A Prospective Study of Incidence, Causes and Management of Polyhydramnios at Tertiary Care Center

Introduction: Polyhydramnios is a condition defined as a pathological increase in the volume of amniotic fluid during pregnancy. Common causes of polyhydramnios include gestational diabetes, congenital gastrointestinal anomalies like cleft palate, tracheoesophageal fistula, duodenal atresia, foetal infections, and others. Diagnosis is made via ultrasound, and the prognosis depends on the cause and severity. Mild forms often remain asymptomatic, while moderate to severe cases can result in complications such as maternal breathlessness, preterm labour, and premature rupture of membranes (PROM), cord prolapse, and postpartum haemorrhage (PPH). Aim: This study was conducted to investigate the incidence, causes, and management of polyhydramnios. Materials and Methods: We studied 106 clinically suspected cases of polyhydramnios beyond 28 weeks of gestation at M.P. Shah Medical College and G.G. Government Hospital, Jamnagar. All cases underwent ultrasonography for fetal surveillance and amniotic fluid index (AFI) calculation. Results: The results of our study revealed that 49.06% of polyhydramnios cases were idiopathic, followed by 24.53% linked to gestational diabetes and 16.98% associated with fetal anomalies. Multiple pregnancies and Rh isoimmunization accounted for 5.66% and 3.77% of cases, respectively. Primigravida patients comprised 59.3% of the study population, indicating a higher prevalence of polyhydramnios in first-time mothers. Management of gestational diabetes was employed in 24.53% of cases, while 7.54% required reductive amniocentesis, and 0.94% were treated with indomethacin. Vaginal delivery was achieved in 79.2% of cases, while cesarean sections accounted for 20.8%, demonstrating that despite complications, the majority of patients could deliver vaginally with proper management. Conclusion: In conclusion, most cases of polyhydramnios are idiopathic, with gestational diabetes and fetal anomalies being significant contributors to severe cases. Individualized management, timely screening, and monitoring are essential to ensure optimal outcomes, with delivery at tertiary care centers recommended for better maternal and fetal care.