Transient Isolated Polyhydramnios and Perinatal Outcomes

Alexandra Berezowsky; Eran Ashwal; Liran Hiersch; Yariv Yogev; Amir Aviram

doi:10.1055/a-0645-1136

Ultraschall in der Medizin - European Journal of Ultrasound, Inhaltsverzeichnis

Ultraschall Med 2019; 40(06): 749-756
DOI: 10.1055/a-0645-1136

Original Article

Transient Isolated Polyhydramnios and Perinatal Outcomes

Transientes isoliertes Polyhydramnion und perinatales Outcome

Alexandra Berezowsky

¹Helen Scheider Hospital for Women, Rabin Medical Center, Petah-Tikva, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

,

Eran Ashwal

²Lis Maternity and Women’s Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

,

Liran Hiersch

²Lis Maternity and Women’s Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

,

Yariv Yogev

²Lis Maternity and Women’s Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

,

Amir Aviram

²Lis Maternity and Women’s Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

› Institutsangaben

Abstract

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.

Zusammenfassung

Ziel Bewertung des Geburtsverlaufs und des perinatalen Outcomes bei transienten isolierten Polyhydramnions.

Material und Methoden Retrospektive Kohortenstudie (2008–2013) an einem universitätsnahen, tertiärmedizinischen Zentrum. Aufgenommen wurden nur Patientinnen mit Einlings-Schwangerschaften nach der 34. Schwangerschaftswoche (SSW), die weder eine bestehende mütterliche Diabetes noch bekannte strukturelle/chromosomale Anomalien aufwiesen und noch keinen Blasensprung vor der Geburt hatten. Bei allen Frauen erfolgte ein routinemäßiger Ultraschall in der 28.–34. SSW zur fetalen Gewichtsschätzung (sEFW) sowie ein zweiter Routine-Ultraschall bei Aufnahme. Wir verglichen Frauen, bei denen zum Zeitpunkt der sEFW ein transientes Polyhydramnion diagnostiziert wurde mit solchen, die während der sEFW einen normalen AFI (amniotic fluid index) aufwiesen.

Ergebnisse Insgesamt entbanden in diesem Zeitraum 44 263 Frauen, von denen bei 292 (0,7 %) ein transientes Polyhydramnion (Studiengruppe) und bei 29 682 eine normale Fruchtwassermenge (Kontrollgruppe) vorlag. Frauen mit transienten Polyhydramnions hatten ein höheres Risiko für vaginal-operative Entbindungen (AVD), hauptsächlich aufgrund einer auffälligen/intermediären fetalen Herzfrequenzkurve (aOR 2,3, 95 % CI 1,2–5,5), sowie ein höheres Risiko für einen Kaiserschnitt (CD), vor allem wegen Geburtsstörung (aOR 2,5, 95 % CI 1,2–5,1 für Stillstand im 1. Stadium und aOR 3,4, 95 % CI 1,6–7,2) im 2. Stadium), Verdacht auf Makrosomie (aOR 3,2, 95 % CI 1,6–6,6) und Lageanomalie (aOR 6,6, 95 % CI 2,0–21,1).

Schlussfolgerung Transiente isolierte Polyhydramnions, die in der 28.–32. SSW in der Sonografie entdeckt wurden, sind ein unabhängiger Risikofaktor für geburtshilfliche Interventionen während der Geburt.

Key words

ultrasound - pregnancy outcome - neonatal outcome - obstetrics - transient isolated polyhydramnios

Volltext

Referenzen

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