Procedure-related complications of rapid amniodrainage in the treatment of polyhydramnios

Authors: Leung W.C.1; Jouannic J.-M.1; Hyett J.1; Rodeck C.1; Jauniaux E.1

Source: Ultrasound in Obstetrics and Gynecology, Volume 23, Number 2, February 2004 , pp. 154-158(5)

Publisher: John Wiley & Sons, Ltd.

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Abstract:

Objective

To investigate the procedure-related complications of rapid amniodrainage in the treatment of polyhydramnios.

Methods

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.

Results

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.

Conclusions

Rapid amniodrainage using a vacuum wound-drainage system is safe and efficient to treat severe polyhydramnios, with a 3.1% complication rate. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.

Keywords: complication; polyhydramnios; rapid amniodrainage

Document Type: Research article

DOI: 10.1002/uog.972

Affiliations: 1: Fetal Medicine Unit, Elizabeth Garrett Anderson & Obstetric Hospital, The University College London Hospitals, London, UK

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