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The effect of increased amnion volume severity on fetal Doppler indices and perinatal outcomes in idiopathic

Hatice Akkaya1, Barış Büke2, Emre Destegül3

  • 1Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|August 8, 2018
PubMed

Insights

Severe idiopathic polyhydramnios is linked to altered fetal Doppler indices, including increased myocardial performance index and middle cerebral artery peak systolic velocity. This condition is also associated with lower Apgar scores in newborns.

Area of Science:

  • Perinatal Medicine
  • Fetal Cardiology
  • Obstetrics

Background:

  • Idiopathic polyhydramnios, characterized by excessive amniotic fluid without a clear cause, can impact fetal well-being.
  • Assessing the severity of polyhydramnios and its correlation with fetal circulatory changes is crucial for predicting perinatal outcomes.

Purpose of the Study:

  • To investigate the relationship between the severity of idiopathic polyhydramnios and changes in fetal Doppler indices.
  • To evaluate the association between polyhydramnios severity, Doppler alterations, and perinatal outcomes.

Main Methods:

  • A prospective case-control study involving 173 singleton pregnancies with idiopathic polyhydramnios (mild, moderate, severe) and 53 controls.
  • Gestational age ranged from 29 to 41 weeks.
  • Fetal echocardiography and Doppler measurements (umbilical artery, middle cerebral artery) were performed, alongside assessment of perinatal outcomes and Apgar scores.

Main Results:

  • Severe polyhydramnios showed a significantly higher myocardial performance index (p=.006) and middle cerebral artery peak systolic velocity (p=.0001).
  • The middle cerebral artery pulsatility index was significantly lower (p=.002) in severe cases, suggesting a brain-sparing effect.
  • Apgar scores at 1 and 5 minutes were significantly lower in the severe polyhydramnios group (p=.011, p=.016).

Conclusions:

  • Increased myocardial performance index and middle cerebral artery peak systolic velocity, along with decreased middle cerebral artery pulsatility index, are observed in severe idiopathic polyhydramnios.
  • Idiopathic polyhydramnios is associated with poorer Apgar scores.
  • The observed Doppler changes, particularly the brain-sparing effect in the middle cerebral artery, intensify with increasing amniotic fluid volume.

Keywords:
Dopplerfetal Doppleridiopathic polyhydramniosmyocardial performance index

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