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Acute polyhydramnios complicating twin pregnancies.

K T Schneider, K Vetter, R Huch

    Acta Geneticae Medicae Et Gemellologiae
    |January 1, 1985
    PubMed
    Summary

    Acute polyhydramnios in twin pregnancies, a serious complication, can be managed with hospitalization, bed rest, and amniocentesis. This approach improved survival rates in a study of monozygous twins.

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    Area of Science:

    • Perinatology
    • Maternal-Fetal Medicine
    • Twin Gestation

    Background:

    • Acute polyhydramnios is a severe complication in second-trimester monozygous twin pregnancies.
    • It results from feto-fetal transfusion, causing anemia in one twin and polycythemia in the other.
    • Unlike chronic cases, acute polyhydramnios does not typically involve an increased incidence of malformations.

    Observation:

    • A 9% incidence of acute polyhydramnios was observed in monozygous twin pregnancies at the University Hospital Zurich between 1979-1983.
    • Ten cases were identified, with most patients hospitalized, treated with bed rest, recurrent amniocenteses, and prophylactic tocolysis.
    • The mean gestational age at diagnosis was 23 4/7 weeks and at delivery 30 3/7 weeks.

    Findings:

    • Eight of 18 newborns survived, with no observed malformations.

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  • In two cases involving unintentional placental vessel puncture, hydramnios did not recur.
  • Hospitalization, bed rest, tocolysis, and serial amniocenteses appeared to positively influence gestation length and outcomes.

    • Implications:

    • The study suggests that aggressive clinical management can improve outcomes in acute polyhydramnios.
    • Reconsideration of clinical management is warranted due to the historically high mortality rates.
    • Further research into optimizing interventions for acute polyhydramnios in twin pregnancies is indicated.