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Polyhydramnios in isolated oral cleft pregnancies: incidence and outcome in a retrospective study
Anne L Depla1, Corstiaan C Breugem2, Chantal M A M van der Horst3
1Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.
Insights
Idiopathic polyhydramnios occurs in 6.5% of isolated oral clefts (OCs) pregnancies, increasing palate involvement risk. However, it does not negatively impact pregnancy or long-term outcomes.
Area of Science:
- Perinatal medicine
- Obstetrics
- Craniofacial anomalies
Background:
- Oral clefts (OCs) are frequently associated with swallowing difficulties, potentially leading to polyhydramnios.
- The relationship between idiopathic polyhydramnios and isolated OCs requires further investigation regarding incidence and outcomes.
Purpose of the Study:
- To determine the incidence of idiopathic polyhydramnios in pregnancies with isolated oral clefts.
- To compare pregnancy outcomes, and neonatal and pediatric follow-up between isolated OC pregnancies with and without polyhydramnios.
- To evaluate the association between polyhydramnios and associated anomalies diagnosed postnatally.
Main Methods:
- Retrospective cohort study of prenatally diagnosed oral clefts.
- Calculation of idiopathic polyhydramnios incidence in isolated OC pregnancies.
- Comparative analysis of pregnancy outcomes and follow-up data; subgroup analysis for associated anomalies.
Main Results:
- Idiopathic polyhydramnios was identified in 6.5% of 230 isolated OC cases.
- Palate involvement was significantly higher in OCs with polyhydramnios (87%) versus without (58%).
- No significant differences in perinatal or long-term outcomes were observed between groups.
Conclusions:
- The incidence of idiopathic polyhydramnios in isolated OC pregnancies is 6.5%.
- Polyhydramnios in isolated OC pregnancies is linked to increased risk of palate involvement but not adverse outcomes.
- Prenatal diagnosis of isolated polyhydramnios does not predict postpartum associated anomalies.
Objectives:
Polyhydramnios is suggested to be associated with oral clefts (OCs) due to swallowing problems. This study assessed incidence and outcome of idiopathic polyhydramnios in isolated OC pregnancies.
Methods:
This was a retrospective cohort study of prenatally diagnosed OC. The incidence of idiopathic polyhydramnios in isolated OC pregnancies was determined. Pregnancy outcome, neonatal and paediatric follow-up were compared between cases with polyhydramnios and those with normal amniotic fluid. Subgroup analysis was conducted to evaluate whether an association exists between polyhydramnios and presence of associated anomalies diagnosed after birth.
Results:
In 230 cases of isolated OC, 15 developed polyhydramnios (6.5%). Involvement of the palate was significantly more common in the presence than in the absence of polyhydramnios (13/15 or 87% vs 125/215 or 58%, p = 0.03, odds ratio 4.7, 95% confidence interval 1.0-30.8). No significant differences were seen in pregnancy outcome or neonatal and paediatric follow-up between the two groups. In subgroup analysis, rate of polyhydramnios was not significantly different in associated cases that appeared isolated prenatally (1/27; 3.7%) compared with that in the isolated cases (15/230; 6.5%).
Conclusions:
The incidence of idiopathic polyhydramnios in isolated OC pregnancies is 6.5%. Polyhydramnios in isolated OC increases the risk of palate involvement. The presence of polyhydramnios is not associated with adverse perinatal or long-term outcome. If isolated at prenatal assessment, polyhydramnios does not increase the risk of associated anomalies postpartum. © 2016 John Wiley & Sons, Ltd.
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