Polyhydramnios: Causes, Diagnosis and Therapy

Hamza, A; Herr, David W.; Solomayer, Erich; Meyberg-Solomayer, G

doi:10.1055/s-0033-1360163

Cited by 98 publications

(101 citation statements)

References 87 publications

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“…It may be due to some preventive measures taken in our medical centers, because various protocols have been used in different studies and as a result some variable consequences were reported. Hamza et al (19) found a direct relationship between gestational diabetes and polyhydramnios in women with PPROM; with the gestational diabetes was associated with the risk of polyhydramnios leading to PPROM. In our study some significant statistical differences were found in the average hospital stay period before childbirth, the average interval between admission and childbirth, the average latent phase length of the vaginal childbirth and the average interval between rupture of membrane and childbirth in control group in contrast to women with gestational diabetes.…”

Section: Discussionmentioning

confidence: 99%

Maternal, Fetal and Neonatal Outcomes in Mothers With Diabetes Mellitus or Gestational Diabetes That Complicated With Preterm Premature Rupture of the Membrane (PPROM)

Kari¹,

Sahhaf²,

Abbasalizadeh³

2017

IJWHR

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IntroductionPreterm birth is the main cause of neonatal morbidity and mortality, which is divided into three categories: preterm premature rupture of membrane (PPROM), preterm labor, and early delivery resulting from medical intervention. PPROM is defined as a condition in which the amniotic membranes are ruptured before 37 weeks of gestation and before the onset of labor, while the extreme PPROM occurs before 26 weeks of gestation (1). PPROM is associated with several risks for both mothers and fetuses. The most important maternal complication of PPROM is intra-amniotic infection (chorioamnionitis), which may affect fetus negatively, as well. Other fetal complications of PPROM are placental abruption, fetal distress, fetal restrictive deformities, pulmonary hypoplasia, preterm birth and fetal or newborn death (2-4). Diabetes mellitus or gestational diabetes is a complication which may be associated with PPROM outbreak or exacerbation during pregnancy. Diabetes mellitus is featured with hyperglycemia and impaired metabolism of carbohydrates, fatty acids and proteins and is associated with the absolute or relative lack of insulin. It is amongst the most common and costly diseases throughout the world whose prevalence rate is increasing because of the changed lifestyles and the improved medical and sanitary conditions, which in turn have enhanced the survival rate in the societies (5). In Iran, the general prevalence rate of diabetes and impaired glucose tolerance (IGT) in people of childbirth age is estimated about 7.6% (6).As the previous studies demonstrated, there is a direct relationship between (mellitus and gestational) diabetes and PPROM in pregnant women and unpleasant consequences of pregnancy (7-15).Given the considerable prevalence rate of (mellitus and gestational) diabetes during the childbirth age and the high possibility of infection and other neonatal and fetal complications in such pregnancies, which are exacerbated by PPROM, and since there has not been found any study covering maternal, neonatal and fetal complications in diabetic pregnant women with PPROM simultaneously (including in Iran), this study tries to consider maternal, fetal and neonatal complications of PPROM in women AbstractObjectives: It has been suggested that the presence of diabetes may increase the possibility of occurrence of premature rupture of the membrane (PPROM), which in turn, could lead to a dramatic escalation in the rate of pregnancy-related complications. The available data, however, are not sufficient in this regard in the literature. This study aims to examine pregnancy outcome in pregnant women with simultaneous diabetes mellitus/gestational diabetes and PPROM. Materials and Methods: A total of 134 pregnant women with gestational diabetes (n = 99) or diabetes mellitus (n = 35) were compared with 135 pregnant women normoglycemic women in terms of maternal, fetal and neonatal outcomes in a teaching hospital. Multiplepregnancy, anomalous fetus, complicated pregnancies, polyhydramnios, placental problems, and intrau...

