Pregnancy Outcome in Pregnant Women with Idiopathic Polyhydramnios

Background: Polyhydramnios is an excess of the amniotic fluid documented by quantitative ultrasonography. Over 40% of polyhydramnios are prenatally idiopathic and diagnosed with a particular abnormality postnatally; the majority of other cases remain unexplained. Objective: To compare the maternal and neonatal outcomes of pregnancies with idiopathic polyhydramnios to pregnancies without polyhydramnios. Methods: A retrospective case-control study involving 38 singleton pregnancies as cases and 65 as controls, outcomes concerning preterm delivery, mode of delivery, presence or absence of antepartum and postpartum hemorrhage, birth weight, weight for gestational age, Apgar score, fetal distress, neonatal intensive care unit (NICU) admission, stillbirth, and neonatal death were then compared. Results: Cases showed a significantly higher preterm delivery rate (52.6% vs. 9.2%), cesarean section prevalence (76.3% vs. 23.1%), and maternal postpartum hemorrhage (PPH) (21.1% vs. 6.2%) compared to controls. Neonates from cases had significantly lower 1-minute (6.3 vs. 7.9) and 5-minute Apgar scores (8.0 vs. 9.0), more significant birth weight variability (3100 vs. 3240g), and higher rates of newborns large for gestational age (LGA) (23.7 vs. 1.5%), fetal distress (36.8 vs. 3.1%), and neonatal intensive care unit (NICU) admission (50.0 vs. 3.1%). Newborns being small for gestational age (SGA) prevalence (13.2 vs. 3.1%), stillbirths (5.3 vs. 3.1%), and neonatal deaths (7.9% vs. 1.5%) showed no significant differences. Conclusions: Idiopathic polyhydramnios is associated with increased risks of preterm delivery, Cesarean section (CS) delivery, neonatal distress, and maternal hemorrhage, highlighting the need for vigilant prenatal care and availability of neonatal intensive care.