Management

This is dependent on the onset - acute or chronic - and the magnitude of the polyhydramnios.

In acute polyhydramnios the mother is usually admitted to hospital and an ultrasound, is taken in order to exclude foetal abnormality. If the fetus appears normal then steps are taken to try and prevent premature labour e.g. the use of prostaglandin antagonists. Diuretics, water and salt restriction seem to be unhelpful and potentially dangerous.

In chronic polyhydramnios an ultrasound investigation and a glucose tolerance test are undertaken. If the polyhydramnios is not severe then the patient is not admitted to hospital.

There is no satisfactory treatment for symptomatic polyhydramnios, acute or chronic, other than the slow release of amniotic fluid via a transabdominal needle. During delivery if the membranes are artificially ruptured then the procedure must be done in such a manner that the release of liquor is slow and controlled. Abdominal amniocentesis may be employed to draw off amniotic fluid prior to rupture of the membranes.

If an apparently normal baby is born to a mother who had polyhydramnios then the paediatrician must check for conditions such as oesophageal atresia.