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Section: Discussionmentioning

confidence: 99%

Maternal, Fetal and Neonatal Outcomes in Mothers With Diabetes Mellitus or Gestational Diabetes That Complicated With Preterm Premature Rupture of the Membrane (PPROM)

Kari¹,

Sahhaf²,

Abbasalizadeh³

2017

IJWHR

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“…Up to 2% of all pregnancies have an excess amount of fluid meeting the criteria for polyhydramnios[1,2]. It is reported in the literature that approximately sixty percent of polyhydramnios is idiopathic; twenty percent of polyhydramnios can be attributed to poorly controlled or undiagnosed diabetes and the remainder of cases of polyhydramnios are associated with fetal anomalies[2-4].…”

Section: Introductionmentioning

confidence: 99%

Amount of polyhydramnios attributable to diabetes may be less than previously reported

Moore

2017

WJD

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AIMTo evaluate the frequency and the quantity of polyhydramnios attributable to diabetes in pregnancy.METHODSThe charts of patients with a four-quadrant amniotic fluid index (AFI) ≥ 20 cm and either a diagnosis of diabetes or a diabetes screening test during the index pregnancy were retrospectively reviewed. AFI was stratified into 5 categories and the frequency of diabetes was evaluated for each group. The frequency of polyhydramnios attributable to diabetes was compared to the frequency of polyhydramnios in the setting of fetal anomalies or no known cause.RESULTSOne thousand five hundred and forty-five patients were included in the study. Eight point five percent (n = 131) had diabetes and no other cause for polyhydramnios. Eleven point two percent (173) had antenatally diagnosed anomalies. For all categories of AFI except the largest (> 40.9 cm) the most common cause of polyhydramnios was idiopathic. In patients with diabetes the AFI was most likely to be between 26 cm and 35.9 cm.CONCLUSIONThe rate of polyhydramnios in this study is 8.5%. Patients with diabetes most commonly have mild polyhydramnios between 26 and 35.9 cm of fluid on a four-quadrant AFI.

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“…Gestational diabetes is one of the common causes of polyhydramnios, but the pathogenesis has not been elucidated yet [28,29]. Possible explanation is increased osmotic diuresis which subsequently leads to polyuria in GDM [29].…”

Section: Implications Of Gestational Diabetesmentioning

confidence: 99%

Gestational Diabetes: Screening, Management, Timing of Delivery

Korkmazer

Solak

Tokgöz

2015

Curr Obstet Gynecol Rep

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Gestational diabetes mellitus (GDM) is a pancreatic function insufficiency to overcome the insulin resistance associated with the pregnant state. The prevalence of GDM is about 2-5 % of normal pregnancies. To prevent the adverse outcome for the mother, the fetus, and neonatal period, detection of GDM is important. Screening methods vary by clinics. Screening can either be selective, based upon risk stratification or universal. Timely testing enables the obstetrician to assess glucose tolerance in the presence of the insulin-resistant state of pregnancy and permits treatment to begin before excessive fetal growth has occurred. After the diagnosis of GDM, close perinatal surveillance is necessary. The goal of treatment in GDM is to reduce fetal and maternal morbidity and mortality. The exact glucose values needed are still unknown. The decision whether and when to induce delivery depends on gestational age, fetal growth, maternal glucose levels, and Bishop score. Screening, follow-up, and treatment of GDM still have controversies.

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Polyhydramnios: Causes, Diagnosis and Therapy

Cited by 98 publications

References 87 publications

Maternal, Fetal and Neonatal Outcomes in Mothers With Diabetes Mellitus or Gestational Diabetes That Complicated With Preterm Premature Rupture of the Membrane (PPROM)

Maternal, Fetal and Neonatal Outcomes in Mothers With Diabetes Mellitus or Gestational Diabetes That Complicated With Preterm Premature Rupture of the Membrane (PPROM)

Amount of polyhydramnios attributable to diabetes may be less than previously reported

Gestational Diabetes: Screening, Management, Timing of Delivery

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