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  IN THIS Article
 ::  Abstract
 ::  Introduction
 ::  Case report
 ::  Discussion
 ::  Acknowledgment
 ::  References

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CASE REPORT
Year : 1991  |  Volume : 37  |  Issue : 2  |  Page : 119-20

Recurrent hydramnios as a result of fetal Bartter's syndrome (a case report).


Department of Obstetrics and Gynaecology, Seth G.S. Medical College, Parel, Bombay, Maharashtra.

Correspondence Address:
Department of Obstetrics and Gynaecology, Seth G.S. Medical College, Parel, Bombay, Maharashtra.


  ::  Abstract

Bartter's syndrome has been reported as a rare case of hydramnios. A unique case of recurrent hydramnios in pregnancy as a result of fetal Bartter's syndrome on both occasions is presented.

How to cite this article:
Shah M H, Batwar O D, Parulekar S V. Recurrent hydramnios as a result of fetal Bartter's syndrome (a case report). J Postgrad Med 1991;37:119


How to cite this URL:
Shah M H, Batwar O D, Parulekar S V. Recurrent hydramnios as a result of fetal Bartter's syndrome (a case report). J Postgrad Med [serial online] 1991 [cited 2019 Nov 18];37:119. Available from: http://www.jpgmonline.com/text.asp?1991/37/2/119/790




  ::   Introduction Top

Bartter's syndrome or juxtaglomerular hyperplasia is characterized by hypokalemic alkalosis, hyperaldosteronism, hyperreninemia and normotension[2]. It is an autosomal recessive disorder. A unique case is presented wherein two successive pregnancies associated with hydrammos resulted in babies suffering from Bartter's syndrome.

  ::   Case report Top

Mrs. RA, a 26-year-old second gravida, primipara presented for antenatal care with a history of 8 months amenorrhoea. Her first pregnancy was terminated with a LSCS, the indication being hydramnios with a floating head and non-progress of labor. The male child subsequently died at the age of 2 months of dehydration - a late diagnosis of Banter's syndrome was made prior to death. On examination, there was massive hydramnios which was confirmed by USC.There was a weight gain of 10 kg in the present pregnancy. Her glucose tolerance test and serum alpha feto proteins were within normal limits. USG did not reveal any congenital anomalies in the fetus. At 36 weeks, she complained of leaking par vaginum. On examination there was a frank leak, the cervical os was admitting a finger and the membranes were absent. The fetal heart sounds dropped to 80 per minute soon after the premature rupture of membranes and an emergency LSCS was done. A male baby was delivered weighing 2.2 kg with an Apaar score of 8/10 at 1 minute and 9/10 at 5 minutes. Retroplacental clots weighing 350 gram were present indicating abruption due to sudden decompression of the uterus follosking premature rupture of membranes. Subsequent investigations in the baby confirmed a diaposis of Banter's syndrome = Serum K 2.4 meq/1. Na 114 meq/1. urinaty K 19 meq/1, Cl 66.87 meq/1, Na 44 meq/1. Plasma renin activity was 6.6 ng/ml/hr and serum Aldostarone level was 3312 pg/ml. Renal USG was normal.

  ::   Discussion Top

Bartter's syndrome is a rare metabolic disorder. The exact etiology is unknown. Postulated mechanisms include:
a) primary defect in chloride reabsorption in the loop of Henle.
b) Primary defect in potassium reabsorption[1].
The etiology of hydramnios in these cases of fetal Bartter's syndrome is excessive loss of fluid from the fetal circulation in the form of hyperosmolar urine into the surrounding amniotic cavity. This loss cannot be compensated by fetal swallowing thus, resulting in increasing volumes of amniotic fluid formation and mmassive hydremnios.
Thus, Bartter's syndrome in the fetus though rare must be considered as an etiologic factor of hydramnios in pregnancy especially if seen in a recurrent manner.

  ::   Acknowledgment Top

Acknowledgments are due to the Dean, Seth GS Medical College and King Edward Memorial Hospital, Mumbai for allowing us to publish this data.

  ::   References Top

1. Behrinan RE, Vaughan III VC. In: "Nelsons Textbook of Paediatrics", 13th edition, W. B. Saunders and Co., 1987, page 1137.  Back to cited text no. 1    
2.Brouhard BH. In: "Juxtagtomerulat Hyperlasia: Paediatrics". AM Rudolph, editor. 18th edition. Norwalk, Connecticut: Appleton and Lange; 1987, pp 1193-1194.  Back to cited text no. 2    
3.Weaver DD. A survey of prenatally diagnosed disorders. Clin Obstet & Gynaecol 1998; 31:266.   Back to cited text no. 3    

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