A clinical study of fetomaternal outcome in pregnancy with polyhydramnios
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20164648Keywords:
Congenital anomalies, PolyhydramniosAbstract
Background: Amniotic fluid not only provides protection to the fetus from traumatic forces, cord compression, and microbial pathogens, but also plays an integral role in the normal development of the fetal musculoskeletal, pulmonary, and gastrointestinal systems. Polyhydramnios, defined as an excessive amount of amniotic fluid, complicates approximately 0.4-3.3% of all pregnancies. Fetal conditions that are associated with polyhydramnios include major congenital anomalies and both the immunologic and non-immunologic forms of hydrops foetalis. Maternal medical conditions are also known to be associated with polyhydramnios and subsequently alter perinatal outcome. So by diagnosing these cases as early as possible, these maternal complications can be prevented and advise proper prenatal counseling in relevant cases.
Methods: This study was conducted in obstetrics and gynaecology department at a tertiary care hospital, over the period of from September 2015 to September 2016. Prospective observational study.
Results: Polyhydramnios is commoner in primigravida. Causative factor are mainly idiopathic after which the most important is fetal defects. Diabetes is also associated finding with polyhydramnios in 8.3% cases. The occurrence of fetal congenital abnormality was directly proportional to the gestational age of pregnancy. Incidence of congenital abnormality was found to be 1.25 %. Congenital heart disease and cleft lip and cleft palate (3%) were the commonest congenital abnormality associated with polyhydramnios followed by anencephaly and spina bifida (3.3%).
Conclusions: In our study Idiopathic polyhydramnios was found to be the most common cause of polyhydramnios. A careful study must be done for detection of etiological factors in all cases of polyhydramnios, careful screening, prenatal and antenatal counseling will help to improve the foetal outcome as well as to prevent the maternal complication.
Metrics
References
Queeran JT, Gadow EC. Polyhydramnios: chronic versus acute. Am J ObstetGynecol. 1970;108:349-52.
Magann EF, Doherty DA, Chauhan SP, Busch FW, Mecacci F, Morrison JC. How well do the amniotic fluid index and single deepest pocket indices (below the 3rd and 5th and above the 95th and 97th percentile) predict oligohydramnios and hydramnios? Am J Obstet Gynecol. 2004;190:164-9.
Cardwell MS. Polyhydramnios. A review Obstet Gynecol Survey. 1987;42:612-7.
Hibbard BM. The fetal membranes and amniotic fluid. In: principles of obstetrics, Butter Worth and Co. (Pub); 1988:94-98.
Pauer HU, Viereek V, Krauss V, Osmers R, KraussT. The incidence of fetal malformations in pregnancies complicated by oligo and polyhydramnios. Arch Gynecol Obstet. 2003;268:52-6.
Thompson O, Brown R, Gunnarson G, Harrington K. Prevalence of polyhydramnios in the third trimester in a population screened by first andsecond trimester ultrasonography. J Perinat Med. 1998;26:371-7.
Erdemoglu E, Mungan T. Significance of detecting insulin like growth factor binding protein-1 in cervico-vaginal secretions: comparison with nitrazine test and amniotic fluid volume assessment. Acta Obstet Gynecol. 2004;83:622-6.
Dashe JS, Mclntire DD, Ramus RM, Santos-Ramos R, Twickler DM. Hydramnios anomaly prevalence and sonographic detection. Obstet Gynecol. 2002;100:134-9.
Phelan JP, Martin Gl. Polyhydramnios fetal andneonatal complications. Clin Perinatol. 1989;16:987.
Lazebnik NN, Lazebnik A. The severity of polyhydramnios, estimated fetal weight and preterm delivery are independent risk factors for presence of congenital malformation. Gynecol Obstet Invest. 1999;48:28-32.
Plating-kemp A, Ngu Yen T, Chang E. Idiopathic polyhydramnios and perinatal outcome. Am J Obstet Gynecol. 1999;181:1079-82.
Fawad A, Shamshad, Danish N. Frequency, causes and outcome of polyhydramnios. Gomal J Med Sci. 2008;6:2.
Tariq S, Cheema S. Polyhydramnios; study of causes and fetal outcome. Professional Med J Dec. 2010;17(4):660-4.
Malas NOM, Jayousi TM. Perinatal outcome in idiopathic polyhydramnios. Bahrain Medical Bulletin. 2005;27:1.
Akram H, Nasir A, Rana T. Increasing severity of polyhydramnios-A risk factor for congenital malformation. Biomedica. 2006;22:9-11.
Akhter S, Mustafa N. Fetal outcome in singleton pregnancies complicated with polyhydramnios from 28 to 36 weeks. Combined Military Hospital. 2011:3.
Phelan JP, Park YM, Ahn MO, Rutherford SE. Polyhydramnios and perinatal. 1990;10;347-50.
Smith CV, Plambeck RD, Rayburn WF, Albaugh KJ. Relation of mild idiopathic polyhydramnios to perinatal outcome. Obstet Gynecol. 1992;79;387-9.
Nordstrom L, Westgren M. Indomethacin treatment for polyhydramnios. Effective but potentially dangerous. Acta Obstet Gynecol Scand. 1992;71;239-41.
