PFM.52 Review of maternal and perinatal outcomes for women with polyhydramnios

Aims To investigate maternal and perinatal outcomes for women with singleton pregnancies with polyhydramnios in Tayside. Methods All women diagnosed with polyhydramnios (AFI ≥ 25 cm/deepest pool ≥ 8 cm) between 01/01/13–31/10/13 were included. All women had an ultrasound scan (USS) assessment of fetal anatomy and a random blood sugar assessment as part of routine ante-natal care. Data for obstetric outcomes were collected from the local maternity database (Torex Protos Evolution, v3.5.19). Results 59/3270(1.8%) were diagnosed with polyhydramnios. Median gestation at diagnosis was 34+2weeks (range = 23+4–40+1 weeks). 14/59(23.7%) were associated with diabetes; 5/59(8.5%) had pre-existing diabetes and 9/59(15.3%) had gestational diabetes. 5/59(7%) had perinatal aetiology; 1 case of rhesus isoimmunisation diagnosed at the ante-natal booking visit and 4 congenital abnormalities. 2 congenital abnormalities were diagnosed ante-natally (1 exomphalos, 1 oro-facial cleft). 1 tracheo-oesophageal fistula and 1 case of arthrogryposis multiplex congenita were diagnosed following delivery. 40/59(68%) had idiopathic polyhydramnios. 14/40(35%) resolved on USS. Median gestation at delivery was 39+1weeks (range = 32+6–41+4weeks). Median birth weight was 3480g (range = 1375–4400g). 3/40(7.5%) had pre-term birth. 18/40(45%) had induction of labour (IOL). The median gestation for IOL was 39+1weeks (range=37+1–40+3weeks). 20/40(50%) required caesarean section. 13/20 had planned CS and 7/20 had emergency CS. 4/40(10%) had major post-partum haemorrhage (PPH). 2/40(5%) neonates required NICU admission. Conclusions Idiopathic polyhydramnios is associated with a high rate of obstetric interventions. A diagnosis of polyhydramnios was associated with high rates for induction of labour, operative delivery and major PPH, and also adverse perinatal outcome. This information will be useful to counsel women with polyhydramnios and plan management.