Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany.
Fetal Diagn Ther. 2012;32(4):251-5. doi: 10.1159/000338659. Epub 2012 Jun 28.
To investigate the proportion and type of fetal anomalies that are associated with polyhydramnios and to examine whether in cases with idiopathic polyhydramnios during the course of pregnancy and fetal anomalies only diagnosed after birth, antenatal characteristics differ.
This was a retrospective study involving all pregnancies with polyhydramnios defined by a deepest pool of amniotic fluid ≥8 cm and a detailed ultrasound examination, a 75 g glucose tolerance test and a TORCH serology.
Between 2004 and 2010, 272 pregnancies fulfilled the inclusion criteria. In 89 (32.7%) and 65 (23.9%) cases, there was a fetal anomaly or diabetes. In 118 (43.4%) pregnancies, polyhydramnios was classified as idiopathic. In 11 (9.3%) of the 118 fetuses, an anomaly was found after birth, mainly gastrointestinal atresia. In these cases, median deepest pool of amniotic fluid was 9.6 cm, and median estimated fetal weight was at the 69th centile, whereas in cases without anomalies diagnosed after birth, median deepest pool was 9.0 cm and median estimated fetal weight at the 90th centile (Mann-Whitney U test: deepest pool p = 0.116, and estimated fetal weight centile p = 0.377). There was also no difference in the maternal and gestational age distribution of these cases (Mann-Whitney U test: maternal age p = 0.293, and gestational age p = 0.499).
In about 40% of pregnancies, polyhydramnios remains unexplained during the course of pregnancy. In 10% of these cases, an anomaly will only be found after birth. In this group, antenatal characteristics such as amniotic fluid volume, estimated fetal weight or gestational and maternal age at the time of diagnosis do not help to detect these anomalies before birth.
研究与羊水过多相关的胎儿畸形的比例和类型，并检查在妊娠期间出现特发性羊水过多且仅在出生后诊断出胎儿畸形的病例中，产前特征是否存在差异。
这是一项回顾性研究，纳入所有通过羊水最大深度≥8cm 及详细超声检查、75g 葡萄糖耐量试验和 TORCH 血清学检查诊断为羊水过多的妊娠。
2004 年至 2010 年，共有 272 例妊娠符合纳入标准。89 例（32.7%）和 65 例（23.9%）存在胎儿畸形或糖尿病。118 例（43.4%）妊娠被归类为特发性羊水过多。在 118 例羊水过多的胎儿中，有 11 例（9.3%）在出生后发现畸形，主要为胃肠道闭锁。这些病例的羊水最大深度中位数为 9.6cm，估计胎儿体重中位数为第 69 百分位数，而在出生后未诊断出畸形的病例中，羊水最大深度中位数为 9.0cm，估计胎儿体重中位数为第 90 百分位数（Mann-Whitney U 检验：羊水最大深度 p=0.116，估计胎儿体重百分位数 p=0.377）。这些病例的产妇年龄和孕龄分布也无差异（Mann-Whitney U 检验：产妇年龄 p=0.293，孕龄 p=0.499）。
在约 40%的妊娠中，妊娠期间羊水过多的原因仍不明。在这些病例中，有 10%的病例仅在出生后才发现畸形。在这组病例中，产前特征如羊水体积、估计胎儿体重或诊断时的孕龄和产妇年龄并不能帮助在出生前检测到这些畸形。
