Obstetric and Neonatal Outcomes in Mild Idiopathic Polyhydramnios

Abstract

Background: Idiopathic polyhydramnios is a controversial clinical condition, as data on perinatal outcomes are conflicting and vary depending on the severity of the condition. The aim of the present study was to compare obstetric and neonatal outcomes between pregnant women with mild idiopathic polyhydramnios and a control population. Methods: A retrospective cohort study was performed at a single university hospital comparing the obstetrics and neonatal outcomes of pregnancies with mild idiopathic polyhydramnios (n = 109) and control pregnancies (n = 2550). Results: Cesarean section (CS) was significantly increased in the group with polyhydramnios compared to controls (46% vs. 32%, respectively, p = 0.047) due to a higher rate of emergency CS in the polyhydramnios group (p = 0.041) because of abnormal cardiotocography (7.3% vs. 2.9%; p = 0.018) or labor dystocia (8.2% vs. 2.9%; p = 0.006). No statistically significant difference was found in the Apgar score, in the rate of neonatal hypoxia, or in the incidence of macrosomia between groups. In four cases, additional diagnoses of anomalies were made after birth, with a rate of 3.2%, which is comparable to the general population. Conclusion: Besides an increased risk of CS, patients with mild idiopathic polyhydramnios should be reassured regarding maternal and feto-neonatal outcomes. The management of pregnancies with stable mild idiopathic polyhydramnios should not differ from uncomplicated pregnancies, except for the need for increased labor surveillance.

Amniotic Fluid Disorders: From Prenatal Management to Neonatal Outcomes

“…The resolution rate of idiopathic polyhydramnios has been reported to be 37%, but it may reach 68% of cases when the degree of polyhydramnios is mild [ 70 , 71 ]. The earlier in pregnancy polyhydramnios is diagnosed, and the milder it is, the more likely it is to resolve during pregnancy [ 70 ].…”

“…There are contrasting results regarding the risk of maternal and neonatal adverse outcomes when polyhydramnios is idiopathic [ 71 ]. The majority of cases of idiopathic polyhydramnios are mild, with probable good prognosis and relatively low incidence of associated anomalies.…”

“…The majority of cases of idiopathic polyhydramnios are mild, with probable good prognosis and relatively low incidence of associated anomalies. Mild idiopathic polyhydramnios also has a low progression rate to a higher degree of severity [ 71 ].…”

“…Conversely, Pri-Paz et al [ 30 ], in a retrospective analysis, did not find a significant association between the degree of polyhydramnios and the occurrence of adverse outcomes in the subgroup of cases with idiopathic polyhydramnios. In a retrospective cohort study, Pasquini et al [ 71 ] selected only cases of mild idiopathic polyhydramnios and found that they had an increased risk only of cesarean section compared to controls, in particular, emergency cesarean sections due to abnormal intrapartum cardiotocography or labor dystocia, with similar rates of preterm delivery, postpartum hemorrhage, macrosomia, neonatal acidosis and low Apgar score. Therefore, the authors suggested that mild polyhydramnios should be considered a different condition from moderate and severe polyhydramnios [ 71 ].…”

“…In a retrospective cohort study, Pasquini et al [ 71 ] selected only cases of mild idiopathic polyhydramnios and found that they had an increased risk only of cesarean section compared to controls, in particular, emergency cesarean sections due to abnormal intrapartum cardiotocography or labor dystocia, with similar rates of preterm delivery, postpartum hemorrhage, macrosomia, neonatal acidosis and low Apgar score. Therefore, the authors suggested that mild polyhydramnios should be considered a different condition from moderate and severe polyhydramnios [ 71 ]. In particular, patients should be reassured regarding maternal and neonatal outcomes, and the management of their pregnancies should not differ from that of an uncomplicated pregnancy except for the need for increased labor surveillance [ 71 ].…”