AMNIOREDUCTION---ITS EFFICACY IN IDIOPATHIC POLYHYDRAMNIOS

Abstract

Objectives: To evaluate the efficacy of amnioreduction in improving maternal dyspnea and premature contractions in singleton pregnancies with idiopathic polyhydrmnios and to find out the frequency of perinatal mortality and complications associated with amnioreduction.

Material and Methods: This pilot interventional study was conducted at Liaqat Memorial Hospital, KUST Institute of Medical Sciences, Kohat from June 2008 to May 2009 on 15 patients having singleton pregnancy with idiopathic polyhydramnios. Amnioreduction was performed by the consultant using standard technique. The Modified Medical Research Council Dyspnea Scale was used to assess the level of maternal dyspnea before and after the procedure. Resolution of premature contractions was also noted. All the babies were seen by the pediatricians and were followed up for one week in the nursery. All relevant details were recorded on predesigned proforma. Data were analyzed by SPSS window’s version 16.

Results: Total 26 amnioreductions were performed on the 15 patients. Frequency of polyhydramnios in our study was 0.529%. Maternal dyspnea improved in 88.9% cases while reduction in premature uterine contractions was observed in only 38.46% cases. Preterm labour (within 1st 48 hours of amnioreduction) was seen in 19.2% cases and abruption placentae (within 24 hours of the procedure) in 11.5% cases. Perinatal mortality in this study was 53.33%.

Conclusion: Amnioreduction is an effective method in relieving maternal dyspnea due to idiopathic polyhydrmnios in singleton pregnancies however its efficacy in reducing uterine contractions was unsatisfactory. The perinatal mortality was higher and the procedure was associated with abruptio placentae and preterm labour.

Key Words: Idiopathic Polyhydramnios, Amnioreduction, Amniotic Fluid Index, Abruptio Placentae, Preterm Labour, Premature Uterine Contractions, Preterm Premature Rupture of the Membrane (PPROM).