Follow-up of children with antenatally diagnosed idiopathic polyhydramnios

Abstract

Objectives: The aim of our work was to assess the development of children with antenatally diagnosed idiopathic polyhydramnios, over 12 months from the end of pregnancy. Material and methods: The study included 91 healthy pregnant patients with idiopathic polyhydramnios. Diagnostic tests results and perinatal medical history were obtained retrospectively. Parents of children were contacted by phone and by mail. The answers were obtained from 64 (70%) parents. For statistical analysis SigmaStat3.5 software was used. Results: Ninety six percent of parents declared that in their opinion the development of children was normal. Abnormalities were found in 44% of the children. Thirty percent of neonates demonstrated mild abnormalities which may be due to organic or functional neuromuscular disorders: abnormal muscle tone, speech apparatus and development disorders, swallowing and breathing problems (manifested as vomiting, excessive regurgitation, idiopathic apnoeas). Isolated small malformations were diagnosed in 12 (19%) children. Two children (3%) with SGA were diagnosed with genetic syndromes. More than one of the abnormalities described above were diagnosed in 14% of children. Gestational age at the time of polyhydramnios diagnosis and its severity were not prognostic factors for abnormalities. Seventy percent of newborns were male. Conclusions: Despite the subjectively positive assessment of the development of children by the majority of parents, groups of common disorders requiring long-term follow-up have been identified. Functional disorders of the gastrointestinal tract, CNS and the group of neuromuscular disorders may be responsible for idiopathic polyhydramnios. SGA with co-existing idiopathic polyhydramnios is associated with the risk of genetic diseases. The more frequent incidence of idiopathic polyhydramnios in male fetuses requires further research.

Obstetric and Neonatal Outcomes in Mild Idiopathic Polyhydramnios

“…High rates of maternal and neonatal complications are reported in pregnancies diagnosed with polyhydramnios [ 2 , 5 , 9 ]; however, there are contrasting results regarding maternal and neonatal outcomes when polyhydramnios is idiopathic [ 2 , 5 , 10 , 11 ]. For example, Lallar et al [ 12 ] reported high rates of maternal and perinatal complications of idiopathic polyhydramnios.…”

What to expect after birth in idiopathic polyhydramnios? An analysis of postnatal diagnoses and their relationship to the polyhydramnios degree

“…In the large cohort of 672 polyhydramnios cases of Dashe et al, only two central nervous system abnormalities diagnosed after birth were reported [1]. Adamczyk et al analyzed the results of 64 idiopathic polyhydramnios cases, and 11% of those who had any abnormality had neuromuscular diseases or speech impairment [9]. A novel nding of our study is the 8.9-fold increase of neurodevelopmental disorders in moderate polyhydramnios, a previously unestablished relationship.…”

“…The proposition of "the more amniotic uid, the greater risk of anomaly" is not supported with consistent evidence. Whereas some studies demonstrated this relationship [1,9,10], several studies did not [5,11,6].…”

Prenatal Diagnosis of Fetal Growth Restriction With Polyhydramnios: Etiology and Impact on Postnatal Outcome

“…Considering that polyhydramnios describes an independent risk factor for an adverse perinatal outcome, a combination of both conditions seems to have a more serious negative impact on fetal outcome [8][9][10][11][12][13][14]. A higher rate of congenital malformations, chromosomal abnormalities, even if undetectable by ultrasound, is frequently encountered.…”