In contrast, no less than 75% (35/47) of women with severe polyhydramnios had an adverse composite fetal outcome. The percentage of women with an adverse composite fetal outcome was 36% (123/340) and 46% (35/77) in the mild and moderate polyhydramnios group, respectively. amniotic fluid index (AFI) evaluation is commonly used for measurement. The fetuss pee makes up most of the amniotic fluid after about 20 weeks of pregnancy. If the fetus is unable to swallow the typical amounts of amniotic fluid, this can lead to polyhydramnios. The normal fetus is constantly swallowing amniotic fluid and urinating to create more fluid. The rates of adverse composite fetal outcome are depicted in figure 1 (bar chart). The amount of this fluid can be measured via several methods. Amniotic fluid is mostly water for the first half of pregnancy. Oligohydramnios can also occur because the patient's amniotic membrane has ruptured and amniotic fluid is leaking out of the uterus. An adverse composite fetal outcome occurred in 42% (193/464) of women. Our cohort consists of a total of 464 women with a median AFI of 27.4 (25.6–30.1). Rates of adverse composite fetal outcome (congenital anomaly and/or death intra-uterine or postpartum) are stratified according to the polyhydramnios classification. We included all pregnant women with a singleton fetus, diagnosed with a polyhydramnios (AFI ≥ 24cm) on Level-II scan in our institution from 2007–2016. The objective of this study is to determine the level of adverse composite fetal outcome (congenital anomalies and adverse fetal outcome) in women with mild, moderate and severe polyhydramnios. Physiology Change in volume through gestation The AFV undergoes characteristic changes with gestation. Risk-stratification of women with polyhydramnios can be helpful in identifying the high risk fetus in need for antenatal tertiary referral. Amniotic fluid volume (AFV) is a function both of the amount of water transferred to the gestation across the placental membrane, and the flux of water across the amnion. Polyhydramnios is classified by the amniotic fluid index (AFI) as mild (AFI 24–30cm), moderate (AFI 30–35cm) or severe (AFI ≥ 35cm).

Amniotic fluid levels