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Ceska Gynekologie 2020A comprehensive overview on idiopathic polyhydramnios and associated complications. (Review)
Review
OBJECTIVE
A comprehensive overview on idiopathic polyhydramnios and associated complications.
DESIGN
Review article.
SETTING
Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and Hospital Na Bulovce, Prague, Czech Republic; Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
METHODS
Literature search using the databases Web of Science, Ovid, Cochrane, Medline databases and an analysis of articles published in peer-reviewed journals with impact factor in the years 1958-2020.
RESULTS
Polyhydramnios occurs in 0.2-2% of pregnancies. Pregnancies with polyhydramnios are more often complicated by abnormal foetal lie or presentation and, moreover, should be associated with adverse pregnancy outcomes, particularly with the higher incidence of intrauterine foetal death, placental abruption, labour induction, caesarean sections, prolonged first stage of labor and shoulder dystocia.
CONCLUSION
The moderate and severe forms of idiopathic polyhydramnios are associated with the higher risk of adverse pregnancy outcomes that implies the need for intensive monitoring of a pregnant woman and the foetus both in pregnancy and during the delivery itself.
Topics: Cesarean Section; Czech Republic; Female; Humans; Labor, Induced; Polyhydramnios; Pregnancy; Pregnancy Outcome
PubMed: 33711902
DOI: No ID Found -
Clinical Obstetrics and Gynecology Jun 1997
Review
Topics: Amniocentesis; Cyclooxygenase Inhibitors; Female; Humans; Incidence; Indomethacin; Polyhydramnios; Pregnancy; Risk Factors; Sulindac
PubMed: 9199839
DOI: 10.1097/00003081-199706000-00004 -
Obstetrical & Gynecological Survey Oct 1987Polyhydramnios is a relatively common obstetrical complication. Major causes include maternal diabetes, chromosomal disorders, isoimmunologic disease, congenital... (Review)
Review
Polyhydramnios is a relatively common obstetrical complication. Major causes include maternal diabetes, chromosomal disorders, isoimmunologic disease, congenital abnormalities, multiple gestations, and idiopathic reasons. Perinatal morbidity and mortality is high and maternal complications are frequent. Successful management depends upon appropriate diagnostic evaluation. Prolongation of the pregnancy for further fetal maturation may be achieved with timely therapeutic amniocenteses.
Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Polyhydramnios; Pregnancy; Pregnancy in Diabetics; Pregnancy, Multiple; Rh Isoimmunization
PubMed: 3118281
DOI: 10.1097/00006254-198710000-00001 -
American Journal of Perinatology Dec 2023Idiopathic polyhydramnios is among the most common etiologies of polyhydramnios. However, conflicting evidence exists regarding the relationship between polyhydramnios...
OBJECTIVE
Idiopathic polyhydramnios is among the most common etiologies of polyhydramnios. However, conflicting evidence exists regarding the relationship between polyhydramnios and neonatal morbidity. We investigated the association between pregnancies with and without idiopathic polyhydramnios and neonatal morbidity at term.
STUDY DESIGN
This is a retrospective cohort study of singleton, term (i.e., ≥37 weeks) pregnancies from 2014 to 2018. Pregnancies complicated by fetal anomalies, pregestational diabetes, and multifetal gestation were excluded. Pregnancies complicated by idiopathic polyhydramnios were defined by the deepest vertical pocket (DVP) ≥8 cm or amniotic fluid index (AFI) ≥24 cm after 20 weeks' gestation and were compared with women without polyhydramnios at time of delivery. These groups were matched 1:2 by gestational age within 7 days at delivery and maternal race. The primary outcome was a composite neonatal morbidity (neonatal death, respiratory morbidity, hypoxic-ischemic encephalopathy, therapeutic hypothermia, seizures, and umbilical artery pH < 7.10). Outcomes were compared between pregnancies with and without idiopathic polyhydramnios. Unadjusted and adjusted risk ratios were estimated using multivariable logistic regression.
RESULTS
Idiopathic polyhydramnios was diagnosed in 192 pregnancies and were matched to 384 pregnancies without polyhydramnios. After adjustment for obesity, women with pregnancies complicated by idiopathic polyhydramnios had an increased risk of composite neonatal morbidity 21.4 versus 5.5% (adjusted risk ratio [aRR] = 4.0, 95% confidence interval [CI]: 2.3-6.7). Term neonatal respiratory morbidity was the primary driver 20.3 versus 4.2%, (aRR = 4.8, 95% CI: 2.7-8.7) and included higher use of continuous positive airway pressure 19.8 versus 3.4%, <0.01 and the need for supplemental oxygen at >12 hours of newborn life 6.8 versus 1.8%, <0.01.
CONCLUSION
Idiopathic polyhydramnios is associated with term neonatal respiratory morbidity at delivery and during the subsequent hours of newborn life, compared with pregnancies without idiopathic polyhydramnios. Further studies are needed to minimize neonatal morbidity at term.
KEY POINTS
· Idiopathic polyhydramnios is associated with increased risk of neonatal morbidity at term.. · Increasing idiopathic polyhydramnios severity was associated with a trend toward worsening morbidity at term.. · Idiopathic polyhydramnios at term requires respiratory support at delivery and during neonatal care..
