Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States; Department of Obstetrics and Gynecology, Women's Health Hospital, Assiut University, Assiut, Egypt.
Eur J Obstet Gynecol Reprod Biol. 2019 Oct;241:126-128. doi: 10.1016/j.ejogrb.2019.05.019. Epub 2019 May 19.
To evaluate indications, pregnancy outcomes, and risk of adverse events following amnioreduction procedures in singleton gestations.
Study of all amnioreduction procedures performed on singleton gestations complicated by polyhydramnios between January 2011 and June 2018 at our tertiary and regional referral fetal center. Clinical indications for amnioreduction procedures were categorized as either maternal shortness of breath, perceived abdominal tightness, or preterm uterine contractions with or without cervical change. Our primary outcome(s) of interest were: preterm premature rupture of membranes (PPROM), placental abruption, chorioamnionitis and/or preterm delivery, each in isolation or as a composite.
Among 358 patients who underwent amnioreduction in the study period, 251 arose from cases of twin-twin transfusion syndrome (TTTS) and 74 were singletons undergoing additional fetal intervention procedures. Each of the remaining 33 patients underwent a median number of one [range 1-12] amnioreductions over the antepartum interval, yielding a total of 66 amnioreduction procedures. Among the study cohort, there were no instances of PPROM, placental abruption, chorioamnionitis or preterm delivery within the 12 h following the procedure but 10.6% experienced preterm delivery within 48 h of amnioreduction.
Our data suggests that among singleton gestations, there was a low risk for preterm delivery in close proximity to the procedure and none experienced rupture of membranes, placental abruption, sepsis, fetal demise or neonatal death. This data may be used in counseling of potential candidates for amnioreduction with singleton pregnancies and symptomatic polyhydramnios.
评估单胎妊娠羊水过多行羊水减量术的适应证、妊娠结局和不良事件风险。
本研究为单胎妊娠羊水过多行羊水减量术的回顾性研究，纳入 2011 年 1 月至 2018 年 6 月在我院三级和区域转诊胎儿中心接受羊水减量术的单胎妊娠患者。羊水减量术的临床适应证分为母亲呼吸困难、自觉腹部紧绷、或伴有或不伴有宫颈变化的早产子宫收缩。我们感兴趣的主要结局包括：胎膜早破（PPROM）、胎盘早剥、绒毛膜羊膜炎和/或早产，分别孤立或作为复合结局。
在研究期间行羊水减量术的 358 例患者中，251 例来自双胎输血综合征（TTTS），74 例为行其他胎儿干预措施的单胎。其余 33 例患者各接受中位数为 1 次[范围 1-12 次]的羊水减量术，共进行 66 次羊水减量术。在研究队列中，术后 12 小时内均未发生胎膜早破、胎盘早剥、绒毛膜羊膜炎或早产，但有 10.6%的患者在羊水减量术后 48 小时内早产。
我们的数据表明，在单胎妊娠中，接近手术时早产的风险较低，且无一例患者发生胎膜破裂、胎盘早剥、感染、胎儿死亡或新生儿死亡。这些数据可用于对单胎妊娠伴羊水过多且有症状的孕妇行羊水减量术的潜在候选者进行咨询。
