Question

A woman presents to you at 36 weeks of gestation with complaints of breathlessness and excessive abdominal distension. Fetal movements are normal. On examination, fetal parts are not easily felt and fetal heartbeat is heard but it is muffled. Her symphysis fundal height is 41 cm. Her abdomen is tense but not tender. What is the most likely diagonosis?

• A. Abruptio placenta
• B. Hydrocephalus of fetus
• C. Polyhydramnios
• D. Fetal-maternal ascites

Answer 1

The Correct Option is C

A woman at 36 weeks of gestation exhibits several symptoms, including breathlessness, excessive abdominal distension, a challenge in palpating fetal parts, and a symphysis-fundal height of 41 cm. These symptoms are key to identifying the appropriate diagnosis.

1. Breathlessness and Abdominal Distension: These may indicate increased pressure in the abdomen, often seen in conditions involving excessive fluid.

2. Fetal Palpation and Heartbeat: Difficulty in palpating fetal parts and a muffled heartbeat suggest that the fetus is surrounded by a substantial amount of fluid.

3. Symphysis-Fundal Height Measurement: At 36 weeks, a symphysis-fundal height of 41 cm is abnormally large, indicating increased uterine size, often due to excess amniotic fluid.

4. Abdomen Condition: A tense (but not tender) abdomen points to possible fluid accumulation without inflammation.

Given these observations, the most likely diagnosis is Polyhydramnios, a condition where there is an excessive amount of amniotic fluid surrounding the fetus.