Follow-up of children with antenatally diagnosed idiopathic polyhydramnios
Abstract
Objectives: The aim of our work was to assess the development of children with antenatally diagnosed idiopathic poly- hydramnios, over 12 months from the end of pregnancy.
Material and methods: The study included 91 healthy pregnant patients with idiopathic polyhydramnios. Diagnostic tests results and perinatal medical history were obtained retrospectively. Parents of children were contacted by phone and by mail. The answers were obtained from 64 (70%) parents. For statistical analysis SigmaStat3.5 software was used.
Results: Ninety six percent of parents declared that in their opinion the development of children was normal. Abnormali- ties were found in 44% of the children. Thirty percent of neonates demonstrated mild abnormalities which may be due to organic or functional neuromuscular disorders: abnormal muscle tone, speech apparatus and development disorders, swallowing and breathing problems (manifested as vomiting, excessive regurgitation, idiopathic apnoeas).
Isolated small malformations were diagnosed in 12 (19%) children. Two children (3%) with SGA were diagnosed with genetic syndromes. More than one of the abnormalities described above were diagnosed in 14% of children. Gestational age at the time of polyhydramnios diagnosis and its severity were not prognostic factors for abnormalities. Seventy percent of newborns were male.
Conclusions: Despite the subjectively positive assessment of the development of children by the majority of parents, groups of common disorders requiring long-term follow-up have been identified. Functional disorders of the gastrointestinal tract, CNS and the group of neuromuscular disorders may be responsible for idiopathic polyhydramnios. SGA with co-existing idiopathic polyhydramnios is associated with the risk of genetic diseases. The more frequent incidence of idiopathic poly- hydramnios in male fetuses requires further research.
Keywords: congenital anomaliesdevelopmentfunctional disordersidiopathic polyhydramniosneuromuscular disorders
References
- Volante E, Gramellini D, Moretti S, et al. Alteration of the amniotic fluid and neonatal outcome. Acta Biomed. 2004; 75 Suppl 1: 71–75.
- Magann EF, Chauhan SP, Doherty DA, et al. A review of idiopathic hydramnios and pregnancy outcomes. Obstet Gynecol Surv. 2007; 62(12): 795–802.
- Lee SM, Jun JK, Lee EJ, et al. Measurement of fetal urine production to differentiate causes of increased amniotic fluid volume. Ultrasound Obstet Gynecol. 2010; 36(2): 191–195.
- Touboul C, Picone O, Levaillant JM, et al. Clinical application of fetal urine production rate in unexplained polyhydramnios. Ultrasound Obstet Gynecol. 2009; 34(5): 521–525.
- Brace RA, Anderson DF, Cheung CY. Fetal swallowing as a protective mechanism against oligohydramnios and polyhydramnios in late gestation sheep. Reprod Sci. 2013; 20(3): 326–330.
- Zhu X, Jiang S, Hu Y, et al. The expression of aquaporin 8 and aquaporin 9 in fetal membranes and placenta in term pregnancies complicated by idiopathic polyhydramnios. Early Hum Dev. 2010; 86(10): 657–663.
- Harlev A, Sheiner E, Friger M, et al. Polyhydramnios and adverse perinatal outcome - what is the actual cutoff? J Matern Fetal Neonatal Med. 2014; 27(12): 1199–1203.
- Yefet E, Daniel-Spiegel E. Outcomes From Polyhydramnios With Normal Ultrasound. Pediatrics. 2016; 137(2): e20151948.
- Dorleijn DMJ, Cohen-Overbeek TE, Groenendaal F, et al. Idiopathic polyhydramnios and postnatal findings. J Matern Fetal Neonatal Med. 2009; 22(4): 315–320.
- Kollmann M, Voetsch J, Koidl C, et al. Etiology and perinatal outcome of polyhydramnios. Ultraschall Med. 2014; 35(4): 350–356.
- Sagi-Dain L, Sagi S. Chromosomal aberrations in idiopathic polyhydramnios: A systematic review and meta-analysis. Eur J Med Genet. 2015; 58(8): 409–415.
- Davies MJ, Moore VM, Willson KJ, et al. Reproductive technologies and the risk of birth defects. N Engl J Med. 2012; 366(19): 1803–1813.
- Sekulić SR, Ilić D, Novakov-Mikić A. Polyhydramnios and bone development: an unexplored relationship. Med Hypotheses. 2010; 75(3): 312–314.
- Kornacki J, Adamczyk M, Wirstlein P, et al. Polyhydramnios - frequency of congenital anomalies in relation to the value of the amniotic fluid index. Ginekol Pol. 2017; 88(8): 442–445.
- Stanescu AD, Banica R, Olaru G, et al. Idiopathic polyhydramnios and fetal gender. Arch Gynecol Obstet. 2015; 291(5): 987–991.
- Kim TH, Kim JM, Lee HH. Questions about and speculations on the incidence of idiopathic polyhydramnios by fetal gender. Arch Gynecol Obstet. 2015; 291(6): 1195.
- Richards RI, Sutherland GR. Dynamic mutations: a new class of mutations causing human disease. Cell. 1992; 70(5): 709–712.
- Güler B, Kılıç SH, Kızıltan MY. Variable genetic penetrance of myotonic dystrophy following the diagnosis of idiopathic polyhydramnios. Int J Gynaecol Obstet. 2016; 134(1): 103.
- Rudnik-Schöneborn S, Zerres K. Outcome in pregnancies complicated by myotonic dystrophy: a study of 31 patients and review of the literature. Eur J Obstet Gynecol Reprod Biol. 2004; 114(1): 44–53.
- Yee C, Choi SJ, Oh SY, et al. Clinical characteristics of pregnancies complicated by congenital myotonic dystrophy. Obstet Gynecol Sci. 2017; 60(4): 323–328.
- Smits MJ, van Wijk MP, Langendam MW, et al. Association between gastroesophageal reflux and pathologic apneas in infants: a systematic review. Neurogastroenterol Motil. 2014; 26(11): 1527–1538.
- Pasquini L, Seravalli V, Sisti G, et al. Prevalence of a positive TORCH and parvovirus B19 screening in pregnancies complicated by polyhydramnios. Prenat Diagn. 2016; 36(3): 290–293.
- Jakab A, Pogledic I, Schwartz E, et al. Fetal Cerebral Magnetic Resonance Imaging Beyond Morphology. Semin Ultrasound CT MR. 2015; 36(6): 465–475.
