FREQUENCY, CAUSES AND FETAL OUTCOME OF POLYHYDRAMNIOS

Authors

  • WEAAM FAIK AL-MAHFOOTH F.I.C.M.S, C.A.B.O.G, D.G.O DEPARTMENT OF GYNECOLOGY & OBSTEERICS COLLEGE OF MEDICINE UNIVERSITY OF BASRAH2014

Abstract

Polyhydramnios is an important obstetric complication, though an uncommon problem, but very distressing for patients. Objective:  This study was carried out to determine its frequency, causes and fetal outcome. Study design: A prospective study was conducted in the obstetric department of Al- Mawany General Hospital, Basra. From October 2011- October 2012. Patients and Methods: Total 83 diagnosed cases of polyhydramnios in 3rd trimester were included in this study. History, clinical examination and relevant investigation were carried out. Ultrasound  used to calculate the amniotic  fluid volume was by measuring amniotic fluid index (AFI) and to detect the types of fetal anomalies . Result: During the study period, 11600 patients needed admission in obstetric and labor word, out of them (83) (0.7%) patients had polyhydramnios. Period of gestation ranged from 28 -40 weeks. The age range was 20 – to more than 40 years. Among these (15) (18%) were primigravida, (62) (74.6%) multigravida and (6) (7.2%) were grandmultigravida. Causative factors were mainly idiopathic after which the most important was fetal anomaly. (42) (50.6%) patients with no cause could be identified. In (28) (33.7%) patients, there were different congenital anomalies in the fetus. Diabetes is also associated with the finding of Conclusion: Idiopathic polyhydramnios was the common type and it’s more common in multigravida. Early detection of congenital anomalies by using ultrasound in early pregnancy and the improvement of prenatal and antenatal screening can help to minimize the morbidity of the patients.polyhydramnios in (8) (9.6%) cases, multiple pregnancy was complicated with polyhydramnios in (5) (6%) cases. In (6) (7.2%) patients, fetuses were hydropic. The impact of polyhydramnios on neonatal outcome is that most of the babies were born without any significant effect. A live birth were (58) (69.9%) and (19) (22.9%) were still birth. Early neonatal deaths were (6) (7.2%).

References

- Moor TR, Cayle JE. The amniotic fluid index in normal human pregnancy .Am J Obstet Gyncol 1990; 162:1168-73.

- ManyA, Hill LM, Lazebnik N, Martin JG. The association between polyhydramnios and preterm delivery. Obstet Gynecol 1995; 86: 389-91.

-Chamber lain PF, Manning FA, Morrison L et al. Ultra sound evaluation of amniotic fluid volume 11.The relationship of increased amniotic fluid volume to perinatal outcome. Am J. Obstet Gynecol 1994; 150: 250-54.

- Erdemoglu E, Mungan T. Significance of detecting insuline like growth factors binding protein-1 in cervico-vaginal secretion: Comparison with nitrazine test and amniotic fluid volume assessment. Acta Obstet Gynecol 2004; 83: 622-6.

- Dashe JS, Mcintire DD, Ramus RM et al. Hydramnios: anomaly prevalence and sonographic detection. Obstet Gynecol 2002; 100: 134-9.

- Phelan JP. Martin GI. Polyhydramnios fetal and neonatal complications. Clinical Perinatal 1989; 16: 987.

- Many A, Lazebnik N, Hill LM. The underlying cause of polyhydramnios determines prematurity. Prenatal Diagnosis 1996; 16: 55- 7.

- Landy HJ, Isada NB, Larsen JW. Genetic implications of idiopathic hydramnios. Am J Obstet Gynecol 1987; 157: 114- 7.

- Shoham I, Wiznitzer A, Silberstien T, et al. Gestational diabetes complicated by hydramnios was not associated with increased risk of perinatal morbidity and mortality. Eur. J Obstet Gynecol Repord Biol. 2001; 100: 46- 9.

- Ieguizamon G, Smith, Younis H, et al. Enhancement of amniotic cyclooxygenase preterm type 2 activity in women with preterm delivery associated with twins or polyhydramnios. Am J Obstet Gynecol 2001; 184: 117- 22.

- Plating –Kemp A, Nguyen T, Chang E, et al. Idiopathic polyhydramnios and perinatal outcome. Am J Obstet Gynecol 1999; 181: 1079- 82.

- Ott WJ. Re – evaluation of relationship between amniotic fluid volume and perinatal outcome. Am J Obstet Gynecol 2005; 192: 1803 – 9.

- Saadia Tariq Plyhydramnios ; Study of causes and fetal outcome. Professional Med. J 2010; 17 (4): 660 – 664.

- Anisa Fawad, Shamshad and Nargis Danish .Frequency, Causes and outcome of polyhydramnios. Gomal Journal of Medical Science 2008, vol. 6, No. 2.

- Hill LM, Breckle R, Thomas ML, et al. Polyhydramnios .Ultrasonographically detected prevalence and neonatal outcome. Obstet Gynecol 1987; 69: 21 – 25.

- Desmedt E, Henry OA, Steinberg LH, et al. Acute and sub acute polyhydramnios in singleton pregnancies. Aust. NZJ Obstet Gynecol. 1990; 30: 191 – 5.

- Biggiro JR, Wenstrom KD, Dubard MB, et al. Hydramnios, Prediction of adverse perinatal outcome. Obstet Gynecol. 1990 ; 94: 773- 7.

- Thompson O, Brown R, Gunnarson, et al. Prevalence of polyhydramnios in population screened by first and second trimester ultrasonography. J Perinat Med. 1998; 26: 375 - 77.

- Glantz JC, Abramovicz JS, Sherer DM. Significance of idiopathic midtrimester, Polyhydramnios .Am. J Perinatal 1994; 11: 305- 8.

- Laze hink N, Hill IM, Guzick D, et al. Severity of polyhydramnios does not affect the prevalence of large for gestational age .J Ultrasound Med. 1996; 15: 385- 8.

- Steel JM, Johnstone FD, Hep Burn DA, et al. Can Pregnancy Care of Diabetic women reduced the risk of abnormal babies ?. Br. Med. J 1996; 301: 1070 – 4.

- Broasteem R, Goyert Gand Bottoms S. Classification of twins and neonatal morbidity. Obstet.Gynecol 89; 74: 98- 101.

- Ryan G and Whittle MJ (1995). Immune and non immune fetal hydrops . In :Reed GB, Claireaux AE and Cockburn F.Disease of fetus and new born . London. Chapman and Hall, PP. 1257- 66.

- Bowell PJ, Wainscoat, Petotea and Gunson HH.Maternal anti D Concentration and outcome in rhesus hemolytic disease of newborn. Br. Med. J .1982 ; 285: 327 – 9.

Downloads

Published

2021-03-03

Issue

Section

Articles