Idiopathic Polyhydramnios and Postnatal Abnormalities

Abstract

Objective: To investigate the proportion and type of fetal anomalies that are associated with polyhydramnios and to examine whether in cases with idiopathic polyhydramnios during the course of pregnancy and fetal anomalies only diagnosed after birth, antenatal characteristics differ. Methods: This was a retrospective study involving all pregnancies with polyhydramnios defined by a deepest pool of amniotic fluid ≥8 cm and a detailed ultrasound examination, a 75 g glucose tolerance test and a TORCH serology. Results: Between 2004 and 2010, 272 pregnancies fulfilled the inclusion criteria. In 89 (32.7%) and 65 (23.9%) cases, there was a fetal anomaly or diabetes. In 118 (43.4%) pregnancies, polyhydramnios was classified as idiopathic. In 11 (9.3%) of the 118 fetuses, an anomaly was found after birth, mainly gastrointestinal atresia. In these cases, median deepest pool of amniotic fluid was 9.6 cm, and median estimated fetal weight was at the 69th centile, whereas in cases without anomalies diagnosed after birth, median deepest pool was 9.0 cm and median estimated fetal weight at the 90th centile (Mann-Whitney U test: deepest pool p = 0.116, and estimated fetal weight centile p = 0.377). There was also no difference in the maternal and gestational age distribution of these cases (Mann-Whitney U test: maternal age p = 0.293, and gestational age p = 0.499). Conclusion: In about 40% of pregnancies, polyhydramnios remains unexplained during the course of pregnancy. In 10% of these cases, an anomaly will only be found after birth. In this group, antenatal characteristics such as amniotic fluid volume, estimated fetal weight or gestational and maternal age at the time of diagnosis do not help to detect these anomalies before birth.

Chromosomal aberrations in idiopathic polyhydramnios: A systematic review and meta-analysis

“…For the comparisons of interrater reliability for study selection, the kappa coefficient was 0.95 during the abstract review (95% CI 0.90 to 0.99), and 0.92 in the full-text stage (95% CI 0.86 to 1.0). Finally, of 4297 initial references, twenty papers encompassing 1729 cases of idiopathic polyhydramnios were included in the review (Abele et al, 2012;Shimada et al, 2009;Drummond et al, 2003;Dashe et al, 2002;Biggio et al, 1999;Lee et al, 1996;Yaman et al, 1996;Barnhard et al, 1995;Hill et al, 1995;Claussen et al, 1994;Glantz et al, 1994;Dombrowski et al, 1993;Zahn et al, 1993;Brady et al, 1992;Gagnon et al, 1992;Hendricks et al, 1991;Carlson et al, 1990;Eydoux et al, 1989;Hentemann et al, 1989;Landy et al, 1987). Table 1 summarizes the studies' characteristics.…”

“…The remaining papers focused on patients diagnosed with polyhydramnios (a certain proportion of which underwent cytogenetic testing), besides Hentemann et al (Hentemann et al, 1989), who analyzed pregnancies with any ultrasonographic abnormality (including polyhydramnios). Some of these studies included only pregnancies above 20 weeks (Dashe et al, 2002;Biggio et al, 1999) or 24 weeks (Abele et al, 2012), others examined only cases prior to 26e27 weeks (Glantz et al, 1994;Hendricks et al, 1991), while one study included only third-trimester polyhydramnios pregnancies (Barnhard et al, 1995). Hill et al described only cases with polyhydramnios that subsequently resolved prior to delivery (Hill et al, 1995), and Zahn et al focused on polyhydramnios to a degree for which hospitalization was recommended (Zahn et al, 1993).…”

“…Hill et al described only cases with polyhydramnios that subsequently resolved prior to delivery (Hill et al, 1995), and Zahn et al focused on polyhydramnios to a degree for which hospitalization was recommended (Zahn et al, 1993). Nine studies did not specify the method they used for chromosomal sampling methods (Abele et al, 2012;Dashe et al, 2002;Biggio et al, 1999;Yaman et al, 1996;Barnhard et al, 1995;Hill et al, 1995;Glantz et al, 1994;Dombrowski et al, 1993;Hendricks et al, 1991), seven studies reported using amniocentesis (Shimada et al, 2009;Claussen et al, 1994;Zahn et al, 1993;Brady et al, 1992;Gagnon et al, 1992;Hentemann et al, 1989;Landy et al, 1987), two papers also employed cordocentesis (Drummond et al, 2003;Lee et al, 1996), and two also examined placental biopsy samples (Carlson et al, 1990;Eydoux et al, 1989) (Table S2). Of note, all the included papers performed microscopic karyotype evaluation, and no studies were found using more advanced genetic methods such as chromosomal microarray analysis (CMA).…”

Bone Development and Mineral Homeostasis in the Fetus and Neonate: Roles of the Calciotropic and Phosphotropic Hormones

“…When swallowing or absorption are not possible, such as in gastrointestinal atresias, an increased volume of amniotic fluid (polyhydramnios) is present at term (8,141).…”

Idiopathic Recurrent Polyhydramnios: A Rare Case Report

“…In more than half cases of polyhydramnios, no definitive cause is attributable; these are labelled as Idiopathic polyhydramnios [1]. Some of these cases of idiopathic polyhydramnios may reveal some congenital anomaly or chromosomal abnormality in the postnatal period [2].…”