PDF(Pubmed)
Abstract：
Pregnancies complicated by severe polyhydramnios are associated with a high rate of underlying fetal anomaly. Amnioreduction may be offered to alleviate maternal symptoms. This is a retrospective study of amnioreductions performed on singleton and twin gestations complicated by symptomatic polyhydramnios between 2010 and 2023 at our tertiary referral center. The indications, procedural techniques and pregnancy and neonatal outcomes were retrieved from an archive database and reviewed with the use of the maternal and child medical record chart, the hospital electronic clinical discharge report and telephone recalls. Our study comprised 86 pregnancies, 65 singletons and 21 twin pregnancies. Fetal anomalies were identified in 79% of cases, mainly gastrointestinal obstructive anomalies; 9.3% of cases were idiopathic. The median gestational age at first amnioreduction was 32.5 weeks, and peri-procedural complications were rare (1 case of placental abruption and 2 cases of preterm delivery). The median gestational age at delivery was 36.5 weeks, with a median prolongation of the pregnancy from the time of first drain until birth of 30 days. Preterm labor < 37 weeks occurred in 48.8% of procedures, with 26.7% of patients delivering before 34 weeks and pPROM < 36 weeks recorded in 23.2% of cases. In conclusion, amnioreduction offered to alleviate maternal symptoms is a reasonably safe procedure with a low complication rate. These pregnancies necessitate management in a tertiary referral center because of their need for a multidisciplinary approach both prenatally and postnatally.
摘要：
妊娠并发严重羊水过多与潜在胎儿异常的高发生率有关。羊膜减少可用于缓解母体症状。这是2010年至2023年在我们的三级转诊中心对单胎和双胎妊娠并发有症状的羊水过多进行的羊膜减少的回顾性研究。适应症,从档案数据库中检索程序技术以及妊娠和新生儿结局，并使用母婴病历图进行审查。医院电子临床出院报告和电话回忆。我们的研究包括86次怀孕，65个单胎和21个双胎怀孕。79%的病例发现胎儿异常，主要是胃肠道梗阻异常；9.3％的病例是特发性的。第一次羊膜减少的中位胎龄为32.5周，围手术期并发症很少见（胎盘早剥1例，早产2例）。分娩时的中位胎龄为36.5周，从第一次引流到出生30天，妊娠的中位数延长。早产<37周发生在48.8%的手术中，26.7%的患者在34周之前分娩，23.2%的病例记录pPROM<36周。总之,提供羊膜减压术以减轻产妇症状是一种相当安全的手术，并发症发生率低。这些怀孕需要在三级转诊中心进行管理，因为它们需要在产前和产后采用多学科方法。
