Kleine Rodolpho Truffa, Bernardes Lisandra Stein, Carvalho Mariana Azevedo, de Carvalho Mario Henrique Burlachini, Krebs Vera Lucia, Francisco Rossana Pulcineli Vieira
a Department of Obstetrics and Gynecology , and.
b Department of Pediatrics , University of São Paulo , São Paulo , Brazil.
J Matern Fetal Neonatal Med. 2016 Dec;29(24):4031-4. doi: 10.3109/14767058.2016.1153060. Epub 2016 Mar 7.
Polyhydramnios is a common complication of fetal malformations and has been described to have high risk of pregnancy complications such as prematurity and placental abruption. In a subgroup of women severe polyhydramnios may lead to maternal dyspnea or untreatable pain, and amnioreduction is the procedure indicated to relieve those symptoms. There is a lack of information concerning the increase in the risk for the pregnancy when the procedure is indicated. Therefore, this study sought to evaluate the risk of complications in pregnancies with severe polyhydramnios that needed amnioreduction in relation to the basal risk for the pregnancy of having polyhydramnios without the need for the procedure.
Patients with singleton pregnancies and severe polyhydramnios followed in our fetal medicine center were evaluated retrospectively. Pregnancy complications (prematurity rate, fetal death, premature rupture of membranes, placental abruption and chorioamnionitis) were studied in the group of patients needing the procedure and their risk was compared to the risk of having a pregnancy with severe polyhydramnios but with no need for the procedure.
One hundred and thirty-five patients were evaluated. Forty-four patients (32.6%) needed amnioreduction. There was no increase in the risk of having complications when the procedure was needed OR = 1.4 (CI 0.46-1.26).
Amnioreduction performed to relieve maternal symptoms did not statistically increase the risk of pregnancy complications with severe polyhydramnios in single pregnancies.
羊水过多是胎儿畸形的常见并发症，并且已被描述为具有早产和胎盘早剥等妊娠并发症的高风险。在一部分女性中，严重羊水过多可能导致母体呼吸困难或无法治疗的疼痛，而羊水减量术是用于缓解这些症状的手术。关于在需要进行该手术时妊娠风险增加的信息尚缺乏。因此，本研究旨在评估与无需该手术的羊水过多妊娠的基础风险相关的、需要进行羊水减量术的严重羊水过多妊娠的并发症风险。
对在我们胎儿医学中心随访的单胎妊娠且严重羊水过多的患者进行回顾性评估。研究了需要进行该手术的患者组中的妊娠并发症（早产率、胎儿死亡、胎膜早破、胎盘早剥和绒毛膜羊膜炎），并将其风险与患有严重羊水过多但无需该手术的妊娠风险进行比较。
评估了135例患者。44例患者（32.6%）需要进行羊水减量术。在需要进行该手术时，并发症风险没有增加，比值比（OR）=1.4（95%置信区间0.46 - 1.26）。
为缓解母体症状而进行的羊水减量术在统计学上并未增加单胎妊娠中严重羊水过多的妊娠并发症风险。
