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Twin with hydramnios: treating premature labor at source.
I R Lange1, C R Harman, K M Ash
1Department of Obstetrics and Gynaecology, University of Manitoba, Winnipeg, Canada.
American Journal of Obstetrics and Gynecology
|March 1, 1989
Summary
Indomethacin effectively reduced amniotic fluid in twin pregnancies with hydramnios, potentially prolonging gestation. This treatment showed no adverse perinatal complications in the studied cases.
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Pharmacology
Background:
- Hydramnios, or excessive amniotic fluid, complicates pregnancies, often leading to premature labor.
- Managing hydramnios and associated risks like preterm birth is a significant clinical challenge.
Purpose of the Study:
- To investigate the efficacy of indomethacin in reducing amniotic fluid volume in twin pregnancies complicated by hydramnios and premature labor.
- To assess the safety and impact of indomethacin on prolonging gestation in this specific obstetric population.
Main Methods:
- Prospective study of six twin pregnancies with gestational age < 32 weeks and amniotic fluid index > 10 cm.
- Indomethacin administered rectally (100 mg loading dose) then orally (50 mg every 6 hours).
- Amniotic fluid measured via ultrasonography before, during, and after treatment; treatment cessation criteria defined.
Main Results:
- All seven treatment cycles resulted in a reduction of amniotic fluid.
- Normal amniotic fluid levels ( < 8 cm) were achieved within 4 to 20 days (mean 12.5 days).
- No perinatal complications were attributed to indomethacin treatment.
Conclusions:
- Indomethacin appears to be a valuable therapeutic option for reducing amniotic fluid in selected twin pregnancies with hydramnios.
- The treatment may contribute to prolonging gestation, thereby potentially improving perinatal outcomes.