Maternal and Fetal Outcomes in Pregnant Women With Polyhydramnios Treated Based on Maternal and Fetal Distress and Preterm Delivery

Abstract

IntroductionPolyhydramnios is a medical condition describing an excess of amniotic fluid in the amniotic sac which can be seen in 1%-2% of women. The overall prevalence of this condition is reported on 750 pregnancies. Patients suffered from polyhydramnios often referred to hospitals complaining about discomfort in the abdomen and respiratory distress. Abnormal magnitude of the uterus (compared to gestational age) along with difficulty touching embryonic organs and problems associated with fetus auscultation can be observed on physical examination. A definitive diagnosis is ultimately possible through ultrasound and by measuring the ammonic fluid index. Amniotic fluid index (AFI) more than 25 cm is considered as polyhydramnios, accordingly (1).Polyhydramnios may be associated with fetal and maternal complications such as respiratory distress, thromboembolism, preterm labor, atonic uterus, anemia, caesarean section, premature fetus, umbilical cord prolapse caused by the rupture of the membranes and fetal distress (2-4).Common treatment methods of polyhydramnios pregnancies include examination of maternal risk factors (diabetes, viral hepatitis, syphilis and other torch infections and addiction) and examination of fetal risk factors (hydrops fetalis, esophageal atresia, gastroschisis, anencephaly, diaphragmatic hernia, placental chorioangioma, severe anemia, heart problems and chromosomal abnormalities). In mild cases, simple control and follow-ups, continuous ultrasound and conservative treatment methods AbstractObjectives: Polyhydramnios is a condition that could be along with significant maternal, fetal and neonatal consequences. One of the most important complications of this condition is preterm labor and delivery of preterm neonates. Although in mild cases expectant conservative management is effective, in more severe cases, medications (such as indomethacin) and amnioreduction could be considered. Each one of these methods could be accompanied with complications. This study aims to examine the results of management of patients with polyhydramnios according to the fetal and maternal distress and preterm labor criteria. Materials and Methods: In this descriptive-analytic setting, 26 pregnant mothers with polyhydramnios (amniotic fluid index [AFI] more than 30) were managed according to the fetal and maternal distress and preterm labor criteria. In cases under 32 gestational weeks, indomethacin was used with an initial dose of 25 mg every 6 hours and a maximum dose of 2-3 mg/kg that was tapered when the AFI diminished. In refractory cases, the flowchart of fetal and maternal distress and preterm labor was employed. In pregnancies aged over 32 weeks, in case of maternal distress amnioreduction was performed, and in asymptomatic patients, cervical length, funneling, color Doppler and placental thickness were evaluated and in normal cases controlling was carried every 1-2 weeks and abnormal cases amnioreduction was carried out. Results: The mean age of studies patients was 28.12 ± 7.22 years and the mean pregnanc...

Frequency of Polyhydramnios among Patients with Preterm Delivery at Lady Reading Hospital, Peshawar

“…Polyhydramnios describes an overabundance of amniotic fluid in the amniotic sac 1 . This medical condition can be commonly complicated in 1-3% of all pregnancies.…”