Hydramnios: ultrasound diagnosis and its impact on perinatal management and pregnancy outcome

Ultrasonographic technique allows for noninvasive quantification of amniotic fluid volume in pregnancy. A series of 12 pregnancies with ultrasonographically confirmed hydramnios is presented in detail. Following the diagnosis of hydramnios an intensive system-by-system evaluation of the fetal structures was performed. Developmental defects known to be associated with the production of hydramnios were detected in 83% of these pregnancies. Anomalies detected included abdominal wall defects, abnormalities of the central nervous system, pleural effusions, obstructions of the fetal gastrointestinal tract, and others. The early definition of hydramnios and the subsequent discovery of anomalies associated with increased amniotic fluid volume may lead to alteration in prenatal care, in intrapartum management, and in postdelivery resuscitative measures in these complicated pregnancies. In this series, despite early diagnosis of hydramnios and associated fetal developmental anomalies, complications of the pregnancies directly resultant from hydramnios resulted in a high perinatal mortality rate.