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Acute Polyhydramnios Complicating Twin Pregnancies

Published online by Cambridge University Press:  01 August 2014

K.T.M. Schneider ,
K. Vetter ,
R. Huch  and
A. Huch
K.T.M. Schneider*
Affiliation:
Department of Obstetrics, University of Zurich
K. Vetter
Affiliation:
Department of Obstetrics, University of Zurich
R. Huch
Affiliation:
Department of Obstetrics, University of Zurich
A. Huch
Affiliation:
Department of Obstetrics, University of Zurich
*
Frauenklinikstr. 10, 8091 Zurich, Switzerland

Abstract

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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.

Keywords

Acute polyhydramniosTwin pregnancyFeto-fetal transfusionAmniocentesis
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 34 , Issue 3-4 , October 1985 , pp. 179 - 184
Copyright
Copyright © The International Society for Twin Studies 1985

References

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