Schneider K T, Vetter K, Huch R, Huch A
Acta Genet Med Gemellol (Roma). 1985;34(3-4):179-84. doi: 10.1017/s0001566000004700.
Acute polyhydramnios in the second trimester is a typical complication in monozygous twin pregnancies. It is caused by a feto-fetal transfusion with anemia on the donor and polycythemia on the recipient twin. Contrary to the chronic hydramnios, there is no increase in malformations. In view of the high mortality rate (100%, according to most authors), the clinical management has to be reconsidered. During the years 1979 to 1983, 10 cases of acute polyhydramnios have been observed at the University Hospital in Zurich. This corresponds to an incidence of 9% in our twin population. All cases investigated were MZ twin pregnancies. With the exception of one patient, who underwent an abortion, all women were hospitalized, had bed rest and received recurrent removals of amniotic fluid and prophylactic tocolysis. The mean gestational age at the time of diagnosis was 23 4/7 weeks and at delivery 30 3/7 weeks. In two cases--one of which is presented in detail--with an unintentional puncture of a placental vessel, the recurrence of the hydramnios did not appear. Eight of 18 newborns survived. No malformations were found. Bed rest, tocolysis and recurrent amniocenteses seem to have a positive influence on the prolongation and outcome of the gestation in acute polyhydramnios.
孕中期急性羊水过多是单卵双胎妊娠的典型并发症。它由胎儿-胎儿输血引起，供血胎儿贫血，受血胎儿红细胞增多症。与慢性羊水过多不同，畸形并无增加。鉴于高死亡率（根据大多数作者的数据为100%），临床处理必须重新考虑。1979年至1983年期间，苏黎世大学医院观察到10例急性羊水过多病例。这在我们的双胎人群中的发生率为9%。所有调查的病例均为单卵双胎妊娠。除一名患者进行了流产外，所有女性均住院，卧床休息，并反复进行羊水穿刺引流及预防性宫缩抑制治疗。诊断时的平均孕周为23又4/7周，分娩时为30又3/7周。在两例（其中一例详细介绍）因意外穿刺胎盘血管的病例中，羊水过多未复发。18名新生儿中有8名存活。未发现畸形。卧床休息、宫缩抑制治疗及反复羊膜腔穿刺似乎对急性羊水过多妊娠的延长及结局有积极影响。
