Volume 03 Issue 04-2023
125
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
125-128
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Polyhydramnios is an obstetric pathology, which is characterized by an increase in the volume of amniotic fluid
(amniotic fluid) of more than 1500 ml. The purpose of the study was to study the frequency of causes, the course of
pregnancy, the outcome of childbirth and the condition of the newborn with polyhydramnios. To achieve this goal, a
retrospective analysis of the history of childbirth of 72 women with polyhydramnios who delivered in the obstetric
department of the Samara State Medical University clinic in 2022 was carried out. The course of pregnancy in women
with polyhydramnios is complicated by: preeclampsia of the first and second half of pregnancy, miscarriage and
premature birth. Perinatal outcomes are characterized by: intrauterine retention syndrome, prematurity,
malformations of the central nervous system, cerebrovascular accidents and intrauterine infections.
KEYWORDS
Polyhydramnios, diagnosis of polyhydramnios, course of pregnancy, perinatal outcomes.
INTRODUCTION
Polyhydramnios is an obstetric pathology, which is
characterized by an increase in the volume of amniotic
fluid (amniotic fluid) of more than 1500 ml. The
frequency of this pathology ranges from 1 to 1.5%,
which increases perinatal pathology and mortality,
reaching high numbers, up to almost 50% due to
impaired
placental
insufficiency,
in
particular
hemostasis, which causes the risk of this pathology.
Research Article
THE CONSEQUENCES OF POLYHYDRAMNIOS FOR THE MOTHER AND
FETUS
Submission Date:
April 20, 2023,
Accepted Date:
April 25, 2023,
Published Date:
April 30, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue04-20
Zakirova Fotima Islamovna
Samarkand State Medical University, Samarkand, The Republic Of Uzbekistan
Abdullaeva Nigora Erkinovna
Samarkand State Medical University, Samarkand, The Republic Of Uzbekistan
Telmanova Jasmina Farruxovna
Samarkand State Medical University, Samarkand, The Republic Of Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 04-2023
126
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
125-128
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
The causes of polyhydramnios are not fully
understood, but more often this pathology is observed
in pregnant women with multiple pregnancies, as well
as with maternal diseases, such as inflammatory
processes of the pelvic organs, heart disease, diabetes
mellitus, abnormal development or damage to the
placenta, genetic diseases that cause malformations .
On the part of the fetus, the causes of polyhydramnios
can be hemolytic disease or fetal abnormalities with
the inability to swallow amniotic fluid with
gastrointestinal malformations (esophageal atresia,
duodenal atresia, CNS malformations hydrocephalus,
anencephaly, chromosomal abnormalities, Down
syndrome, as well as fetal renal disorders, leading to to
increase urine production.
In this regard, the management of pregnant women
with polyhydramnios is an urgent problem of modern
obstetrics.
The purpose of the study: to study the frequency of
causes, the course of pregnancy, the outcome of
childbirth and the condition of the newborn with
polyhydramnios.
Material and methods of research: To achieve this goal,
a retrospective analysis of the history of childbirth of
72 women with polyhydramnios who delivered in the
obstetric department of the Samara State Medical
University clinic in 2022 was carried out.
By age, women were distributed in the following order:
up to 20 years old - 12 (16.66%) women, 21-25 years old -
28 (38.8%), 26-30 -21 (29.16%), 31-35-10 (13, 88%), and
over 40 years -1 (1.38%). The diagnosis of
polyhydramnios was based on complaints - shortness
of breath, nagging pain in the abdomen, edema,
anamnesis data, external and internal obstetric
research methods - an increase in the abdomen, the
size of the uterus that does not correspond to the
duration of this pregnancy, shiny skin of scars,
ultrasound (which determined the volume (amniotic
liquid), as well as the determination of prolactin in the
amniotic fluid, its low content, which does not
correspond to the gestational age, which is the most
informative for the diagnosis of this pathology... The
final diagnosis was confirmed after childbirth -
examination of the placenta, followed by histological
examination, the state and amount of amniotic fluid.
Results of the study: The causes of polyhydramnios in
the observed group were: maternal diseases,
infections - viral, bacterial in 55.6% of women according
to microbiological and serological studies. In the 2nd
trimester, the following types of infection were
detected in pregnant women before the start of
treatment - bacterioscopy revealed an increased
content of leukocytes in 72 (100%) women, the
presence of coccal - 62 (86.1%), fungal 58 (80.5%) flora,
gardenerella 40 (55.6%). Bacteriological examination
revealed various anaerobic infections - chlamydia - 49
(68%), mycoplasmas - 10 (13.8%), ureplasma - 7 (9.7%)
and CMV - in 6 (8.3%) cases. A combination of two or
more infections occurred in 9 (12.5%) pregnant women.
Before pregnancy, 24 (33.33%) women suffered from
inflammatory diseases of the female genital organs,
ARVI suffered; 42 (58.3%) women who had
polyhydramnios during this pregnancy received
appropriate
treatment.
Gynecological
diseases
suffered: primary infertility - primary in -4 (5.55%) and
secondary - in 4 (5.55%) women, endometritis - 6
(8.33%), posterior perimetritis - 6 (8.33%), pyovar was
observed in 5 (6.9%), diffuse toxic goiter in one patient.
The course of this pregnancy - in 24 (33.3%) cases
proceeded without complications, in 23 (31.9%) cases
there was a threat of premature birth, in 16 (22.2%)
cases there was early preeclampsia and in 10% (13.8%) -
Volume 03 Issue 04-2023
127
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
125-128
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
preeclampsia of the second half of pregnancy, in
particular, mild and severe preeclampsia.
