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Hydramnios: anomaly prevalence and sonographic detection.

Jodi S Dashe1, Donald D McIntire, Ronald M Ramus

  • 1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, USA. jodi.s.dashe@drexel.edu

Obstetrics and Gynecology
|July 9, 2002
PubMed
Summary

In pregnancies with hydramnios (excess amniotic fluid), ultrasound detects nearly 80% of fetal anomalies. Even with normal ultrasounds, the risk of major anomalies is low, but increases with severe hydramnios.

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Area of Science:

  • Perinatology
  • Fetal Medicine
  • Medical Imaging

Background:

  • Hydramnios, characterized by excess amniotic fluid, is associated with increased risk of fetal anomalies and aneuploidy.
  • Accurate prenatal diagnosis of fetal anomalies is crucial for appropriate management and counseling.

Purpose of the Study:

  • To determine the prevalence and ultrasound detection rates of fetal anomalies in pregnancies complicated by hydramnios.
  • To estimate the risks of anomalies and aneuploidy in cases of hydramnios with normal sonographic findings.

Main Methods:

  • Retrospective cohort study of singleton pregnancies diagnosed with hydramnios.
  • Hydramnios severity classified as mild, moderate, or severe based on amniotic fluid index.
  • Comparison of antenatal ultrasound anomaly detection with neonatal assessment; analysis of aneuploidy and fetal death rates.

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Main Results:

  • Hydramnios occurred in 672 pregnancies; 11% of neonates had anomalies.
  • Ultrasound detected 79% of anomalies, with detection rates not varying by hydramnios severity.
  • Major anomaly risk after normal ultrasound was 1% (mild), 2% (moderate), and 11% (severe) hydramnios.

Conclusions:

  • Nearly 80% of fetal anomalies are detected by ultrasound in hydramnios pregnancies, regardless of severity.
  • The residual risk of major anomalies following a normal sonographic evaluation is low (≤2%) for mild/moderate hydramnios but significant (11%) for severe hydramnios.