Purpose To evaluate labor and perinatal outcomes of transient isolated polyhydramnios. Materials and Methods A retrospective cohort study (2008–2013) at a university-affiliated, tertiary medical center. Eligibility was limited to patients with singleton gestations, no maternal diabetes or known structural/chromosomal anomalies, and no rupture of the membranes prior to delivery, at > 34 weeks of gestation. All women underwent routine sonogram for estimation of fetal weight (sEFW) between 28–34 weeks of gestation, and a second routine sonogram at admission. We compared women diagnosed with polyhydramnios at the time of the sEFW which later resolved, with women who had normal AFI during the sEFW. Results Overall, 44 263 women delivered during this time period, of which 292 (0.7 %) with transient polyhydramnios (study group) and 29 682 with a normal amniotic fluid level (control group) were eligible for analysis. Women with transient polyhydramnios had a higher risk for assisted vaginal delivery (AVD), mainly due to abnormal/intermediate fetal heart rate tracings (aOR 2.3, 95 % CI 1.2–5.5), and a higher risk for cesarean delivery (CD), mostly because of labor dystocia (aOR 2.5, 95 % CI 1.2–5.1 for 1st stage arrest and aOR 3.4, 95 % CI 1.6–7.2) for 2nd stage arrest), suspected macrosomia (aOR 3.2, 95 % CI 1.6–6.6) and malpresentation (aOR 6.6, 95 % CI 2.0–21.1). Conclusion Transient isolated polyhydramnios detected during the sonogram at 28–32 weeks of gestation is an independent risk factor for the need for obstetrical intervention during labor.

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<b><i>Objective:</i></b> We aimed to evaluate the association between second trimester biochemical markers and pathological placentation. <b><i>Methods:</i></b> This was a retrospective case-control study (2007–2014) of singleton gestations at a university-affiliated tertiary center. Women with pathologic placentation were subdivided into three groups: placenta accreta (group A), placenta previa (group B), or both (group C). We compared second trimester biochemical screening markers taken between 16 + 0 and 19 + 6 weeks of gestation between groups A, B, and C, and women with normal placentation (group D). Obstetrical and neonatal outcomes, risk factors for pathologic placentation, and second trimester biochemical marker values were compared between groups. <b><i>Results:</i></b> Overall, 301 deliveries were evaluated: 64 (21%) in group A, 66 (22%) in group B, 17 (6%) in group C, and 153 (51%) in group D. Each of the pathological placentation groups individually had a higher median alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) multiples of median (MoM) than the controls, with the highest values of AFP and hCG observed among women with placenta accreta and the lowest values among the controls. When a multivariant analysis was applied, the hCG levels remained significantly correlated with pathological placentation. Receiver operation characteristic curves for AFP, hCG, or both were computed. For AFP the area under the ROC curve (AUC) was 0.573 (95% CI 0.515–0.630, <i>p</i> &#x3c; 0.0274) and a cut-off value above 0.99 MoM demonstrated a sensitivity and specificity of 71 and 46%, respectively, for the prediction of pathological placentation. For hCG, the AUC was 0.662 (95% CI 0.605–0.715, <i>p</i> &#x3c; 0.0001) and a cut-off value of 1.25 MoM demonstrated a sensitivity and specificity of 53 and 68%. When both markers were plotted, the AUC was 0.668 (95% CI 0.611–0.721, <i>p</i> &#x3c; 0.0001) and sensitivity and specificity were 63 and 64%, respectively. A percentile MoM cut-off approach distinguished between two groups: a high-risk group (patients with AFP or hCG or both above the 75th percentile, odds ratio (OR) for pathological placentation 2.27, 95% CI 1.42–3.63), and a low-risk group (patients with AFP or hCG or both below the 25th percentile, OR for pathological placentation 0.38, 95% CI 0.24–0.60). <b><i>Conclusion:</i></b> Second trimester biomarkers such as hCG and AFP can be used to raise a suspicion towards characterizing women into high-risk and low-risk groups for pathological placentation.