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PubMed1986

Analysis of amniotic fluid proteins by isoelectrofocusing (IEF) in pregnancies complicated by polyhydramnios and Rh-sensitization.

Among the most recent methods for investigation of proteins in biological fluids SDS polyacrilamide-gel-electrophoresis (SDS-PAGE) and isoelectrofocusing (IEF) have recently been introduced into laboratory practice. The present investigation was performed on 14 samples of amniotic fluid obtained during the third trimester in pregnancies complicated by Rh-sensitization and polyhydramnios in which protein concentration was higher than in normal pregnancies. The obtained results suggest that IEF analysis seems to have a selective advantage in allowing the separation of bands which cannot easily be recognized with SDS electrophoresis. These bands detected by IEF and present in amniotic fluid during late pregnancy seem to be related to some molecular weight lipoprotein fractions and we suggest that they might be used as a possible marker for monitoring fetal lung maturation. In conclusion we think that it would be of great interest to evaluate the usefulness of IEF analysis in examining amniotic fluid obtained during pregnancies complicated by polyhydramnios and Rh-sensitization.

Amniotic Fluid↗
PubMed1983

Reversal of polyhydramnios by drainage of a fetal renal cyst. A case report.

At 28 weeks' gestation a patient developed polyhydramnios associated with a large fetal renal cyst demonstrated by ultrasound. Drainage of the cyst was performed, resulting in the disappearance of polyhydramnios. The pregnancy progressed normally to term and resulted in the delivery of a healthy infant.

Adult↗
PubMed1996

In utero congestive heart failure due to maternal indomethacin treatment for polyhydramnios and premature labour in a fetus with antenatal closure of the foramen ovale.

A case of severe fetal congestive heart failure due to occlusion of the ductus arteriosus in a mother treated with indomethacin for polyhydramnios and premature contractions is described. Closure of the fetal foramen ovale that escaped detection by prenatal echocardiography was later demonstrated at neonatal autopsy. This case suggests that indomethacin treatment in a ductus-dependent fetus may be hazardous. Therefore, careful surveillance of the fetus exposed to indomethacin in utero is warranted.

Adult↗
PubMedDate not supplied

Congenital granular cell epulis causing polyhydramnios.

We report a case of an extremely large granular cell epulis situated on the maxillary alveolar ridge of a newborn. It obstructed the infant's mouth and caused polyhydramnios. The lesion was detected in utero by ultrasonography and removed after birth in the delivery room, with satisfactory results. It is evident that the epulis increased in size during the last phase of pregnancy. The literature concerning this peculiar lesion is reviewed and theories of histogenesis are discussed.

Adult↗
PubMed1993

Myasthenia gravis with polyhydramnios in the fetus of an asymptomatic mother.

Transient myasthenia gravis was observed in an infant whose mother had no signs of neuro-muscular disease. The case presented with severe polyhdramnios at 31 weeks. Sonographic and invasive work-up showed only an absence of fetal swallowing. At birth, the infant had severe muscle weakness and respiratory distress. He had high titres of anti-acetylcholine receptor (anti-AChR) antibodies of maternal origin. Anti-AChR antibodies were also found in stored samples of fetal serum and amniotic fluid. To our knowledge, this is the first case of neonatal myasthenia gravis for which neither past nor present evidence of disease could be obtained in the mother. Anti-AChR antibody testing should be considered in cases of unexplained polyhydramnios.

Abnormalities, Multiple↗
PubMed2002

Congenital mesoblastic nephroma associated with polyhydramnios and hypercalcemia.

Congenital mesoblastic nephroma (CMN) can present with atypical clinical and imaging findings. A premature male neonate was born to an 18-year-old woman after 33 weeks' gestation, which was complicated by polyhydramnios and placenta abruptio. A right abdominal mass was diagnosed antenatally. From the 1st day of life, the newborn had hypercalcemia with initially normal parathormone levels and polyuria for the first hours of life and normal urine output afterwards. Ultrasonographic study and magnetic resonance imaging of the abdomen showed at the upper pole of the right kidney a heterogeneous, solid, poorly defined mass, partially surrounded by a subcapsular fluid collection mimicking malignant rhabdoid tumor of the kidney. Surgical resection revealed a CMN of mixed, classic, and in areas, cellular type. One year after the resection, the patient is asymptomatic and normocalcemic. In conclusion, CMN may present with atypical clinical and imaging findings, necessitating an extensive work-up in order to exclude highly malignant renal tumors of the neonatal period.

Adolescent↗
PubMed1982

Sonographic detection of polyhydramnios: a five-year experience.

Between 1975 and 1980, 16,586 sonograms, including repeat scans, were obtained on pregnant women for various obstetric indications. The diagnosis of polyhydramnios was made 78 times by an experienced sonographer as a simple observer judgment of an excess amount of amniotic fluid. In pregnancies thus diagnosed, the fetus was then carefully scanned for anomalies, and repeat scans were done. Major clinical problems encountered are discussed.

Congenital Abnormalities↗
PubMed1990

Maternal indomethacin therapy in the treatment of polyhydramnios.

