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Quantifiable polyhydramnios: diagnosis and management.

D E Carlson¹, L D Platt, A L Medearis

¹Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Women's Hospital, Los Angeles.

Obstetrics and Gynecology

|June 1, 1990

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Ultrasonographic diagnosis of polyhydramnios should utilize an amniotic fluid index (AFI) of 24 cm or greater. This quantitative measure better identifies fetuses with serious defects and poor outcomes compared to descriptive terms or single pocket measurements.

Area of Science:

Perinatology
Maternal-Fetal Medicine
Diagnostic Ultrasound

Background:

Polyhydramnios diagnosis and management lack standardized ultrasonographic quantification.
Descriptive assessments of amniotic fluid volume correlate poorly with fetal outcomes.

Purpose of the Study:

To establish a quantitative ultrasonographic definition for polyhydramnios.
To evaluate the efficacy of different amniotic fluid volume measurements in predicting adverse fetal outcomes.

Main Methods:

Prospective study of 112 non-diabetic women diagnosed with polyhydramnios.
Defined significant polyhydramnios as an amniotic fluid index (AFI) ≥ 24 cm.
Compared AFI with descriptive assessments and single deep pocket measurements.

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Main Results:

49 of 112 patients met the AFI ≥ 24 cm definition.
The AFI ≥ 24 cm definition included all fetuses with serious structural defects or demise.
Descriptive terms and single pocket measurements showed poor correlation with fetal outcomes.

Conclusions:

An amniotic fluid index (AFI) of 24 cm or greater is a reliable quantitative definition for significant polyhydramnios.
Descriptive polyhydramnios assessments and single deep pocket measurements should be abandoned.
Recommended management includes detailed sonography, cytogenetic studies, and antepartum surveillance.