Term delivery was in 15 (20.8%), premature - in 22
(30.5%) women. Prolonged pregnancy was observed in
12 (16.6%) women, post-term pregnancy in 2 (2.77%)
women. Of these, in 6 (8.33%) births ended with a
caesarean section. The indications for surgery were a
scar on the uterus, breech presentation of the fetus, a
large fetus, incorrect insertion of the head (posterior
view of the facial presentation), disproportion of the
head with the size of the pelvis (functional narrow
pelvis) and premature detachment of a normally
located placenta.
Childbirth was complicated by: early rupture of
amniotic fluid in 8 (11.1%) women, shoulder dystocia
was in 4 (5.5%), malformation of the fetus - transverse
in 3% of cases, prolapse of umbilical cord loops - in 2
puerperas with prenatal rupture waters with
pronounced
polyhydramnios.
Postpartum
hemorrhage, in particular uterine hypotension,
occurred in 6 (8.33%) puerperas.
Born - 37 newborns, of which weighing from 1000-1500-
1 (1.38%), from 1500-2000-1 (1.38%), from 2001-2500-4
(5.55%), 2201-3000 -19 (26.4%), from 3001 to 3500 - 6
(8.33%), from 3501 and over 4000 - in 6 (8.33%). -11
(15.2%) newborns, 7-8 points in 11 (15.2%), 5-4 points in 4
(5.55%), 4-0 points in 11 (15.2%) 1 child died.
According to the literature, the prognosis for the fetus
is not favorable with polyhydramnios, in 50% of cases it
causes perinatal mortality, the main cause is
prematurity and malformations.
In our studies, polyhydramnios also had a pathological
effect on the intrauterine development of the fetus.
So, chronic fetal hypoxia was observed in 22 cases,
fetal retention syndrome in -5 cases, cerebrovascular
accident of the 1st degree in -3 cases, the 2nd degree in
- 4 cases, partial atelectasis of the lungs occurred in - 3
cases, respiratory distress syndrome in -4 cases, the
risk of intrauterine infection - in 22 newborns. Almost
half of the born newborns - due to increased fetal
mobility due to the presence of polyhydramnios,
entanglement of the umbilical cord was noted, which
amounted to 16.6%. cases. 31 (43%) children were
discharged, 5 (6.94%) newborns were transferred to
acute renal failure with symptoms of incipient
pneumonia, pneumopathy and fetal weight deficiency.
CONCLUSIONS
1.
Polyhydramnios is a serious complication of
pregnancy and childbirth, women with this
pathology should be classified as a high-risk group.
2.
Currently
used
methods
for
diagnosing
polyhydramnios at the preclinical stage are
reliable. This once again confirms the need for early
diagnosis of polyhydramnios, which provides early
and, possibly, prenatal preparation of pregnant
women with a high risk of polyhydramnios to
reduce perinatal complications in the mother and
fetus.
3.
The course of pregnancy in women with
polyhydramnios is complicated by: preeclampsia of
the first and second half of pregnancy, miscarriage
and premature birth.
4.
Perinatal
outcomes
are
characterized
by:
intrauterine
fetal
retention
syndrome,
prematurity, malformations of the central nervous
system, cerebrovascular accidents and intrauterine
infections.
REFERENCES
1.
Ветрова А.В.// Особенности анамнеза, тесения
беременности и родов при многоводии//
Volume 03 Issue 04-2023
128
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
125-128
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Смоленский медицинский альманах. 2018.С. 47
-
48
2.
Закирова Н.И., Закирова Ф.И.// Репродуктивное
здоровье женщин Самаркандской области//
Проблемы биологии и медицины
- 2021-
№1.1(
126)
с. 101
-103
3.
Закирова Н.И., Закирова Ф.И., Абдуллаева Н.Э. //
Достижения и перспективы развития акушерско
-
гинекологической службы в узбекистане//
Эффективная фармакотерапия// ТОМ 19
-
№ 7
-
2023
–
С. 95
-96
4.
Игитова М.Б., Мегрелидзе Е.В., Пьякова И.В
.,
Богомолова И.В.// Идиопатическое многоводие:
факторы
риска
и
некоторые
аспекты
патогенеза// « Бюллетень медицинской науки».
2018
5.
Мудров В.А., Мочалоа М.Н., Мудров А.А.//
Особенности
определения
объема
околоплодных вод на современном этапе// «
Журнал акушерства и женских болезней». 2018.
Т. 67. № 5. С. 74
-78
6.
Сидоренко В.Н., Бугров В.Ю., Кленций С.К.,
Сахаров
И.В.//
Современный
взгляд
на
этиопатогенез маловодия и многоводия и пути
их решения при многоводии инфекционной
природы// « Медицинские новости. С. 53
-57. 2018
7.
Zakirova N.I., Abdullaeva N.E., Zakirova F.I.//
Women`s health and modern contraceptive
technology after childbirth // Bulletin of
fundamental and clinic medicine-
2022 № 3(3) P.82
-
83
8.
Zakirova N.I., Abdullaeva N.E., Zakirova F.I.//
Features of pregnancy management and birth
outcomes in women with fetal macrosomia with
active and expectant tactics// Journal of
reproductive health and uro-nephrology research -
Volume 3 № 4 2022 P.77
-79
