P29.16: Fetal prognosis is associated with the onset of polyhydramnios

Abstract

The diagnosis of polyhydramnios is easy because of improved ultrasound imaging technology. On the other hand, approximately 60 percent of cases were considered idiopathic polyhydramnios, determining the etiology can be challenging. To date, there is no published report about association between fetal prognosis and onset of polyhydramnios. We evaluated that whether the time of diagnosis of polyhydramnios is associated with etiology. All pregnant women were diagnosed in the Kochi Health Sciences Center between April 2005 and January 2010. This was a retrospective study of 2619 singleton pregnancies excluded 152 twins and 5 triplets. Polyhrdramnios was identified sonographically by amniofluid index over 25. In addition, we investigated the time of diagnosis, severity of polyhydramnios, fetal diagnosis, changes in symptoms and neonatal diagnosis was compared with fetal diagnosis. Polyhydramnios was diagnosed in 18 cases (0.69%), and 14 cases (78%) of 18 neonates had one or more anomalies. Idiapathic polyhydramnios were present in only 4 cases (22%) of polyhydramnios, tended to be determined after 34 weeks gestation. All cases of fetal death or severe sequela with polyhydramnios were diagnosed at less than 30 weeks gestation. 6 cases of polyhydramnios were diagnosed after 34 weeks gestation. 2 of 3 cases with excerbation of polyhydramonios diagnosed after birth Prader-Willi syndrome and Pena-Shokeir syndrome, respectively. There was no apparent relevance to fetal prognosis and the severity of polyhydramnios. There is a lot of severe fetal abnormalitirs which been diagnosed by fetal diagnosis of idiopathic polyhydramnios. In the case with worsening rapidly polyhydramnios in the 3rd trimester and of early onset before 30 weeks gestation, it is necessary to consider about underlying severe congenital abnormalities by ultrasound examination can not be determined.