Relation of polyhyderamnios to predisposing aetiological factors and perinatal outcome

Original article


H. Legnain1, J. EI Mahdawi2

1) Department of Obstetrics and Gynaecology, Faculty of Medicine, Garyounis University
2) Department of Obstetrics and Gynaecology, Al Jamahiriya Hospital
Benghazi Libya

JMJ Vol.3 No.1 (March) 2004: 76-80


Polyhydramnios, which is associated with many maternal and foetal complications, is defined as an amniotic fluid index of 24 cm or more. 105 cases entered the study, subdivided into mild, moderate and severe polyhydramnios according to maximal amniotic fluid pocket measurements. 82.8% of the cases were mild, 14.3% were moderate and 2.9% were severe. Regarding the underlying causes, 65.7% were idiopathic, 18.1% had maternal causes and 16.21% had foetal causes. 40% of moderate group were diabetic (P: 0.022), and 40% of moderate group were hypertensive (P:O. 117). 2 Rh-isoimmunization: one mild and one moderate. 52 foetuses delivered by caesarean section, 86.5% belong to mild group. The association between mode of delivery and polyhydramnios is insignificant. (P: 0.598). All severe polyhydramnios were low birth weight newborns, 3.4% in mild group and 20% of moderate group (P: 0.000). Despite 52.8% of mild and 66.7% of moderate cases had macrosomic newborns, the relation was insignificant (P: 0.105). Preterm labour reported in 10 cases: 5 in mild, 4 in moderate, and 1 in severe (P: 0.304). Post-term detected in 14 cases out of 87 mild polyhydramnios (P: 0.091). 10 cases of mal-presentation: 7 in mild, 3 in moderate (P: 0.294). 17 foetal anomalies: 10 in mild, 4 in moderate, and 3 in severe (P: 0.000). 14 foetuses of perinatal mortality: 6 in mild, 7 in moderate, and 1 in severe (P: 0.000). The study showed that patients with severe polyhydramnios are at an increased risk of congenital abnormality, low birth weight, prematurity, and perinatal mortality. Mal-presentation was not a related risk. When ultrasound failed to detect structural malformation in growth-retarded foetus, chromosomal analysis, DNA testing, and biochemical study should be carried out. Patients with polyhydramnios were at risk of macrosomia.

Keywords: Polyhydramnios, perinatal outcome, foetal anomalies, mal-presentation, low birth weight, growth-retarded foetus