This document discusses polyhydroamnios, which is an excess of amniotic fluid during pregnancy. It defines polyhydroamnios as amniotic fluid exceeding 2000 ml or an amniotic fluid index greater than 24 cm. Potential causes include fetal anomalies, multiple pregnancies, or idiopathic cases. Signs and symptoms range from abdominal pain and difficulty breathing with acute cases to leg swelling and discomfort with chronic cases. Ultrasound and amniocentesis are used for diagnosis. Complications include preterm labor and cord prolapse. Management may involve medications, monitoring, and in severe cases, early delivery.

2. SPECIFIC OBJECTIVES :-
After the completion of the topic student will be able
to :-
1. Introduction of polyhydroamnios.
2. Definition of polyhydroamnios.
3. Enlist the cause of polyhydroamnios.
4. Clinical types of polyhydroamnios.
5 Describe the sign & symptoms of polyhydroamnios
6. Enlist the investigations for polyhydroamnios.
7. Complications of polyhydroamnios.
8. Discuss the management of polyhydroamnios.

4. INTRODUCTION :-
Polyhydroamnios is a medical condition that occurs
in pregnancy & charactorised by excess of amniotic
fluid in amnion sac that is more than the expected
level for the gestational age
It is seen in about 1% of pregnancies .

5. Definition
1. Polyhydroamnios is define as a state where liquor
amnii exceed 2000 ml.
2. Polyhydroamnios is a medical condition when
the amniotic fluid index (AFI) is greater then
24cm.
Normal level :- 600-800ml
AFI:- 8-18 cm.

6. CAUSES OF POLYHYROAMNIOS
 Idiopathic .
 Fetal anomalies / genetic .
- Anencephaly .
- Facial cleft .
- Esophagial Atresia .
- Diaphragmatic hernia.
 Genitourinary tract system .
 Multiple pregnancy .

7.  Clinical Types Of
Polyhydroamnios
Two Types Of Polyhydroamnios :-
1. Acute polyhydroamnios.
2. Chronic polyhydroamnios.
1. Acute Polyhydroamnios :- If amniotic
fluid increase rapidly over days can cause
severe symptoms is known as acute
polyhydroamnios.
2. Chronic polyhydroamnios :- If amniotic
fluid volume increase progressively over
months the symptoms are usually milder is
known is chronic polyhydroamnios.

8. Signs And Symptoms Of Acute
Polyhydroamnios :-
1. Abdomen pain.
2. Nausea or vomiting.
3. Fluid thrill may be present.
4. Abdomen in hugely enlarged .
5. Fetal parts cannot be felt normal but the
fetal heart sound is audible.

9. Sign And Symptoms Of The
Chronic Polyhydroamnios :-
Symptoms are mainly due to mechanical
causes..
1. Dyspnea is more common in supine
position.
2 . Edema in legs.
3. Uterine Contractions.
4. Urterine Discomfortness.

10.  Sign And Symptoms Of The
Polyhydroamnios:--
1. Difficulty in breathing.
2. Feeling tightness in the belly.
3. Swelling in the lower extremities.
4. Patient looks ill.
5. Absence of features of shock.
6. Fluid thrill is present.

11. Various Lab Investigation For
The polyhydroamnios :-
1. Blood test :- Blood test for infection
disease is associated with polyhydroamnios
may be offered.
2. Amniocentesis :- Amniocentesis is a
procedure in which a sample of amniotic
fluid which contain fetal cell and various
chemical produced by baby are removed
from the uterus for testing.Testing may use
to screen the chromosome for abnormality.

12. 3. Non stress test :- This test check how the
baby's heart rate reacts when the baby moves.
During the test patient will wear a special
device on the abdomen to measure the baby's
heart rate. A buzzer like device can be used to
wake up the baby & encourage the baby for
movement.

13.  Diagnostic Tests For
Polyhydroamnios :-
1. Ultrasound:-
(A).Fetal abnormalities
(B). Excessive amniotic fluid.
2. Abdominal examination :-
(A). Inspection.
(B). Palpation.

14. Complications Of The
Polyhydroamnios :-
1. Preterm labor.
2. Premature rupture of membrane
3. Placenta separated from uterus
4. Internal bleeding
5. Umbilical cord prolapsed.

15. Discuss The Management Of
The Polyhydroamnios
The patient who has symptomatic
polyhydroamnios may need Hospital
admission.
Medical Management:-
Antacids may be prescribed to relieve
heartburn and nausea.

16. Prostaglandin Synthesis Inhibitor:-
1. Indomethacin:- Indomethacin cross the
Placenta and can reduce the fetal urine
production to treat the polyhydroamnios.
It does so by reducing renal blood flow.
Dose:- 25 mg/6 hrs/oral
2. Sulindac :- Dose:- 200 mg/12 hrs/oral

18. Nursing Responsibilities :--
Following conditions are assessed:-
1) Assess the excess fluid volume.
2) Assess patients general condition.
3) Monitor intake and output every 4 hours.
4) Assess fetal condition by electronic fetal
monitoring.
5) Assess the abdominal girth to assess uterine
height and compare with the previous
measurements.