COMPARISON OF FETOMATERNAL OUTCOMES IN PREGNANT WOMEN WITH AND WITHOUT POLYHYDRAMNIOS

Abstract

Background: Polyhydramnios is an excessive accumulation of amniotic fluid and is associated with maternal and fetal complications. Ultrasound evaluation, particularly the amniotic fluid index (AFI) measured by the four-pocket method, is central to the diagnosis and clinical assessment of this condition.

Objective: To compare fetomaternal outcomes in pregnancies with adequate amniotic fluid and in pregnancies complicated by polyhydramnios.

Methods: A comparative study was carried out at Syed Medical Centre, Bahawalpur, over nine months. The thesis results tables contained 218 singleton pregnancies, comprising 109 pregnancies with adequate amniotic fluid and 109 pregnancies with polyhydramnios. Ultrasound was performed using a Toshiba Aplio 300 machine with a 3.5-MHz convex transducer. Maternal age, gestational age by last menstrual period (GA LMP), gestational age by ultrasonography (GA USG), fetal biometry, birth weight, AFI, and recorded fetal and maternal outcomes were analyzed. Descriptive statistics and independent-samples t-tests were used in SPSS version 25.

Results: The mean GA USG was significantly higher in the polyhydramnios group than in the adequate-fluid group (30.20 ± 3.45 vs 28.06 ± 3.59 weeks; p < 0.001). Mean AFI was also significantly higher in the polyhydramnios group (27.86 ± 1.69 vs 18.30 ± 3.76 cm; p < 0.001). Maternal age, GA LMP, BPD, AC, HC, FL, and birth weight were not significantly different between groups. Abnormal fetal position (32 vs 21), cord prolapse (14 vs 3), maternal dyspnea (20 vs 11), placental abruption (4 vs 1), PPROM (8 vs 0), and preterm labor (10 vs 5) were more frequent in the polyhydramnios group. Low birth weight occurred only in the adequate-fluid group, whereas both macrosomia cases occurred in the polyhydramnios group.

Conclusion: Polyhydramnios was associated with significantly increased AFI and higher ultrasound-estimated gestational age, together with a greater descriptive burden of several adverse fetal and maternal outcomes. Careful ultrasound-based assessment of AFI and associated pregnancy findings remains important for surveillance and risk stratification in such pregnancies.