Kollmann M, Voetsch J, Koidl C, Schest E, Haeusler M, Lang U, Klaritsch P
Department of Obstetrics and Gynecology, Medical University of Graz.
Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz.
Ultraschall Med. 2014 Aug;35(4):350-6. doi: 10.1055/s-0034-1366115. Epub 2014 Apr 11.
To determine causes of polyhydramnios and the respective perinatal outcome.
We retrospectively analyzed cases with polyhydramnios at the Medical University Graz, Austria from 2003 - 2011. Inclusion criteria were single deepest pocket ≥ 8 cm, amniotic fluid index ≥ 25 cm, each of the latter parameters > 95th percentile or subjective impression. Etiologies, including TORCH infection, diabetes and congenital malformations, as well as perinatal outcome were evaluated.
Out of 860 singleton pregnancies with polyhydramnios, 2.9 % had positive TORCH serology, 8.5 % had congenital anomalies, 19.8 % had maternal diabetes, and 68.8 % were idiopathic. The most common fetal anomalies were cardiac defects (32.9 %). Elective caesarean sections were more common in the groups with malformations and maternal diabetes. Low birth weight combined with severe polyhydramnios or maternal diabetes was associated with malformations.
Diagnosis of polyhydramnios should prompt glucose-tolerance testing, detailed sonography including fetal echocardiography, and TORCH serology. Especially pregnancies with polyhydramnios and small fetuses as well as those with maternal diabetes should be carefully evaluated for malformations.
确定羊水过多的原因及相应的围产期结局。
我们回顾性分析了2003年至2011年奥地利格拉茨医科大学羊水过多的病例。纳入标准为单一最深羊水池≥8 cm、羊水指数≥25 cm，后一项参数均>第95百分位数或主观判断。评估病因，包括TORCH感染、糖尿病和先天性畸形，以及围产期结局。
在860例单胎妊娠羊水过多病例中，2.9%的TORCH血清学检查呈阳性，8.5%有先天性畸形，19.8%有母体糖尿病，68.8%为特发性。最常见的胎儿畸形是心脏缺陷（32.9%）。选择性剖宫产在畸形组和母体糖尿病组中更为常见。低出生体重合并严重羊水过多或母体糖尿病与畸形有关。
羊水过多的诊断应促使进行葡萄糖耐量试验、包括胎儿超声心动图在内的详细超声检查以及TORCH血清学检查。特别是羊水过多且胎儿较小以及患有母体糖尿病的妊娠应仔细评估是否存在畸形。
