Polyhydramnios and adverse perinatal outcome – what is the actual cutoff?

Abstract

A significant linear association exists between AFI > 20 and perinatal complications such as perinatal mortality, low Apgar scores and preterm labor. Hence, the critical cutoff for polyhydramnios should be re-evaluated.

Association of Isolated Polyhydramnios at or Beyond 34 Weeks of Gestation and Pregnancy Outcome

“…Suboptimal cord position is another possible mechanism for variable decelerations. As opposed to other studies, 10,11,19,24,25 we did not find an increased risk for lower Apgar scores or higher mortality rate for neonates in the isolated polyhydramnios group. As amniotic fluid volume increases, amniotic fluid pressure increases as well and may alter oxygen delivery to the placenta and fetus, resulting in lower umbilical artery pH.…”

Outcomes From Polyhydramnios With Normal Ultrasound

“…This information was reported previously. 4,[17][18][19][20][21] This study is innovative in demonstrating that the rate of CD was increased mainly due to elective surgeries for suspected macrosomia and not emergent CD during labor. Macrosomia has previously been shown to be a risk factor for CD.…”

“…Within the polyhydramnios group, the patients were subdivided into the following groups: (1) (17) Values are expressed as mean ± SD (median) or n (%). a Indicates number of births the woman had including the present one.…”

The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years

“…The maternal demographic characteristics analyzed and compared between the groups were age, ethnicity, obesity, smoking during pregnancy, chronic hypertension, diabetes mellitus, gravidity and parity, and history of recurrent pregnancy loss (defined as two or more failed pregnancies). The pregnancy and obstetric outcomes examined were pregnancy duration at delivery, mild and severe pre‐eclampsia, premature rupture of membranes (defined as rupture of membranes prior to delivery), oligohydramnios (amniotic fluid index <5), polyhydramnios (amniotic fluid index >24), cervical insufficiency (defined as painless cervical dilatation), GDM (defined as at least two abnormal glucose tolerance test results), labor induction (any iatrogenic attempt to deliver for any medical reason), preterm delivery (defined as deliveries before 37 weeks of pregnancy, including both spontaneous and indicated preterm delivery), and cesarean delivery. The perinatal outcomes included in the analyses were non‐reassuring fetal heart rate pattern, fetal malpresentation (defined as any non‐vertex presentation), meconium‐stained amniotic fluid, 1‐ and 5‐minute Apgar scores below seven, low delivery weight (defined as <2500 g), macrosomia (defined as ≥4000 g), major fetal anomalies (defined as structural or functional anomalies, genetic syndromes, or chromosomal anomalies occurring during the intrauterine period and can be identified prenatally or at delivery), and perinatal mortality (including intrauterine fetal death, intrapartum death, and postpartum death up to 7 days after delivery).…”