Hydraminos

1. Presented by
MRS AGNES MAHIMA DAVID
Msc nursing
Obstertics and gynaecological nursing

2.  It is a state where liquor amnii exceeds
2000ml

3.  Fetal anomalies
 Anencephaly –transudation from the exposed
meninges
 Absence of fetal swallowing reflex
 Suppression of fetal ADH leading to excessive
urination
 Open spina bifida- increased transudation from
meninges
 Esophageal or duodenal atresia –prevent
swallowing of the liquor
 Facial clefts neck masses
 Hyrops fetalis

4.  Placenta
 Chorioangioma of the placenta
 Multiple pregnancy
 Maternal
 Diabetes
 Cardiac or renal disease –edema of placenta
lead to increase in transudation

5.  Chronic –few weeks
 Acute - few days

6.  The onset is acute and the fluid
accumulates within a few days. It usually
occurs before 20 weeks of pregnancy . It is
usually associated with uniovular twins or
chorioangioma of the placenta

7.  Signs
 The patient look ill
 Edema of the legs
 Abdomen is hugely enlarged more than the period of
amenorrhea
 Fluid thrill is present
 Fetal part cannot be felt nor is the FHS audible
 Internal examination reveals effacement of cervix or
dilatation of the os
 Sonography reveals multiple pregnancy or fetal anomalies

8.  Symptom
 Abdominal pain
 Nausea and vomiting

9.  symptom
 Dyspnea
 Palpitation
 Edema of legs,varicosities in the legs or
vulva or haemorrhoids

10.  the patient may be in a dyspnoeic state in
the lying down position
 Evidence of pre eclampsia

11.  Inspection
 Abdomen –enlarged ,looks globulars with fullness
at the flanks
 Skin is tense, shiny with large straie
 Palpation
 Height of the uterus is more than the period of
amneorrhea
 Girth of the abdomen round the umbilicus is
more than normal
 Fluid thrill can be elicted in all direction over
uterus
 Fetal part are difficult to feel
 Amniotic fluid index test to estimate the total
volume

12.  Auscultation –fetal heart rate is difficult to
hear
 internal examination – cervix may be pulled
up ,dilated , to admit a finger tip through
which tense bulged membranes can be felt

13.  Sonography
 ABO and RH grouping
 PP sugar ,GTT
 AFP

14.  Maternal
 during pregnancy
 Pre eclampsia
 Mal-presentation
 PROM
 Pre term labor
 Accidental hemorrhage

15.  During labor
 Early rupture of the membrane
 Cord prolapse
 Uterine inertia
 Operative delivery due to malpresentation
 Retained placenta, PPH and shock

16.  Pueperium
 Sub involution
 Increased puerperal morbidity due to infection resulting
from operative interference and blood loss
 Fetal
 Prematurity
 Congenital abnormality