Performance of diagnostic ultrasound to identify causes of hydramnios. (24th November 2020)

• Record Type: Journal Article
• Authors: Adam, Marie‐José; Enderle, Isabelle; Le Bouar, Gwenaëlle; Cabaret‐Dufour, Anne‐Sophie; Tardif, Cécile; Contin, Laurence; Arnaud, Alexis; Proisy, Maïa; Jaillard, Sylvie; Pasquier, Laurent; Le Lous, Maela
• Is Part Of: Prenatal diagnosis. Volume 41:Number 1(2021)
• Page Start: 111
• Page End: 122
• Publication Date: 2020-11-24
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.5825
• Languages: English
• ISSNs: 0197-3851

Abstract

Abstract: Introduction: We aimed to assess the diagnostic yield of ultrasonography in the identification of the etiology of hydramnios, and the added value of MRI or amniocentesis. Methods: We conducted a single‐center retrospective study including pregnancies with confirmed hydramnios (defined as deepest pocket ≥8 cm) between January 2013 and May 2017. Twin pregnancies, secondary hydramnios discovered after the diagnosis of a causal pathology, and pregnancies of unknown outcome were excluded. All pregnancies underwent a targeted scan, and selected cases underwent MRI or amniocentesis. Results: A total of 158 patients with confirmed hydramnios were included. Hydramnios was associated with a fetal pathology in 37 cases (23.4%), with diabetes in 39 (24.6%), isolated macrosomia in 16 (10.1%), and considered idiopathic in 66 (41.7%). Ultrasonography established a diagnosis of the underlying pathology in 73% of cases. Amniocentesis was done in 31 cases (20%) and it allowed diagnosis of chromosome anomalies, esophageal atresia, myotonic dystrophy congenital type, Prader‐Willi syndrome, and Bartter syndrome. MRI was done in 15 cases (10%) and it allowed one additional diagnosis of esophageal atresia. The diagnostic yields of MRI and amniocentesis were 91.7% and 95.2%, respectively. There were five false positive diagnoses at ultrasonography, and one false positive diagnosis at MRI. Conclusion: Hydramnios can be associated with a wide variety of underlying pathologies. Diagnostic ultrasound can attain a diagnosis in the majority of cases. Amniocentesis offers a valuable complementary assessment.