Influence of polyhydramnios on perinatal outcome in pregestational diabetic pregnancies

Idris, N, Wong, SF, Thomae, M, Gardener, G and McIntyre, DH (2010) Influence of polyhydramnios on perinatal outcome in pregestational diabetic pregnancies. Ultrasound in Obstetrics and Gynecology, 36 3: 338-343. doi:10.1002/uog.7676


Author Idris, N
Wong, SF
Thomae, M
Gardener, G
McIntyre, DH
Title Influence of polyhydramnios on perinatal outcome in pregestational diabetic pregnancies
Journal name Ultrasound in Obstetrics and Gynecology   Check publisher's open access policy
ISSN 0960-7692
1469-0705
1472-1201
Publication date 2010-09
Sub-type Article (original research)
DOI 10.1002/uog.7676
Volume 36
Issue 3
Start page 338
End page 343
Total pages 6
Place of publication West Sussex, United Kingdom
Publisher John Wiley & Sons
Collection year 2011
Language eng
Formatted abstract
Objective
This study was carried out to evaluate the perinatal outcomes of pregnancy with pregestational diabetes mellitus complicated by polyhydramnios. 

Methods
This was a retrospective study of singleton pregnancies, with an antepartum diagnosis of polyhydramnios, seen at the maternal fetal medicine department of Mater Mothers' Hospital, a tertiary-level facility. All pregnancies in women with pregestational diabetes with a singleton pregnancy beyond 24 weeks of gestation, from 1996 to 2006, were reviewed (n = 314), and pregnancies complicated by polyhydramnios were identified (n = 59). Pregnancy outcomes of women whose pregnancy was complicated with polyhydramnios were compared to those without this complication.

Results
The incidence of polyhydramnios in the study population was 18.8%. Women with polyhydramnios had increased hemoglobin A1c (HbA1c) levels throughout the pregnancy, and the difference was significant during the prepregnancy period and in the third trimester (P = 0.003 and P = 0.025, respectively). Significantly more mothers in the polyhydramnios group delivered preterm (54.2% vs. 33.3%, P = 0.004), the majority of which were iatrogenic preterm deliveries (44.1%). More pregnancies with polyhydramnios were delivered by Cesarean section (83.0% vs. 62%; P = 0.006), with the majority being performed electively in both groups (79.6% and 70.3%, respectively). Regardless, there were no significant differences in perinatal mortality rates, congenital abnormality rates, the incidences of low Apgar score, acidemia, hypoglycemia requiring intravenous therapy, phototherapy and ventilatory needs between the babies of the two groups.

Conclusion
Pregestational diabetic pregnancy with polyhydramnios is associated with poor diabetic control. Despite this, there is no significant increase in adverse perinatal outcome in these pregnancies, apart from a higher iatrogenic preterm birth rate.
Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

Keyword Diabetes
High-risk pregnancy
Polyhydramnios
Pregnancy outcomes
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Sun, 17 Oct 2010, 00:00:07 EST