[Amnionic infusion therapy in conditions with low amnionic fluid levels]

Amnioreduction in treatment of increased amniotic fluid volume

Introduction Increased amniotic fluid volume may significantly increase the risk for preterm delivery. Amniodrainage is a symptomatic treatment by which excess amniotic fluid is reduced to provide fetal lung maturation. The aim of this study is to estimate the efficacy and safety of this procedure, our results and give a literature review. Material and methods Sonografic criteria were used (AFI> 400 ml, or the biggest amniotic fluid pocket > 150 mm) to choose patients in whom 18G needle was used to allow leaking of excessive amniotic fluid. Results 10 patients underwent 26 procedures. The procedures were performed at 28.6th week gestation, on average and 6.25 weeks average gain or 1000 g. We had two sets of monochorionic twins with twin-to-twin transfusion syndrome (TTTS), where one child survived. One procedure was followed by premature placental abruption, and premature delivery in 28th week. The rest of procedures were uneventful. Conclusion In our series of 10 women, 26 procedures were performed to prolong pregnancies, enable fetal maturation and weight gain. In majority of cases amnioreduction was done without complications, so we could repeat the intervention and prolong the pregnancy. Survival of one child in two TTTS pregnancies should not be regarded unsuccessful in our conditions.