F113The diagnosis and therapy in pregnancies complicated by acute hydramnios

Abstract

BackgroundThe aim of the study was an analysis of frequency of hydramnios and its etiology, and assessment of therapeutic modalities.MethodThe study group consisted of 77 pregnant women with detected hydramnios. The entry criteria were amniotic fluid index (by Phellan) > 28 cm.ResultsThe mean gestational age was 29 ± 4.5 weeks. The mean AFI was 35 ± 7.9 cm. In 30 cases of hydramnios the congenital malformation was diagnosed. The most frequent were anomalies of gastrointestinal tract, lesions of central nervous system and teratomas. In 23 cases viral infections were diagnosed. Another group of pregnancies with the acute hydramnios constitute 13 twin gestations with TTS. In 16 cases, no etiologic factor was found. In all cases, the therapy of acute hydramnios was based on serial amnioreductions. In two cases maternal treatment with indomethacin was introduced beside amniocentesis. In 13 cases there were performed additional intrauterine drainage procedures. The mean gestational age during delivery was 33.6 ± 4.6 weeks. The mean interval between the diagnosis and delivery was 4.6 weeks. The mean birth weight was 2055 ± 1060g. 5th min Apgar score was 4pt. In 13 cases intrauterine demise of fetus occurred.ConclusionThe most frequent causes of acute hydramnios include fetal anomalies, the TTS in twin pregnancies and congenital infections. Amnioreductions are the therapeutic approach with a significant effect on the prolongation of pregnancy.