Materno-fetal characteristics, etiological factors and perinatal outcome in pregnancies with polyhydramnios

Abstract

This study aimed to evaluate materno-fetal characteristics, etiological factors and perinatal outcome in pregnancies with polyhydramnios. A total of 330 pregnancies diagnosed with polyhydramnios were included in this retrospective study conducted at a tertiary care clinic. Data on maternal age, obstetric characteristics, etiology of polyhydramnios, detailed prenatal ultrasonography findings on fetal anomaly, cesarean delivery and the adverse pregnancy outcomes were recorded. The polyhydramnios was idiopathic in 47.0% of cases, while the maternal diabetes (29.4%, gestational diabetes in 19.1%) and fetal conditions (23.6%) were responsible for the etiology in the remaining cases. The most common anomalies identified on prenatal ultrasonography were central nervous system (CNS) anomalies (29.5%, spina bifida in 12.8%), followed by the gastrointestinal system anomalies (11.5%, esophageal atresia in 6.4%). Cesarean delivery occurred in 38.2% of pregnancies, while adverse pregnancy outcomes were noted in 64.5% of pregnancies and included delivery of a neonate with congenital anomaly (36.6%), macrosomia (21.1%), preterm delivery (18.3%), perinatal mortality (13.1%) and pregnancy termination (10.8%). In conclusion, our findings revealed the polyhydramnios to be idiopathic in half of cases, and to be due to either maternal diabetes (gestational diabetes in particular) or fetal pathology (CNS and gastrointestinal anomalies, in particular) in the other half. Given the occurrence of adverse pregnancy outcomes in a considerable portion of pregnancies with polyhydramnios, our findings emphasize the vital role of intensive monitoring of the maternal-fetal condition in pregnancies with polyhydramnios. Meticulous diagnostic approach seems crucial for timely recognition of fetal anomalies via detailed imaging studies as well as the early recognition and strict control of gestational diabetes via close follow up, given the likelihood of erroneously diagnosed idiopathic polyhydramnios to challenge the implementation of proper management and appropriate counselling of patients.

Keywords

• polyhydramnios
• maternal
• fetal
• etiology
• idiopahtic
• pregnancy outcome

References

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