![]() Ultrasound evaluation of the amount of amniotic fluid can be either a subjective assessment or a semiquantitative estimation using the maximal vertical pocket (MVP), amniotic fluid index (AFI) 5, 6, two-diameter pocket 7 or three-dimensional measurements 8. ![]() Although historically the detection of polyhydramnios was made clinically by abdominal palpation or at the time of delivery 4, the diagnosis is now commonly made sonographically. Polyhydramnios, defined as excessive accumulation of amniotic fluid, affects 1–2% of pregnancies, but the incidence has been reported to range from as low as 0.2% to as high as 3.9% 1- 3. There is an association between the frequencies of a variety of adverse pregnancy outcomes and the severity of polyhydramnios as reflected by the maximal AFI. No significant association between degree of polyhydramnios and adverse outcome was demonstrated in cases of idiopathic polyhydramnios ( n = 253). The most severe form of polyhydramnios, as based on the maximal AFI (≥ 35 cm n = 67), was associated with the highest rates of prenatally diagnosed congenital anomalies (79%), preterm delivery (46%), small-for-gestational-age neonate (16%), aneuploidy (13%) and perinatal mortality (27%). Higher AFI was associated with a statistically significant increase in the frequency of adverse pregnancy outcomes. Data were collected to determine the frequency of the following adverse pregnancy outcomes: prenatally diagnosed congenital anomalies, fetal aneuploidy, preterm delivery, Cesarean delivery, low birth weight, 5-min Apgar score < 7 and perinatal mortality. The cohort was stratified into four groups based on the maximal AFI noted during the pregnancy: < 25 cm but with MVP ≥ 8 cm 25–29.9 cm 30–34.9 cm and ≥ 35 cm. ![]() Polyhydramnios was defined as either AFI ≥ 25 cm or a maximum vertical pocket (MVP) ≥ 8 cm even in the presence of AFI < 25 cm. This was a retrospective chart review of 524 singleton pregnancies diagnosed with polyhydramnios and delivered in a single tertiary referral center between 20. Our aim was to evaluate the association between the maximal amniotic fluid index (AFI) and the frequency of specific adverse outcomes. Polyhydramnios is present in approximately 2% of pregnancies and has been associated with a variety of adverse pregnancy outcomes.
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