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Etiology and perinatal outcome of polyhydramnios

M Kollmann1, J Voetsch1, C Koidl2

  • 1Department of Obstetrics and Gynecology, Medical University of Graz.

Ultraschall in Der Medizin (Stuttgart, Germany : 1980)
|April 15, 2014
PubMed

Insights

Polyhydramnios in singleton pregnancies is often idiopathic but warrants investigation for maternal diabetes, congenital anomalies, and TORCH infections. Careful evaluation for fetal malformations is crucial, especially with co-existing maternal diabetes or small fetuses.

Area of Science:

  • Perinatal Medicine
  • Maternal-Fetal Medicine
  • Obstetrics

Background:

  • Polyhydramnios, characterized by excessive amniotic fluid, is a significant obstetric complication.
  • Identifying the etiology of polyhydramnios is crucial for predicting perinatal outcomes.
  • Previous studies have explored various causes and associations of polyhydramnios.

Purpose of the Study:

  • To investigate the etiological factors contributing to polyhydramnios.
  • To determine the perinatal outcomes associated with different causes of polyhydramnios.

Main Methods:

  • Retrospective analysis of 860 singleton pregnancies diagnosed with polyhydramnios between 2003 and 2011.
  • Inclusion criteria included amniotic fluid measurements (single deepest pocket ≥ 8 cm, amniotic fluid index ≥ 25 cm) or subjective assessment.
  • Etiologies evaluated included TORCH infections, maternal diabetes, congenital malformations, and idiopathic causes.

Main Results:

  • Idiopathic polyhydramnios accounted for 68.8% of cases.
  • Maternal diabetes was present in 19.8%, congenital anomalies in 8.5%, and TORCH infections in 2.9%.
  • Cardiac defects were the most common fetal anomaly (32.9%). Increased rates of elective cesarean sections were observed in pregnancies with malformations and maternal diabetes. Low birth weight combined with severe polyhydramnios or maternal diabetes correlated with malformations.

Conclusions:

  • Diagnosis of polyhydramnios necessitates glucose tolerance testing, detailed sonography (including fetal echocardiography), and TORCH serology.
  • Pregnancies with polyhydramnios, particularly those with small fetuses or maternal diabetes, require thorough evaluation for congenital malformations.
Abstract

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