Leung W C, Jouannic J-M, Hyett J, Rodeck C, Jauniaux E
Fetal Medicine Unit, Elizabeth Garrett Anderson and Obstetric Hospital, The University College London Hospitals, London, UK.
Ultrasound Obstet Gynecol. 2004 Feb;23(2):154-8. doi: 10.1002/uog.972.
To investigate the procedure-related complications of rapid amniodrainage in the treatment of polyhydramnios.
We followed prospectively all patients with polyhydramnios treated with rapid amniodrainage under continuous ultrasound guidance using a vacuum wound-drainage system from 1995 to 2002 in the fetal medicine unit of a university teaching hospital. We recorded: maternal age, type of pregnancy (singleton/twin), cause of polyhydramnios, gestational age at amniocentesis, volume of amniotic fluid drained, duration of the procedure, other intrauterine procedures in addition to the amniodrainage, and procedure-related complications including placental abruption, premature rupture of membranes (PROM), chorioamnionitis, fetal bradycardia and preterm delivery within 48 h of amniodrainage.
Seventy-four consecutive women had 134 rapid amniodrainage procedures during the study period. Four procedures were excluded because the women were already in labor at the time of amniodrainage and they delivered within 48 h of the procedure. The final database therefore consisted of 70 patients with 130 procedures. Sixty-two percent (80/130) of the procedures were performed for the treatment of twin-twin transfusion syndrome (TTTS). There were altogether four procedure-related complications (3.1%; 95% CI, 1.0-8.0%). Three of them occurred in the TTTS group (3/80 procedures, 3.8%; 95% CI, 1.0-11.0%): one case each of placental abruption, PROM and fetal bradycardia. One PROM occurred in the non-TTTS group (1/50 procedures, 2.0%; 95% CI, 0-11.0%). In both cases of PROM the women presented in labor.
Rapid amniodrainage using a vacuum wound-drainage system is safe and efficient to treat severe polyhydramnios, with a 3.1% complication rate.
探讨快速羊水引流治疗羊水过多的手术相关并发症。
1995年至2002年，我们在一所大学教学医院的胎儿医学科，对所有在持续超声引导下使用负压伤口引流系统进行快速羊水引流治疗的羊水过多患者进行前瞻性随访。我们记录了：产妇年龄、妊娠类型（单胎/双胎）、羊水过多的原因、羊膜腔穿刺时的孕周、引流出的羊水量、手术持续时间、除羊水引流外的其他宫内操作，以及手术相关并发症，包括胎盘早剥、胎膜早破（PROM）、绒毛膜羊膜炎、胎儿心动过缓和羊水引流后48小时内早产。
在研究期间，74名连续的女性接受了134次快速羊水引流手术。4例手术被排除，因为这些女性在羊水引流时已经临产，且在手术后48小时内分娩。因此，最终数据库包括70名患者的130次手术。62%（80/130）的手术是为了治疗双胎输血综合征（TTTS）。共有4例手术相关并发症（3.1%；95%CI，1.0 - 8.0%）。其中3例发生在TTTS组（3/80次手术，3.8%；95%CI，1.0 - 11.0%）：胎盘早剥、胎膜早破和胎儿心动过缓各1例。1例胎膜早破发生在非TTTS组（1/50次手术，2.0%；95%CI，0 - 11.0%）。在这两例胎膜早破病例中，女性均已临产。
使用负压伤口引流系统进行快速羊水引流治疗重度羊水过多是安全有效的，并发症发生率为3.1%。
