Predictive Ability of Combined Factor Scores for Chromosomal Abnormalities in Pregnant Women With Polyhydramnios

Area of Science:

• Maternal-Fetal Medicine
• Prenatal Diagnostics
• Genetics

Background:

• Polyhydramnios, an excess of amniotic fluid, is associated with an increased risk of fetal chromosomal abnormalities.
• Accurate prediction of these abnormalities is crucial for appropriate prenatal management and counseling.

Purpose of the Study:

• To investigate and evaluate prenatal factors that can predict chromosomal abnormalities in pregnant women diagnosed with polyhydramnios.
• To assess the predictive capability of various prenatal factors using receiver operator characteristic (ROC) curves.

Main Methods:

• A cohort of 76 pregnant women with polyhydramnios was analyzed.
• Data collected included maternal age, presence of major anomalies, and various fetal biometric measurements (abdominal circumference, femur length, estimated fetal weight).
• Combined factor scores were calculated and evaluated using ROC curve analysis.

Main Results:

• Chromosomal abnormalities were detected in 25% of the cases, with trisomy 18 and trisomy 21 being the most common.
• Combined factor scores demonstrated strong predictive ability for chromosomal abnormalities (Area Under Curve: 0.81-0.87).
• The combined score achieved a sensitivity of 79% and a specificity of 75%.

Conclusions:

• Combined prenatal factor scores are more accurate predictors of chromosomal abnormalities than individual factors in pregnancies with polyhydramnios.
• Elevated combined scores warrant suspicion of chromosomal abnormalities, even in the absence of detected fetal anomalies on ultrasound.
• Consideration for delivery at a specialized (Level III) facility is recommended for high-risk cases.