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Term Idiopathic Polyhydramnios, and Labor Complications

Background and Aim: Polyhydramnios is associated with an increased risk of various adverse pregnancy outcomes, yet complications during labor have not been sufficiently studied. We assessed the labor and perinatal outcomes of idiopathic polyhydramnios during term labor. Methods: Retrospective cohort...

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Autores principales: Bas Lando, Maayan, Urman, Marnina, Weiss, Yifat, Srebnik, Naama, Grisaru-Granovsky, Sorina, Farkash, Rivka, Sela, Hen Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917959/
https://www.ncbi.nlm.nih.gov/pubmed/36769629
http://dx.doi.org/10.3390/jcm12030981
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author Bas Lando, Maayan
Urman, Marnina
Weiss, Yifat
Srebnik, Naama
Grisaru-Granovsky, Sorina
Farkash, Rivka
Sela, Hen Y.
author_facet Bas Lando, Maayan
Urman, Marnina
Weiss, Yifat
Srebnik, Naama
Grisaru-Granovsky, Sorina
Farkash, Rivka
Sela, Hen Y.
author_sort Bas Lando, Maayan
collection PubMed
description Background and Aim: Polyhydramnios is associated with an increased risk of various adverse pregnancy outcomes, yet complications during labor have not been sufficiently studied. We assessed the labor and perinatal outcomes of idiopathic polyhydramnios during term labor. Methods: Retrospective cohort study at a tertiary medical center between 2010 and 2014. Women with idiopathic polyhydramnios defined as an amniotic fluid index (AFI) greater than 24 cm or a deep vertical pocket (DVP) > 8 cm (cases) were compared with women with a normal AFI (5–24 cm) (controls). Statistics: Descriptive, means ± SDs, medians + IQR. Comparisons: chi-square, Fisher’s exact test, Mann–Whitney Test, multivariate logistic models. Results: During the study period 11,065 women had ultrasound evaluation completed by a sonographer within two weeks of delivery. After excluding pregnancies complicated by diabetes (pre-gestational or gestational), fetal anomalies, IUFD, multifetal pregnancies, elective cesarean deliveries (CD) or missing data, we included 750 cases and 7000 controls. The degree of polyhydramnios was mild in 559 (75.0%) cases (AFI 24–30 cm or DVP 8–12 cm), moderate in 137 (18.0%) cases (30–35 cm or DVP 12–15 cm) and severe in 54 (7.0%) cases (AFI >35 cm or DVP > 15 cm). Idiopathic polyhydramnios was associated with a higher rate of CD 9.3% vs. 6.2%, p = 0.004; a higher rate of macrosomia 22.8% vs. 7.0%, p < 0.0001; and a higher rate of neonatal respiratory complications 2.0% vs. 0.8%, p = 0.0001. A multivariate regression analysis demonstrated an independent relation between polyhydramnios and higher rates of CD, aOR 1.62 (CI 1.20–2.19 p = 0.002) and composite adverse neonatal outcome aOR 1.28 (CI 1.01–1.63 p = 0.043). Severity of polyhydramnios was significantly associated with higher rates of macrosomia and CD (p for trend <0.01 in both). Conclusions: The term idiopathic polyhydramnios is independently associated with macrosomia, CD and neonatal complications. The severity of polyhydramnios is also associated with macrosomia and CD.
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spelling pubmed-99179592023-02-11 Term Idiopathic Polyhydramnios, and Labor Complications Bas Lando, Maayan Urman, Marnina Weiss, Yifat Srebnik, Naama Grisaru-Granovsky, Sorina Farkash, Rivka Sela, Hen Y. J Clin Med Article Background and Aim: Polyhydramnios is associated with an increased risk of various adverse pregnancy outcomes, yet complications during labor have not been sufficiently studied. We assessed the labor and perinatal outcomes of idiopathic polyhydramnios during term labor. Methods: Retrospective cohort study at a tertiary medical center between 2010 and 2014. Women with idiopathic polyhydramnios defined as an amniotic fluid index (AFI) greater than 24 cm or a deep vertical pocket (DVP) > 8 cm (cases) were compared with women with a normal AFI (5–24 cm) (controls). Statistics: Descriptive, means ± SDs, medians + IQR. Comparisons: chi-square, Fisher’s exact test, Mann–Whitney Test, multivariate logistic models. Results: During the study period 11,065 women had ultrasound evaluation completed by a sonographer within two weeks of delivery. After excluding pregnancies complicated by diabetes (pre-gestational or gestational), fetal anomalies, IUFD, multifetal pregnancies, elective cesarean deliveries (CD) or missing data, we included 750 cases and 7000 controls. The degree of polyhydramnios was mild in 559 (75.0%) cases (AFI 24–30 cm or DVP 8–12 cm), moderate in 137 (18.0%) cases (30–35 cm or DVP 12–15 cm) and severe in 54 (7.0%) cases (AFI >35 cm or DVP > 15 cm). Idiopathic polyhydramnios was associated with a higher rate of CD 9.3% vs. 6.2%, p = 0.004; a higher rate of macrosomia 22.8% vs. 7.0%, p < 0.0001; and a higher rate of neonatal respiratory complications 2.0% vs. 0.8%, p = 0.0001. A multivariate regression analysis demonstrated an independent relation between polyhydramnios and higher rates of CD, aOR 1.62 (CI 1.20–2.19 p = 0.002) and composite adverse neonatal outcome aOR 1.28 (CI 1.01–1.63 p = 0.043). Severity of polyhydramnios was significantly associated with higher rates of macrosomia and CD (p for trend <0.01 in both). Conclusions: The term idiopathic polyhydramnios is independently associated with macrosomia, CD and neonatal complications. The severity of polyhydramnios is also associated with macrosomia and CD. MDPI 2023-01-27 /pmc/articles/PMC9917959/ /pubmed/36769629 http://dx.doi.org/10.3390/jcm12030981 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bas Lando, Maayan
Urman, Marnina
Weiss, Yifat
Srebnik, Naama
Grisaru-Granovsky, Sorina
Farkash, Rivka
Sela, Hen Y.
Term Idiopathic Polyhydramnios, and Labor Complications
title Term Idiopathic Polyhydramnios, and Labor Complications
title_full Term Idiopathic Polyhydramnios, and Labor Complications
title_fullStr Term Idiopathic Polyhydramnios, and Labor Complications
title_full_unstemmed Term Idiopathic Polyhydramnios, and Labor Complications
title_short Term Idiopathic Polyhydramnios, and Labor Complications
title_sort term idiopathic polyhydramnios, and labor complications
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917959/
https://www.ncbi.nlm.nih.gov/pubmed/36769629
http://dx.doi.org/10.3390/jcm12030981
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