From the Guidelines
Management of polyhydramnios should prioritize identifying and treating the underlying cause, with a focus on maternal and fetal well-being, and may involve conservative management, amnioreduction, or oral indomethacin therapy, depending on the severity and symptoms of the condition. The initial evaluation should include a detailed ultrasound to assess fetal anatomy, screening for gestational diabetes, and consideration of amniocentesis to rule out genetic abnormalities or infections 1. For mild to moderate polyhydramnios without complications, conservative management with regular monitoring is appropriate. In symptomatic cases, amnioreduction can provide temporary relief by removing excess amniotic fluid through amniocentesis.
Some key considerations in managing polyhydramnios include:
- Identifying the underlying cause, such as gestational diabetes or fetal anomalies
- Monitoring maternal and fetal well-being through serial ultrasounds and non-stress tests
- Using amnioreduction or oral indomethacin therapy to reduce amniotic fluid production in symptomatic cases
- Considering the risks and benefits of each treatment option, including the potential for premature ductal closure with indomethacin therapy 1
- Delivery planning should take into account the severity of polyhydramnios and the potential for complications during labor, such as cord prolapse or placental abruption 1.
It is also important to note that the management of polyhydramnios may involve a multidisciplinary team, including a maternal-fetal medicine specialist, a neonatologist, and a pediatric cardiologist, particularly if NSAID therapy is considered 1. Close monitoring and regular follow-up are crucial to ensure the best possible outcomes for both the mother and the fetus.