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Polyhydramnios is a medical condition describing an excess of amniotic fluid in the amniotic sac.It is seen in about 1% of pregnancies. [1] [2] [3] It is typically diagnosed when the amniotic fluid index (AFI) is greater than 24 cm. [4] [5] There are two clinical varieties of polyhydramnios: chronic polyhydramnios where excess amniotic fluid accumulates gradually, and acute polyhydramnios ...
The fetal symptoms are related to fluid retention, including ascites and polyhydramnios. [3] Fetal hydrops suggests the presence of an important and probably fatal fetal pathology . It can be associated with parvovirus B19 infection and with twin-to-twin transfusion syndrome .
Other birth defects may co-exist, particularly in the heart, but sometimes also in the anus, spinal column, or kidneys. This is known as VACTERL association because of the involvement of Vertebral column, Anorectal, Cardiac, Tracheal, Esophageal, Renal, and Limbs. It is associated with polyhydramnios in the third trimester. [9]
The blood volume of the recipient twin is increased, which can strain the fetus's heart and eventually lead to heart failure, and also higher than normal urinary output, which can lead to excess amniotic fluid (becoming polyhydramnios). The demise of the fetus is typically a result of ischemia related to the lack of
Congenital heart problems e.g. pulmonary artery stenosis (common), Tetralogy of Fallot, overriding aorta, ventricular septal defect; and right ventricular hypertrophy. Liver (jaundice, pruritus, hepatosplenomegaly, acholia, xanthoma) Andersen–Tawil syndrome: This condition affects the QT interval (in blue) Antley–Bixler syndrome: Barth syndrome
Twin oligohydramnios-polyhydramnios sequence is a rare condition that may occur when twins sharing a single placenta develop significant vascular cross-connections, known as anastomoses, resulting in blood flowing away from one twin to the other. [23] This process can result in polyhydramnios in one twin and oligohydramnios in the other twin. [23]
Generally, the pump twin is structurally normal, although it is smaller than normal. [2] Due to related problems including the rapid growth of the acardiac twin, polyhydramnios, umbilical cord entanglement and congestive heart failure due to high output, there is a high mortality rate for the pump twin if left untreated.
With enough pressure, blood may travel from the right atrium to the left. If there is a clot in the right side of the heart, it can cross the PFO, enter the left atrium, and travel out of the heart and to the brain, causing a stroke. If the clot travels into a coronary artery it can cause a heart attack. [6]