The risk of fetal death in nonanomalous pregnancies affected by polyhydramnios

Pilliod, Rachel A.; Pagé, Jessica; Burwick, Richard M.; Kaimal, Anjali J; Cheng, Yvonne W.; Caughey, Aaron B.

doi:10.1016/j.ajog.2015.05.022

Cited by 37 publications

(24 citation statements)

References 13 publications

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“…These studies were not specific to cases with NIHF, however, and did not consider the importance of placentomegaly. Furthermore, the increased risk of IUFD with polyhydramnios has been demonstrated most drastically at term . As only 20% of our NIHF‐with‐P/PM cases delivered after 37 weeks, it is likely that most delivered before the increased risk attributable to polyhydramnios became substantial.…”

Section: Discussionmentioning

confidence: 95%

“…Furthermore, the increased risk of IUFD with polyhydramnios has been demonstrated most drastically at term. 17 As only 20% of our NIHF-with-P/PM cases delivered after 37 weeks, it is likely that most delivered before the increased risk attributable to polyhydramnios became substantial. Therefore, we suspect that the decreased IUFD rate seen in hydropic fetuses with P/PM was driven by the higher rate of PTB in this group, hence allowing less time for the demise to occur.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Non‐Immune Hydrops Fetalis: Do Placentomegaly and Polyhydramnios Matter?

Berger

Sparks

Jelin

et al. 2017

J of Ultrasound Medicine

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 97%

Non‐Immune Hydrops Fetalis: Do Placentomegaly and Polyhydramnios Matter?

Berger

Sparks

Jelin

et al. 2017

J of Ultrasound Medicine

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“…In 2015, Pilliod et al 43 used birth certificate data to review >1.8 million singleton nonanomalous births in California, of which 0.4% were identified to have polyhydramnios. Acknowledging the limitations of birth certificate data, including a lack of information on the degree of polyhydramnios, the authors found that the ongoing risk of fetal demise was greater in otherwise low-risk pregnancies affected by polyhydramnios at all gestational ages, with the greatest increase in risk seen at term.…”

Section: Antepartum Managementmentioning

confidence: 99%

SMFM Consult Series #46: Evaluation and management of polyhydramnios

Dashe

Pressman

Hibbard

2018

American Journal of Obstetrics and Gynecology

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Polyhydramnios, or hydramnios, is an abnormal increase in the volume of amniotic fluid. Identification of polyhydramnios should prompt a search for an underlying etiology. Although most cases of mild polyhydramnios are idiopathic, the 2 most common pathologic causes are maternal diabetes mellitus and fetal anomalies, some of which are associated with genetic syndromes. Other causes of polyhydramnios include congenital infection and alloimmunization. The purpose of this document is to provide guidance on the evaluation and management of polyhydramnios. The following are Society for Maternal-Fetal Medicine recommendations: (1) we suggest that polyhydramnios in singleton pregnancies be defined as either a deepest vertical pocket of ≥8 cm or an amniotic fluid index of ≥24 cm (GRADE 2C); (2) we recommend that amnioreduction be considered only for the indication of severe maternal discomfort, dyspnea, or both in the setting of severe polyhydramnios (GRADE 1C); (3) we recommend that indomethacin should not be used for the sole purpose of decreasing amniotic fluid in the setting of polyhydramnios (GRADE 1B); (4) we suggest that antenatal fetal surveillance is not required for the sole indication of mild idiopathic polyhydramnios (GRADE 2C); (5) we recommend that labor should be allowed to occur spontaneously at term for women with mild idiopathic polyhydramnios; that induction, if planned, should not occur at <39 weeks of gestation in the absence of other indications; and that mode of delivery should be determined based on usual obstetric indications (GRADE 1C); and (6) we recommend that women with severe polyhydramnios deliver at a tertiary center due to the significant possibility that fetal anomalies may be present (GRADE 1C).

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“…Up to one quarter of presumed isolated polyhydramnios cases are diagnosed with an abnormality in the postpartum period [9][10][11][12]. Although considered isolated, idiopathic polyhydramnios was found to be associated with adverse outcomes such as increased risk for fetal macrosomia, caesarean delivery (CD), or assisted vaginal delivery (AVD) and an increased risk of perinatal morbidity and mortality [4,[13][14][15][16][17]. Transient isolated polyhydramnios (TIP) is defined as polyhydramnios diagnosed during gestation, which later resolves.…”

Section: Introductionmentioning

confidence: 99%

Transient Isolated Polyhydramnios and Perinatal Outcomes

et al. 2018

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Purpose To evaluate labor and perinatal outcomes of transient isolated polyhydramnios. Materials and Methods A retrospective cohort study (2008–2013) at a university-affiliated, tertiary medical center. Eligibility was limited to patients with singleton gestations, no maternal diabetes or known structural/chromosomal anomalies, and no rupture of the membranes prior to delivery, at > 34 weeks of gestation. All women underwent routine sonogram for estimation of fetal weight (sEFW) between 28–34 weeks of gestation, and a second routine sonogram at admission. We compared women diagnosed with polyhydramnios at the time of the sEFW which later resolved, with women who had normal AFI during the sEFW. Results Overall, 44 263 women delivered during this time period, of which 292 (0.7 %) with transient polyhydramnios (study group) and 29 682 with a normal amniotic fluid level (control group) were eligible for analysis. Women with transient polyhydramnios had a higher risk for assisted vaginal delivery (AVD), mainly due to abnormal/intermediate fetal heart rate tracings (aOR 2.3, 95 % CI 1.2–5.5), and a higher risk for cesarean delivery (CD), mostly because of labor dystocia (aOR 2.5, 95 % CI 1.2–5.1 for 1st stage arrest and aOR 3.4, 95 % CI 1.6–7.2) for 2nd stage arrest), suspected macrosomia (aOR 3.2, 95 % CI 1.6–6.6) and malpresentation (aOR 6.6, 95 % CI 2.0–21.1). Conclusion Transient isolated polyhydramnios detected during the sonogram at 28–32 weeks of gestation is an independent risk factor for the need for obstetrical intervention during labor.

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The risk of fetal death in nonanomalous pregnancies affected by polyhydramnios

Cited by 37 publications

References 13 publications

Non‐Immune Hydrops Fetalis: Do Placentomegaly and Polyhydramnios Matter?

Non‐Immune Hydrops Fetalis: Do Placentomegaly and Polyhydramnios Matter?

SMFM Consult Series #46: Evaluation and management of polyhydramnios

Transient Isolated Polyhydramnios and Perinatal Outcomes

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