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Too much of a good thing

by Dr Howard Lee
continued from page 2
How is the diagnosis made?
It will usually be necessary to take a full medical history, and make a proper examination, following which an ultrasound examination will be made. This will measure pockets of fluid - called the Amniotic Fluid Index - in order to estimate the total volume. These indices do change depending on gestational age, therefore the norms for your baby's age will need to be known.

At the same time, this ultrasound examination may help to find a possible cause of the hydramnios - such as a multiple pregnancy, or some form of birth defect.

Treatment
Sometimes it can only be the symptoms of hydramnios that can be treated and not the cause. Your obstetrician will determine any specific treatments. These will be based on:

  • Your pregnancy
  • Your overall health and medical history
  • The extent of the condition
  • Your own tolerance for specific treatments, procedures and medications
  • Expectations for the course of the condition
  • Your own opinion or preferences
All that may be necessary is:
  • Close monitoring of the amount of amniotic fluid - repeat measures of the AF Index - with frequent follow-up visits.
  • Medications to reduce the urine production of your baby.
  • Medications for the relief of 'inflammation', like Indomethacin.
  • Amniotic fluid reduction (amniocentesis), performed by withdrawing fluid through a small needle introduced into the sac via the tummy wall. This may need to be repeated on several occasions.
  • Delivery of your baby - if complications endanger the well-being of either your baby's or your own health.

The main aim of any treatment is to relieve any discomfort that may be present and to continue the pregnancy if this is possible. It is not possible to prevent hydramnios.

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