Polyhydramnios not associated with
Ans. is 'a' i.e. B/L renal agenesis Polyhydramnios is defined as a state where liquour amni exceeds 2000 ml.Amniotic fluid measures about 50 ml at 12 weeks, 400 ml at 20 weeks and reaches its peak of 1 litre at 36-38 weeks.There after the amount diminishes till at term it measures about 600-800 ml Amniotic fluid formation:- Early pregnancy - Ultrafiltrate of plasma Beginning of 2nd trimester - Composed largely of extracellular fluid that diffuses through the fetal skin. After 20 weeks - Cornification of fetal skin prevents this diffusion and the amniotic fluid is composed largely of fetal urine.The fluid in the amniotic fluid is completely changed and replaced in every 3 hours.Causes of increase in amniotic fluid (Polyhydramnios)Because the fetus normally swallows the amniotic fluid and excretes it through urine it has been assumed that this mechanism is one of the ways by which the volume is controlled.Thus renal agenesis will lead to oligohydramnios not polyhydramnios.Anencephaly causes polyhydramnios because of transudation from exposed meninges and absence of fetal swallowing reflex.Open spina bifida leads to polyhydramnios because of transudation of meninges.Causes of polyhydramnios MaternalPh isoimmunisationDiabetes PlacentalPlacental chrioangiomaCircumvallate placenta syndrome FetalMultiple pregnancyFetal anomaliesCNS abnormalities (Anencephaly)G.L abnormalities (Oesophageal or duodenal atresia)G. U. abnormalitiesSkeletal malformationsFetal tumoursCardiac anomaliesChromosomal abnormalitiesGenetic syndromesHematological disordersIntrauterine infectionsMiscellaneous IdiopathicComplications of Polyhydramnios:Most of the maternal complications of polyhydramnios arise purely from pressure exerted within the overdistended uterus and upon adjacent organs. Which areRespiratory discomfortPremature rupture of membranePremature labourPregnancy induced hypertensionAbruptio placentaCord prolapsePlacental insufficiencyPost partum hemorrhageFetal complications:Fetal morbidity and mortality is significant in cases of polyhydramnios.The major causes of mortality are congenital abnormalities incompatible with life.
B/L renal agenesis
Anencephaly
Open spina bifida
Tracheo esophageal fistula
Hydramnios and Oligo Hydramnios