WOMENS-HEALTH Messages for July, 1997: Re: VBAC Risks and Prior Polyhydramnios...To Dr. Braun

Re: VBAC Risks and Prior Polyhydramnios...To Dr. Braun

From: Mary (anonymous@obgyn.net)
Thu, 31 Jul 1997 07:51:17 -0500 (CDT)

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In reply to: R.Daniel: "Re: VBAC Risks and Prior Polyhydramnios"

At Wed, 30 Jul 1997, R.Daniel Braun, MD FACOG wrote:

>Polyhydramnios which by the way is redundant and should really be
>hydramnios which means too much water, in the last pregnancy should not
>affect this pregnancy at all unless you have a recurrence of the
>hydramnios.
>Hydramnios is most commonly idiopathic ( that really means of unknown
>cause, but I tell people it means "The idiots can't find the
>pathology"). This does not tend to recur.

I am unsure if your reply was to Darcy's response or if you read my original question. ? Regardless, I used the term "polyhydramnios" because it was used by everyone connected to my last pregnancy (Ob/Gyn, 5 MFM Drs, L&D and antepartum unit nurses) along with being the diagnosis in my charts at the Ob/Gyn office, MFM office, level 3 hospital and it was also the term noted on the autopsy report. Side note: In my first pregnancy 12 years ago, the term "acute polyhydramnios" was applied.

I did not question the reason for the (poly)hydramnios as that has been determined. I have had two babies with: cortical disarray - brain, anterior horn cell loss - spinal cord, congenital hypomyelination neuropathy, arthrogryposis, hydrocephalus, omphalocele, hydronephrosis, pulmonary congestion, pleural effusions, pulmonary hypoplasia, cystic hygromas, malrotation of intestines and clubbed feet and hands. So between the neurological, muscular and intestinal/omphalocele problems, the reason for the excessive amniotic fluid is quite clear.

Since this has occurred more than once, the above anomalies are considered to be an undefined recessive genetic trait. This is being written up as a "new entity" by the genetics professor at the UofMN and my genetics counselor. I am aware of the 1 in 4 chance of recurrence.

>My first blush is that it would
>make uterine rupture more likely, but then as I think about it more I
>can see a mechanism whereby it would have no effect. What mechanism
>actually occurs is totally unkown to me.

This is why I initially asked the question. It seems logical that the extra fluid would put more pressure on the uterus (and the previous scar).

>Therefore, I don't
>know!!!!(There I've said it,, a Doctor doesn't know)

>R.Daniel Braun, MD

You are human. As are all doctors. I have heard "I don't know" a zillion times throughout my two "affected" pregnancies. I would prefer to hear honest words such as that as opposed to inaccurate responses anyday.

BTW, sorry to hear you had such a rotten day yesterday.

-- Mary

--
Twin Cities Area
Minnesota

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