Frequency of congenital anomolies in polyhydramnios

ABSTRACT

Polyhydramnios is a relatively uncommon but distressing complication associated with pregnancy. To find frequency of congenital anomalies with increasing severity of polyhydramnios. Prospective study. This study was conducted in Lady Willingdon Hospital, Lahore from July 2009 to June 2011. Total 70 diagnosed cases of polyhydramnios from 20-41 weeks of gestation were included in the study. Polyhydramnios was diagnosed in 170 pregnancies. Mild polyhydramnios [AFI 24.0-29.9cm] was found in 112 [65.88%] pregnancies, moderate [AFI 30.0-34.9 cm] in 38 [22.35%] pregnancies and severe [AFI 35.0 cm or more] in 20 [11.76%] pregnancies. Antenatal detection of anomalies was 71 [41.76%] fetuses. The prevalence of anomalies was higher in pregnancies with more amniotic fluid. A total of 83 anomalies were detected in 71 fetuses. Pregnancies complicated with severe polyhydramnios had maximum number of fetuses with multiple anomalies. 37 pregnant women out of 170 [21.76%] with polyhydramnios had maternal diabetes. Of these 37 pregnancies 11 [29.72%] had pregestational diabetes, 13 [35.13%] had gestational insulin treated diabetes, 13 [35.13%] had gestational diet controlled diabetes. Anomalous fetuses were present in 5 [13.51% of diabetic pregnancies with polyhydramnios. There were 7 [4.11%] fetal deaths in pregnancies complicated with polyhydramnios. This study proves that pregnancies with severe polyhydramnios have a greater frequency of fetal anomalies. Diagnosis of second trimester polyhydramnios should initiate a search for possible associated fetal anomalies and causative factors