Sonographic Association of Polyhydramnios with Adverse Perinatal Outcomes in Diabetic Mothers from 34 to 40 Weeks of Pregnancy

Abstract

Objective: Polyhydramnios carries a high rate of complications during pregnancies and adverse perinatal outcomes. Obstetrical ultrasound screening is the prime tool to rule out any possible adverse outcome that might lead towards worst scenarios outcome such as growth retardation, C-section and preterm delivery. The objective of this study was to determine sonographic association of polyhydramnios with adverse perinatal outcomes in diabetic mothers from 34 to 40 weeks of pregnancy. Methodology: A cross sectional analytical study was carried out at the Department of Radiology in Services Hospital Lahore, Pakistan. Duration of study was from March 2017 to November 2017. Patients in 3rd trimester of pregnancy with Polyhydramnios and diabetes were chosen subsequent to fulfilling consideration (inclusion) and rejection (exclusion) criteria. A complete history and investigation were finished. All necessary examination done. Polyhydramnios confirmed by estimating amniotic fluid index. Statistical Software for Social Sciences (SPSS version 24) was used for analysis of all data.  Standard and Mean Deviation (SD) remained calculated for continuous variables. Findings: The sample size was 101 in this study. While throughout the study period data of 89 patients was collected.  Patients were between the age group of 18 to 35 years. Severity of polyhydramnios was classified as mild moderate and severe. Out of 89 babies delivered during study 66 had no complications while 4 were macrosomic, 1 infant suffered from shoulder dystocia, 1 was lager for gestational age, 3 had respiratory distress syndrome and 3 were smaller for gestational age. Hb1AC levels were higher in diabetic patients with the mean value of 6.18%.  In this study, we found that polyhydramnios is associated with poor diabetic control. This research shows that polyhydramnios is associated with an increased risk of adverse perinatal outcomes, and there is a significant positive relation with maternal age, diabetes, fetal anomalies, and fetal macrosomia. Pregnant women with GDM showed higher risk of macrosomic newborns. This study demonstrates that the likelihood of an adverse perinatal outcome increases in association with polyhydramnios.