Large-volume therapeutic amniocentesis in the treatment of hydramnios.

OBJECTIVE

To evaluate the safety and outcome of large-volume therapeutic amniocentesis in the treatment of hydramnios.

METHODS

Therapeutic amniocentesis was defined as an attempt to remove enough amniotic fluid (AF) in pregnancies complicated by symptomatic hydramnios to leave a normal volume of AF (AF index less than 25 cm). This report includes all therapeutic amniocenteses that were performed at Good Samaritan Regional Medical Center in Phoenix, Arizona, from 1988-1993.

RESULTS

Ninety-four patients had 200 therapeutic amniocenteses. The most common condition treated with therapeutic amniocentesis was twin-twin transfusion syndrome (36 patients). The mean volume of fluid removed was 1666 +/- 1245 mL (mean +/- standard deviation). The median volume of fluid removed was 1500 mL (range 350-10,000). The fluid was removed at a mean rate of 54 +/- 22 mL/minute. Complications were limited to one patient with ruptured membranes one day after therapeutic amniocentesis, one patient who developed chorioamnionitis, and one patient with an anencephalic fetus who had an abruption following removal of 10,200 mL of fluid.

CONCLUSION

Large-volume therapeutic amniocentesis can be used to treat hydramnios, with a 1.5% complication rate.