title: Pregnancy outcomes in severe polyhydramnios: no increase in risk in patients needing amnioreduction for maternal pain or respiratory distress.
abstract: BACKGROUND
  Polyhydramnios is a common complication of fetal malformations and has been described to have high risk of pregnancy complications such as prematurity and placental abruption. In a subgroup of women severe polyhydramnios may lead to maternal dyspnea or untreatable pain, and amnioreduction is the procedure indicated to relieve those symptoms. There is a lack of information concerning the increase in the risk for the pregnancy when the procedure is indicated. Therefore, this study sought to evaluate the risk of complications in pregnancies with severe polyhydramnios that needed amnioreduction in relation to the basal risk for the pregnancy of having polyhydramnios without the need for the procedure.
  
  
  METHODS
  Patients with singleton pregnancies and severe polyhydramnios followed in our fetal medicine center were evaluated retrospectively. Pregnancy complications (prematurity rate, fetal death, premature rupture of membranes, placental abruption and chorioamnionitis) were studied in the group of patients needing the procedure and their risk was compared to the risk of having a pregnancy with severe polyhydramnios but with no need for the procedure.
  
  
  RESULTS
  One hundred and thirty-five patients were evaluated. Forty-four patients (32.6%) needed amnioreduction. There was no increase in the risk of having complications when the procedure was needed OR = 1.4 (CI 0.46-1.26).
  
  
  CONCLUSIONS
  Amnioreduction performed to relieve maternal symptoms did not statistically increase the risk of pregnancy complications with severe polyhydramnios in single pregnancies.
authors.affiliation: a Department of Obstetrics and Gynecology , and.
authors.forename: Rodolpho Truffa
authors.initials: RT
authors.lastname: Kleine
authors.affiliation: a Department of Obstetrics and Gynecology , and.
authors.forename: Lisandra Stein
authors.initials: LS
authors.lastname: Bernardes
authors.affiliation: a Department of Obstetrics and Gynecology , and.
authors.forename: Mariana Azevedo
authors.initials: MA
authors.lastname: Carvalho
authors.affiliation: a Department of Obstetrics and Gynecology , and.
authors.forename: Mario Henrique Burlachini
authors.initials: MH
authors.lastname: de Carvalho
authors.affiliation: b Department of Pediatrics , University of São Paulo , São Paulo , Brazil.
authors.forename: Vera Lucia
authors.initials: VL
authors.lastname: Krebs
authors.affiliation: a Department of Obstetrics and Gynecology , and.
authors.forename: Rossana Pulcineli Vieira
authors.initials: RP
authors.lastname: Francisco
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000653:Amniotic Fluid; D004322:Drainage / Q000379:methods*; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D006831:Polyhydramnios / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012306:Risk; D018709:Statistics, Nonparametric; D018084:Ultrasonography, Interventional; D016216:Ultrasonography, Prenatal
keywords: Amniodrainage; amnioreduction; fetal malformation; polyhydramnios; pregnancy complication; pregnancy outcome; premature labor