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Acute Polyhydramnios Complicating Twin Pregnancies


Schneider, K T M; Vetter, K; Huch, R; Huch, A (1985). Acute Polyhydramnios Complicating Twin Pregnancies. Acta geneticae medicae et gemellologiae, twin research, 34(3-4):179-184.

Abstract

Acute polyhydramnios in the second trimestr is a typical complication in monozygous twin pregnancies. It is caused by a feto-fetal transfusion with anemia on the donor and polycytemia 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.

Abstract

Acute polyhydramnios in the second trimestr is a typical complication in monozygous twin pregnancies. It is caused by a feto-fetal transfusion with anemia on the donor and polycytemia 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.

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Item Type:Journal Article, not_refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:Unspecified
Language:English
Date:1 October 1985
Deposited On:18 Oct 2018 10:53
Last Modified:18 Oct 2018 13:04
Publisher:Cambridge University Press
ISSN:0001-5660
OA Status:Green
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1017/s0001566000004700
Related URLs:https://www.swissbib.ch/Search/Results?lookfor=nationallicencecambridge101017S0001566000004700 (Library Catalogue)

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