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Performance of diagnostic ultrasound to identify causes of hydramnios

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 5 false positive diagnoses at ultrasonography, and 1 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.
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Submitted on : Monday, October 19, 2020 - 3:48:07 PM
Last modification on : Wednesday, January 20, 2021 - 9:22:34 AM
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Marie-José Adam, Isabelle Enderle, Gwenaëlle Le Bouar, Anne-Sophie Cabaret-Dufour, C Tardif, et al.. Performance of diagnostic ultrasound to identify causes of hydramnios. Prenatal Diagnosis, Wiley, 2020, ⟨10.1002/pd.5825⟩. ⟨hal-02959737⟩

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