Management of idiopathic severe polyhydramnios

Severe polyhydramnios is defined as amniotic fluid index ≥35 cm or single deepest pocket ≥16 cm. Severe symptoms can be defined as significantly interfering with the patient's ability to conduct the normal activities of daily life. Amnioreduction relieves symptoms immediately, but amniotic fluid may reaccumulate within a few days to weeks. Intervention to reduce amniotic fluid is not indicated in asymptomatic patients or patients with mild shortness of breath, abdominal discomfort, and/or uterine irritability that is reasonably tolerable.

GA: gestational age.
* Uterine irritability is treated in the same way as preterm labor:

For GA <32 weeks: Administer indomethacin for 48 hours for tocolysis and its amniotic fluid-reducing effects.
For GA 32 to <34 weeks: Administer nifedipine or a beta-sympathomimetic for up to 48 hours for tocolysis.
For GA ≥34 weeks: No tocolysis.

¶ Administer a course of betamethasone per standard guidelines, and

For GA <32 weeks: Administer indomethacin for 48 hours for tocolysis and its amniotic fluid-reducing effects.
For GA 32 to <34 weeks: Administer nifedipine or a beta-sympathomimetic for up to 48 hours for tocolysis.
For GA ≥34 weeks: No tocolysis.

Graphic 127797 Version 2.0

خرید پکیج

Management of idiopathic severe polyhydramnios