Fetomaternal Outcome in Polyhydramnios.
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Date
2018-09
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Society for Health Care & Research Development
Abstract
Background:Polyhydramnios is diagnosed if on ultrasound the deepest vertical pocket is more than 8 cm or amniotic fluid index (AFI) is more than 95th percentile for the corresponding gestational age. Approximately 0.5%-1.5% are complicated by polyhydramnios. Polyhydramnios adversely affect fetomaternal outcome in many cases hence it is important to diagnose it in time so that further evaluation and appropriate management steps can be taken. Methods: This was a prospective observational study comprising of 60 pregnant women included in this study on the basis of a predefined inclusion and exclusion criteria. A detailed history was taken in all the cases and detailed clinical examination was done. Polyhydramnios was diagnosed on the basis of amniotic fluid index. Presence of fetal anomalies detected on antenatal ultrasound were noted. Postnatally a pediatrician examined all the newborn babies and presence of any congenital anomaly was also noted. Maternal and fetal complications were studied. Perinatal and neonatal mortality and its causes were analyzed. Data analysis was carried out using Minitab 17 version software. Result: Amongst the studied cases 34 (56.67%) patients were primigravida while rest of the patients were multigravida (43.33%). Mean age of the patients was found to be 26.15 +/- 5.07 years. The risk factors such as maternal anemia, pre-eclampsia, gestational diabetes and Rh isoimmunization was present in 9 (15 %), 8 (13.33%), 6 (10%) and 5 (8.33%) patients respectively. No identifiable risk factor was found in 32 cases. Most of the patient diagnosed with polyhydramnios were between 37-42 weeks (76.67%). The most common gestational age when congenital anomalies were detected was between 27-42 weeks (20%). Fetal congenital anomalies were seen in 11 (18.33%) patients. Maternal complications were seen in 27 patients (55%). There was no maternal mortality in any case. Perinatal deaths were seen in 8 cases while Neonatal Deaths (excluding deaths in perinatal period) were seen in 4 cases. Conclusion: Polyhydramnios adversely affect fetomaternal outcome. Moreover, there is increased incidence of congenital anomalies in cases with polyhydramnios. Proper antenatal diagnoses of these congenital anomalies is essential part of management and helps prospective parents in taking informed decision.
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Gopchade Chetana A, Gopchade Ajeet. Fetomaternal Outcome in Polyhydramnios.. Annals of International medical and Dental Research. 2018 Sep; 4(5): 19-23