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Polyhydramnios
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Polyhydramnios


  Hello.  I'm 31 yo and this is my 3rd pregnancy (prior two pregnancies were normal).  I'm currently 36+ weeks, due on April 1st.  About a month or so ago, my doctor noticed that my uterus was a little large and ordered a new ultrasound to determine the cause.  He said that the results showed excessive amniotic fluid.  Since then I have seen him weekly.  He started doing pelvic exams early and has done two non-stress tests.  So far everything looks normal but at each successive visit he has seemed more nervous/concerned.  At my last visit (03/03/99) he ordered another ultrasound (I've had three so far) and bed-rest.  On the sonogram orders he had written "polyhydramnios," but I can see no mention of "Level II" (does this mean he only ordered level I/should I be having a level II?). I go in for my ultrasound on Monday 3/8, and return to my doctor on 3/11.  The last few days I have been researching polyhydramnios on the web and the information I have found has not been very comforting.  How concerned should I be?  I like my doctor, but should I be inquiring about being referred to a specialist in high-risk pregnancies?  Should I request that a neonatalogist be present at the birth (or that the baby be delivered at a hospital specially equipped for at-risk newborns)?  We are in the Henry Ford system (HFMC-Lakeside) and are scheduled to deliver at St. Joseph's - West (in Clinton Twp.).  Can you recommend any other specific questions I should be asking the doctor at my next visit?  Thank You.
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Dear Sherry,
How concerned should you be:  it depends on how severe the polyhydramnios is--an amniotic fluid index of 24 to 40 is usually considered mild.  Studies vary somewhat but a study of 97 women showed no increase in adverse pregnancy outcomes in women with mild, "unexplained" polyhydramnios.  Unexplained meaned the ultrasound doesn't show any fetal abnormalities, you don't have diabetes or you aren't Rh negative and sensitized.  As far as seeing a specialist--not usually necessary.  Having a neonatalogist present at birth usually isn't needed since you are no longer at risk of delivering a preterm infant.  A pediatrician should evaluate the baby for stomach abnormalities that wouldn't show up at birth but with the first feeding.  Questions to ask would be how severe is the polyhydramnios and are there any other ultrasound abnormalities.  
This information is provided for general medical educaiton purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.





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