Midwifery Nursing Management of Polyhydramnios
What Do You Mean by Polyhydramnios?
An excess of liquor amni termed as polyhydramnios or hydramnios. It is arbitrarily defined as more than 2000 ml of liquor amni, because it becomes clinically obvious beyond this limit. Normal amniotic fluid volume is 500 -1500ml.
Nursing Management of Polyhydramnios:
- Mild to moderate degrees usually does not require treatment.
- Hospitalization if symptoms are severe dyspnea, abdominal pain and difficult ambulation.
- Maintain bed rest with sedation to make the situation endurable.
- Monitor the patient for signs and symptoms of premature labor.
- Monitor maternal vital signs and fetal heart rate frequently; report changes immediately.
- Prepare the patient for amniocentesis and possible labor induction, as appropriate; keep in mind that amniocentesis for fluid removals is only temporary and may need to be done repeatedly.
You can follow: Types, Causes and Symptoms of Polyhydramnios
Pregnancy less than 37 weeks:
- Amniocentesis: slow decompression is done at the rate of about 500 ml per hour.
- Amount should be sufficient enough to relieve the mechanical distress.
- Amniotic fluid tested for fetal lung maturity.
Pregnancy more than 37 weeks:
- Induction of labor is done.
- Amniocentesis
- Termination of pregnancy with congenital fetal anomaly.
During labour:
- Usual management.
What is Amniocentesis?
Amniocentesis is a procedure in which amniotic fluid is removed from the uterus for testing or treatment. Amniotic fluid is the fluid that surrounds and protects a baby during pregnancy. This fluid contains fetal cells and various proteins.
Why Amniocentesisis Done in Case of Polyhydramnios?
Amniocentesis can be done for various reasons:
1. Genetic testing: Genetic amniocentesis involves taking a sample of amniotic fluid and testing it for certain conditions, such as Down syndrome.
2. Fetal lung testing: Fetal lung maturity testing involves taking a sample of amniotic fluid and testing it to determine whether a baby’s lungs are mature enough for birth.
3. Diagnosis of fetal infection: Occasionally, amniocentesis is used to evaluate a baby for infection or other illness. The procedure can also be done to evaluate the severity of anemia in babies who have Rh sensitization- an uncommon condition in which a mother’s immune system produces antibodies against a specific protein on the surface of the baby’s blood cells.
4. Treatment: If you accumulate too much amniotic fluid during pregnancy (polyhydramnios), amniocentesis might be done to drain excess amniotic fluid from your uterus.
5. Paternity testing: Amniocentesis can collect DNA from the fetus that can then be compared to DNA from the potential father.
Complications of Amniocentesis:
Complications associated with amniocentesis include the following:
- The risk of miscarriage.
- Some women get cramps after the procedure.
- Some women have a small amount of vaginal bleeding after the procedure.
- Rarely, amniocentesis may cause amniotic fluid to leak out of the body.
- Another rare complication is a uterine infection.
- If you have an infection such as hepatitis C or HIV, amniocentesis can cause the infection to transfer to your unborn baby.
