CHRONIC POLYHYDRAMNIOS

Anatomically, Polyhydramnios is defined as the condition where liquor amnii exceeds 2000ml.

Clinical definition states- the excessive accumulation of liquor amnii causing discomfort to the patient and/or when an imaging help is needed to substantiate the clinical diagnosis of the lie and presentation of the foetus.

In majority of cases, the accumulation of liquor is gradual and as such, the patient is not very much inconvenienced.

SYMPTOMS: -

• Respiratory: - the patient may suffer from Dyspnoea or even remain in the sitting position for easier breathing
• Palpitations
• Oedema of the legs, varicosities in the legs, or vulva and hemorrhoids

SIGNS: -

• The patient may be in a dyspnoeic state in the lying down position.
• Evidence of Pre-eclampsia (oedema, Hypertension and Proteinuria) may be present.

ABDOMINAL EXAMINATION: -

INSPECTION: -  abdomen is markedly enlarged, looks globular with fullness at the flanks.

the skin is tense, shiny with large striae.

PALPATION: - Height of the uterus is more than the period of amenorrhea.

• Girth of the abdomen round the umbilicus is more than normal.
• Fluid thrill can be elicited in all directions over uterus.
• Fetal parts cannot be well defined, so also the presentation or the position. External ballottement can be elicited more easily.

AUSCULTATION: - Fetal heart sound is not heard distinctly, although its presence can be picked up by Doppler ultrasound.

INVESTIGATIONS: - Sonography reveals Amniotic fluid index is more than 25cm. Largest Vertical pocket more than 8 cms.

HOMOEOPATHIC MEDICINES FOR MANAGING CHRONIC POLYHYDRAMNIOS: -

1) SEPIA: - Chilly patient, predisposed to take cold at the change of weather. Past history of repeated Abortions. Nausea with sour eructations specially in morning before eating from sight or thought of food and smell.

2) COLCHICUM: - Nausea and faintness from the odour of cooking food, fish, eggs or fat meat. Vomiting of mucus,bile and food. Nausea is better by lying quietly and perfectly still,is renewed by every motion.

3) ARSENIC ALBUM: - Nausea, retching, vomiting especially after eating or drinking. Cannot bear the sight or smell of food.

4) IPECACUANHA: - Constant and continual nausea with no relief even after vomiting. Vomiting of food, bile, blood, white glairy mucus, sometimes immediately after meal. Vomiting worse by stopping.