Incidence of fetal malformations in pregnancies complicated by oligo- and polyhydramnios.
Oligo- and polyhydramnios could be observed in 1%-7% of all pregnancies and are associated with an increased risk of fetal anomalies. We evaluated the fetal outcomes of 840 pregnancies with oligo- and polyhydramnios on the basis of ultrasonographic findings (oligohydramnios: single deepest pocket <2 cm, polyhydramnios: single deepest pocket >8 cm) between 12 and 42 weeks of gestation. We observed 734 pregnancies (752 fetuses) with oligohydramnios and 106 pregnancies (108 fetuses) with polyhydramnios. Of the 752 fetuses with oligohydramnios, 81% survived and 19% died in utero. Among the 108 fetuses of pregnancies with polyhydramnios, 72% of the babies survived and 28% died in utero. In polyhydramnios, 48% (52 of 108) of the fetuses had severe malformations, which is significant compared to the rate of 11.8% (89 of 752) of fetal malformations in oligohydramnios ( P-value<0.001). Oligohydramnios is predominantly associated with malformations of the urinary tract, whereas polyhydramnios is associated with anomalies of the gastrointestinal tract. In conclusion, measurement of single deepest pocket is a valuable screening method to evaluate pregnancies showing the complications of oligo- and polyhydramnios. Pregnancies with severe polyhydramnios have a poorer outcome and fetuses have a significantly higher risk of congenital malformations compared to pregnancies with oligohydramnios.
Pauer
Hans-Ulrich
HU
Department of Obstetrics and Gynecology, University of Goettingen, Robert-Koch-Strasse 40, 37075 Goettingen, Germany. hpauer@gwdg.de
Viereck
Volker
V
Krauss
Volker
V
Osmers
Rüdiger
R
Krauss
Thomas
T
D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005333:Fetus / Q000002:abnormalities*; D006801:Humans; D015994:Incidence; D016104:Oligohydramnios / Q000150:complications*; D006831:Polyhydramnios / Q000150:complications*; D011247:Pregnancy; D012307:Risk Factors; D016216:Ultrasonography, Prenatal