Topics: Pregnancy; Infant, Newborn; Humans; Female; Polyhydramnios; Retrospective Studies; Amniotic Fluid; Gestational Age; Logistic Models
PubMed: 34775584
DOI: 10.1055/s-0041-1739435 -
European Journal of Medical Genetics Aug 2015The objective of this meta-analysis was to summarize the existing literature examining the risk of chromosomal aberrations in idiopathic polyhydramnios. Search was... (Meta-Analysis)
Meta-Analysis Review
The objective of this meta-analysis was to summarize the existing literature examining the risk of chromosomal aberrations in idiopathic polyhydramnios. Search was conducted by a research librarian in five databases. Language and time restrictions were not applied. By independent screening of titles and abstracts, two investigators selected original researches examining the risk of chromosomal aberrations in idiopathic polyhydramnios. Twenty articles were included, encompassing a total of 1729 pregnancies with idiopathic polyhydramnios. The average rate of chromosomal aberrations in these cases was 2.8 ± 3.7%, ranging between 0% and 13.8%. No studies were found examining the relative risk for chromosomal abnormalities in low-risk women with idiopathic polyhydramnios. An analysis of seven case-control trials, including women at high risk for aneuploidy, yielded a relative risk of 3.09 (95% confidence interval 1.92-4.97) for chromosomal aberration. Overall quality of evidence was rated as very low using Grading of Recommendations Assessment, Development and Evaluation criteria. In conclusion, the suboptimal quality of the evidence precludes from drawing any solid recommendations regarding routine karyotype testing in idiopathic polyhydramnios cases, especially in women at low risk for chromosomal aberrations. Future high-quality trials addressing the discussed methodological shortcomings should be conducted to assess this important issue.
Topics: Amniotic Fluid; Chromosome Aberrations; Female; Humans; Karyotyping; Polyhydramnios; Pregnancy; Retrospective Studies; Risk Factors
PubMed: 26186913
DOI: 10.1016/j.ejmg.2015.06.010 -
Seminars in Perinatology Jun 1993
Review
Topics: Amniocentesis; Female; Fetal Diseases; Humans; Incidence; Indomethacin; Polyhydramnios; Pregnancy; Twins, Monozygotic
PubMed: 8378802
DOI: No ID Found -
Clinics in Perinatology Jun 1992Polyhydramnios is an uncommon cause of premature labor and delivery. After sonographic evaluation has confirmed the polyhydramnios and a determination is made of the... (Review)
Review
Polyhydramnios is an uncommon cause of premature labor and delivery. After sonographic evaluation has confirmed the polyhydramnios and a determination is made of the potential etiologies, indomethacin appears to be an effective agent in reducing the amniotic fluid volume and in preventing prematurity.
Topics: Amniocentesis; Clinical Trials as Topic; Combined Modality Therapy; Female; Humans; Incidence; Indomethacin; Obstetric Labor, Premature; Polyhydramnios; Pregnancy; Pregnancy Outcome; Ultrasonography, Prenatal
PubMed: 1617881
DOI: No ID Found -
Clinics in Perinatology Dec 1989Polyhydramnios is a common obstetric condition with a high incidence of neonatal morbidity and mortality. Early prenatal diagnosis is essential to provide proper... (Review)
Review
Polyhydramnios is a common obstetric condition with a high incidence of neonatal morbidity and mortality. Early prenatal diagnosis is essential to provide proper perinatal care. Understanding the physiology of these defects can assist the entire perinatal team in optimizing care for the mother, fetus, and infant.
Topics: Amniocentesis; Female; Fetal Diseases; Humans; Infant, Newborn; Polyhydramnios; Pregnancy; Prenatal Diagnosis; Ultrasonography
PubMed: 2686899
DOI: No ID Found -
International Journal of Gynaecology... Apr 2022
Topics: Female; Humans; Polyhydramnios; Pregnancy
PubMed: 34719034
DOI: 10.1002/ijgo.14001 -
Journal of Ultrasound in Medicine :... Nov 2022To compare maternal and perinatal outcomes in pregnancies with transient and persistent idiopathic polyhydramnios to those with normal amniotic fluid volume.
OBJECTIVES
To compare maternal and perinatal outcomes in pregnancies with transient and persistent idiopathic polyhydramnios to those with normal amniotic fluid volume.
METHODS
This retrospective cohort study included subjects delivering a singleton pregnancy between January 1, 2015, and June 30, 2020, with sonography ≥26 weeks' gestation demonstrating transient or persistent idiopathic polyhydramnios (amniotic fluid index [AFI] ≥24.0 cm) or normal AFI (referent group). The primary maternal outcome was a composite of spontaneous preterm delivery <37 weeks, cesarean delivery for malpresentation, abnormal labor progress, or nonreassuring fetal status, operative vaginal delivery, hemorrhage requiring transfusion, and umbilical cord prolapse. The primary perinatal outcome was a composite of birthweight >4500 g, fetal or neonatal death, 5-minute Apgar score <7, and neonatal intensive care unit admission for >24 hours.
RESULTS
Patients with transient polyhydramnios (n = 259) exhibited maternal outcomes similar to those of the referent group (n = 435) but had significantly increased odds for the primary perinatal outcome (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.15-2.53; P = .008) and for birthweight ≥4500 g (OR 8.70, 95% CI 1.89-40.0; P = .005). Persistent polyhydramnios (n = 176) was significantly associated with both the primary maternal (OR 1.93, 95% CI 1.27-2.95, P = .002) and primary perinatal outcome (OR 2.15, 95% CI 1.40-3.30; P < .001), and individually with cesarean delivery for abnormal labor (OR 3.22, 95% CI 1.55-6.68; P = .002) and birthweight ≥4500 g (OR 8.97, 95% CI 1.84-43.6; P = .007).
CONCLUSIONS
Transient idiopathic polyhydramnios does not impact maternal outcomes but is associated with increased odds of newborn birthweight >4500 g. Persistent polyhydramnios is associated with both adverse maternal and perinatal outcomes.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Polyhydramnios; Birth Weight; Pregnancy Outcome; Retrospective Studies; Amniotic Fluid
PubMed: 35312096
DOI: 10.1002/jum.15974