This document discusses hydrops fetalis, which is a condition where excess amniotic fluid accumulation (over 2000ml) occurs in the fetus. It summarizes potential causes of hydrops fetalis including fetal anomalies like anencephaly or open spina bifida, placental abnormalities like chorioangioma, or maternal conditions like diabetes. Signs and symptoms in the mother include edema, abdominal distension, and difficulty hearing the fetal heartbeat. Diagnosis involves ultrasound to check for fetal anomalies or multiple pregnancies. Management focuses on treating the underlying cause and monitoring for potential maternal complications during pregnancy, labor, and postpartum like preeclampsia, malpresentation, and infection. Fetal risks include prematurity and congen

1. Presented by
MRS AGNES MAHIMA DAVID
Msc nursing
Obstertics and gynaecological nursing

2.  It is a state where liquor amnii exceeds
2000ml

3.  Fetal anomalies
 Anencephaly –transudation from the exposed
meninges
 Absence of fetal swallowing reflex
 Suppression of fetal ADH leading to excessive
urination
 Open spina bifida- increased transudation from
meninges
 Esophageal or duodenal atresia –prevent
swallowing of the liquor
 Facial clefts neck masses
 Hyrops fetalis

4.  Placenta
 Chorioangioma of the placenta
 Multiple pregnancy
 Maternal
 Diabetes
 Cardiac or renal disease –edema of placenta
lead to increase in transudation

5.  Chronic –few weeks
 Acute - few days

6.  The onset is acute and the fluid
accumulates within a few days. It usually
occurs before 20 weeks of pregnancy . It is
usually associated with uniovular twins or
chorioangioma of the placenta

7.  Signs
 The patient look ill
 Edema of the legs
 Abdomen is hugely enlarged more than the period of
amenorrhea
 Fluid thrill is present
 Fetal part cannot be felt nor is the FHS audible
 Internal examination reveals effacement of cervix or
dilatation of the os
 Sonography reveals multiple pregnancy or fetal anomalies

8.  Symptom
 Abdominal pain
 Nausea and vomiting

9.  symptom
 Dyspnea
 Palpitation
 Edema of legs,varicosities in the legs or
vulva or haemorrhoids

10.  the patient may be in a dyspnoeic state in
the lying down position
 Evidence of pre eclampsia

11.  Inspection
 Abdomen –enlarged ,looks globulars with fullness
at the flanks
 Skin is tense, shiny with large straie
 Palpation
 Height of the uterus is more than the period of
amneorrhea
 Girth of the abdomen round the umbilicus is
more than normal
 Fluid thrill can be elicted in all direction over
uterus
 Fetal part are difficult to feel
 Amniotic fluid index test to estimate the total
volume

12.  Auscultation –fetal heart rate is difficult to
hear
 internal examination – cervix may be pulled
up ,dilated , to admit a finger tip through
which tense bulged membranes can be felt

13.  Sonography
 ABO and RH grouping
 PP sugar ,GTT
 AFP

14.  Maternal
 during pregnancy
 Pre eclampsia
 Mal-presentation
 PROM
 Pre term labor
 Accidental hemorrhage

15.  During labor
 Early rupture of the membrane
 Cord prolapse
 Uterine inertia
 Operative delivery due to malpresentation
 Retained placenta, PPH and shock

16.  Pueperium
 Sub involution
 Increased puerperal morbidity due to infection resulting
from operative interference and blood loss
 Fetal
 Prematurity
 Congenital abnormality