Fifteen patients with polyhydramnios and clinical symptoms related to excess amniotic fluid volume were treated with indomethacin therapy that was started at a mean gestational age of 27.4 +/- 2.79 weeks and discontinued at a mean gestational age of 32.9 +/- 1.83 weeks. Patients were treated with 2.0 to 2.2 mg of indomethacin per kilogram of body weight per day, either orally or by rectal suppositories. No therapy was administered after 35 weeks, and the duration of therapy was no longer than 4 weeks. The majority of fluid reduction occurred within the first week of treatment. Subsequently, a smaller but steady reduction of fluid was observed. All patients were delivered after 38 weeks with a mean birth weight of 3543 +/- 586.3 gm. Examinations of newborns at birth and follow-up at 3 months, 6 months, and 1 year revealed no adverse effects of indomethacin administration.

Administration, Oral↗
PubMed1986

Acute polyhydramnios and cord presentation--complication of chorioangioma of the placenta--a case report.

Chorioangioma of the placenta is an uncommon benign tumor of the placenta. Large tumors are rare and they often cause increased maternal morbidity and fetal morbidity and mortality. A patient with continuous abdominal pain at 29 weeks gestation was clinically diagnosed to have acute polyhydramnios. Multiple pregnancy was suspected because of a tense uterus much larger than the dates and three palpable "fetal poles". An ultrasound examination revealed the third pole to be a large chorioangioma. She went into premature labor and a cesarean section was performed because of a cord presentation. Both mother and infant had an uneventful recovery. The complications of chorioangioma is discussed.

Adult↗
PubMed1989

Acute polyhydramnios.

A case of acute polyhydramnios successfully managed via therapeutic amniocentesis is reported. A discussion and review of this rare entity is presented.

Acute Disease↗
PubMed1982

Ultrasonic detection of fetal ascites associated with polyhydramnios.

The combination of fetal ascites and polyhydramnios is an uncommon problem that can be detected in utero by sonography. A case is reported where the etiology was found to be generalized cytomegalovirus infection. The differential diagnosis, etiology and diagnostic procedures are discussed. A thorough sonographic study is essential in the diagnosis and evaluation of fetal ascites in utero.

Adult↗
PubMed1993

Efficacy and safety of indomethacin therapy for polyhydramnios.

The maternal and perinatal outcome of seven gravidas receiving 2.2-2.5 mg/kg per day of indomethacin for polyhydramnios are reported. Such therapy was started between 26 and 33 weeks of gestational age (mean, 30.4 weeks) and lasted for 20.1 days (range, 2-37 days). Median of amniotic fluid index ranged from 47 at the start of therapy (range, 32-53) to 15 (range, 2-50) when indomethacin was ended. Interval between the end of the therapy and the delivery ranged from 0 to 45 days (mean, 15 days). On average, pregnancies were prolonged by 5.1 weeks (range, 2-8 weeks). The newborn weight was 2678 g on average (range, 620-3700 g). Oligohydramnios was seen in two instances; one patient developed constriction of the fetal ductus arteriosus, which returned to normality after indomethacin suppression; one newborn in which other causes of neonatal bleeding could be excluded, developed a disseminated intravascular coagulation and died 15 h after birth. Finally, one mother presented an acute renal failure immediately after indomethacin administration; this patient completely recovered after indomethacin withdrawal. Thus, the benefit of pregnancy prolongation should be balanced against the increased risks for the newborn, mainly fetal ductus arteriosus constriction and possible bleeding disorders. A causal relationship of indomethacin administration to the latter complication warrants further investigation.

Female↗
PubMed2006

Twin anemia-polycythemia sequence in two monochorionic twin pairs without oligo-polyhydramnios sequence.

Placental vascular anastomoses in monochorionic twins may lead to acute or chronic inter-twin transfusion. We report an uncommon form of chronic inter-twin transfusion, referred to as twin anemia-polycythemia sequence (TAPS), with severe anemia in one twin and polycythemia in the other, without the characteristically associated twin oligo-polyhydramnios sequence (TOPS) seen in the classical twin-to-twin transfusion syndrome (TTTS). The clinical course and placental characteristics of two pairs of monochorionic twins with TAPS born at, respectively, 33 and 34 weeks' gestation were reviewed. Serial fetal ultrasound examinations revealed no signs of TOPS. At birth, both donor twins were severely anemic requiring blood transfusion and both recipients were polycythemic, one requiring partial volume exchange transfusions. Inter-twin difference in reticulocyte counts was extremely high, suggesting a chronic form of inter-twin blood transfusion. Placental injection studies revealed a preponderance of very small (<1mm) arterio-venous anastomoses in one direction. In conclusion, chronic inter-twin transfusion may lead to an uncommon form of inter-twin transfusion, named TAPS, not associated with TOPS, resulting in severe fetal or neonatal hematological complications. We hypothesize that TAPS is mediated through minuscule unidirectional anastomoses. TAPS can be diagnosed antenatally with Doppler studies and postnatally by hemoglobin and reticulocyte measurements.

Adult↗
PubMed1996

Acute reversal of oligohydramnios-polyhydramnios sequence in monochorionic twins.

Two cases of monochorionic diamniotic twin gestation with severe oligohydramnios-polyhydramnios sequence ('stuck' twin) are described. In each of these cases there was a marked fluctuation in amniotic fluid volume and reversal of which twin was 'stuck'. The definitive identification of the twins was evident due to a discordant fetal malformations in each twin pair.

Adult↗