MBchB study guide

Apr 28th, 2015
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HYDRAMNIOSIntroduction:Minor to moderate degrees of hydramnios-2 to 3 L-are rather common. Because of the difficulty of complete collection and measurement of fluid, the diagnosis is usually clinical and confirmed by sonographic estimationIncidence: Hydramnios is identified in around 1 percent of all pregnancies. Most clinical studies define hydramnios as an amnionic fluid index of greater than 24 to 25 cm-corresponding to greater than either the 95th or 97.5th percentilesMild hydramnios: defined as pockets measuring 8 to 11 cm in vertical dimension-was present in 80 percent of cases with excessive fluid. Moderate hydramnios: defined as a pocket containing only small parts and measured 12 to 15 cm deep-was found in 15 percent. Only 5 percent had severe hydramnios defined by a free-floating fetus found in pockets of fluid of 16 cm or greater. Although two thirds of all cases were idiopathic, the other third were associated with fetal anomalies, maternal diabetes, or multifetal gestationCauses of hydramnios The degree of hydramnios, as well as its prognosis, is related to the cause.Obvious pathological hydramnios is frequently associated with fetal malformations, especially of the central nervous system or gastrointestinal tract. For example, hydramnios accompanies about half of cases of anencephaly and esophageal atresia.Pathogenesis Early in pregnancy, the amnionic cavity is filled with fluid very similar in composition to extracellular fluid. During

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