macrosomia in GDM patients. There was no increase in the complications of preterm labor and premature rupture of membranes, despite the increased risk of polyhydramnios. Although treated with insulin, macrosomia still occurred in patients with GDM, but there was no shoulder dystocia as there was an increase in the incidence of cesarean section (CS). The IGT group was not associated with adverse fetal or maternal outcomes, but there was an increase in intervention and the incidence of CS. The IFG group was associated with a significantly increased risk of pre-eclampsia and macrosomia. These findings challenge the concept of IFG being a lesser pathology than GDM. Further prospective studies with a larger number of patients are needed to ascertain the significance of these findings. CONCLUSION: There was an increased risk of pre-eclampsia and macrosomia in both the GDM and IFG patients, but IGT was not associated with adverse fetal or maternal outcomes.

Adult↗
PubMed1992

A case-control study of unexplained antepartum stillbirths.

OBJECTIVE: To ascertain factors that will identify women who are at increased risk of unexplained antepartum stillbirth. DESIGN: Matched case-control study. The cases and controls were initially analysed as a whole group and again after dichotomizing into those of low birthweight (< 2500 g) and those of normal birthweight (> or = 2500 g). SETTING: Western Australia 1980-1983. SUBJECTS: Unexplained antepartum stillbirths of > or = 1000 g birthweight (cases) and liveborn infants individually matched for year of birth, plurality, sex and birthweight of infant and race of mother (controls). RESULTS: The case pregnancies had more polyhydramnios (OR 10.83, 95% CI 2.41-48.69) and cord problems (OR 6.57 95% CI 1.36-31.75) than the controls but, paradoxically, other obstetric and medical complications were less common in the cases. The association with polyhydramnios persisted when the analysis was confined to those with low birthweight. With normal birthweight fetal distress was more frequent in the cases (OR 3.65 95% CI 1.36-9.80) but there were few other differences. CONCLUSIONS: The clinical and diagnostic systems currently in use are unable to identify many fetuses at risk of death. Decreases in the rate of unexplained antepartum stillbirths await the discovery of new preventable causes, or of innovations in clinical or laboratory aspects of obstetric care.

Birth Weight↗
PubMed1993

Non-immune hydrops fetalis and bilateral pulmonary hypoplasia in a newborn infant with extralobar pulmonary sequestration.

Extralobar pulmonary sequestration was found in a newborn premature infant that presented with non-immune hydrops fetalis, massive bilateral hydrothorax and polyhydramnios in utero. The baby died of severe respiratory insufficiency 15 h after birth. Postmortem examination revealed distended lymphatic vessels in the sequestered lung tissue probably due to impeded lymph drainage. We suggest that not extralobar pulmonary sequestration itself but a subsequent massive unilateral hydrothorax due to severe obstruction of lymph drainage was the cause of the non-immune hydrops fetalis, pulmonary hypoplasia and polyhydramnios. If these symptoms are diagnosed before delivery, a search for extralobar pulmonary sequestration is indicated.

Adult↗
PubMed1990

Model study of placental water transfer and causes of fetal water disease in sheep.

The purpose of the computer simulation was to use experimentally measured parameters of placental water transfer to compute conceptual water acquisition during the last third of ovine pregnancy and to evaluate the possible role of each of these parameters in the pathophysiology of polyhydramnios. Total conceptual water at birth was almost insensitive to the value of the placental filtration coefficient. It was more sensitive to fetal and maternal placental blood flows, the concentrations of actively transported or metabolically produced solutes in fetal plasma (bicarbonate, fructose, alpha-amino acids, urea, lactate), and the hydrostatic pressure difference across the placental barrier. It was quite sensitive to the NaCl reflection coefficient and permeability. We conclude that the actively transported or produced solutes in fetal plasma constitute a primary driving force. The opposing diffusion gradient of NaCl, and to a much lesser extent that of glucose, are essential to restrain the process. The causes of polyhydramnios in this species are, in order of probability, an increase in the placental diffusion permeability of NaCl, a decrease in the placental reflection coefficient for NaCl, or an increase in the concentration of an osmotically effective solute in fetal plasma, by active transport or metabolic production.

Animals↗
PubMedDate not supplied

Enlarged cisterna magna in the third trimester as a clue to fetal trisomy 18.

Six of 19 fetuses with trisomy 18 confirmed by late karyotyping in the third trimester were found to have an enlarged cisterna magna (10 mm or more). For trisomy 18 conceptuses, there is a significant excess of females in both fetuses and livebirths; however, we found this ratio to be reversed in the third-trimester trisomy 18 fetuses with an enlarged cisterna magna (5 males vs. 1 female), indicating males are more likely to have this associated defect. Each of the 6 cases was associated with other trisomy markers including intrauterine growth retardation and polyhydramnios. Since a significant proportion of pregnancies may escape early prenatal care and some potentially detectable fetal abnormalities may be missed on early ultrasound and/or by maternal serum screenings, prenatal detection of an enlarged cisterna magna associated with intrauterine growth retardation and/or polyhydramnios in late gestation should prompt complete genetic counseling, rapid karyotyping and a careful search for other congenital anomalies.

Adult↗
PubMedDate not supplied

Relationship between meconium staining and amniotic fluid volume in term pregnancies.

OBJECTIVE: Our purpose was to evaluate the relationship between meconium-stained amniotic fluid (MEC-AF) and amniotic fluid volume (AFV) and their impact on the risk of cesarean delivery for fetal indications in term pregnancies. METHODS: 1,655 live-born singleton gestations delivering at > or = 37 weeks within 7 days of sonographic assessment of the amniotic fluid index (AFI) were studied. AFI was categorized as: oligohydramnios (< or = 5.0 cm); decreased (5.1-8.0 cm); normal (8.1-18.0 cm); increased (18.1-23.9 cm), and polyhydramnios (> or = 24.0 cm). Frequencies of MEC-AF for each AFV category were stratified by gestational age (GA) and rates of cesarean delivery for fetal indications compared between patients with clear amniotic fluid and those with MEC-AF. Stepwise logistic regression analyses were performed for determinants of MEC-AF and the need for cesarean delivery for fetal indications. RESULTS: The frequency of MEC-AF at birth in term pregnancies was not related to AFV: oligohydramnios (16.7%); decreased (16.7%); normal (20.1%); increased (24.4%), and polyhydramnios (22.1%). The only factor associated with the occurrence of MEC-AF was increasing GA at delivery (p < 0.01). Both MEC-AF (p < 0.02) and decreasing neonatal ponderal index (p < 0.02) were independently associated with cesarean delivery for fetal distress. CONCLUSIONS: MEC-AF does not appear to be related to AFV in term pregnancies, and its presence increases the risk of cesarean delivery for fetal distress independent of AFV and neonatal ponderal index.

Amniotic Fluid↗