Improving management strategy for patients with polyhydramnios

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective: To evaluate the effectiveness of combination therapy in patients with virus-induced polyhydramnios.

Materials and methods: The study included 82 patients with polyhydramnios who had a new coronavirus infection COVID-19. The patients of the main group received combination treatment with indomethacin and immunomodulator Superlymph, the patients of the control group were treated with systemic antibiotics.

Results: The average size of the maximum pocket in the patients of the main group was 12.42 cm at the start of treatment, it decreased to 10.5 cm on the 3rd day and normalized in 19.23% of patients. Amniotic fluid volume was normalized on the 10th day from the start of therapy in 51.92% of patients, mild polyhydramnios persisted in 44.23% of women, moderate polyhydramnios was noted in 3.85% of patients. After two weeks from the start of treatment, amniotic fluid volume was completely normalized in 78.85%, mild polyhydramnios persisted in 15.38%, moderate polyhydramnios was observed in 5.77%. The diagnosis of polyhydramnios was eliminated in 92.31% of the patients after three weeks. The effectiveness of treatment was 60% in the control group. The size of the maximum pocket was 12.57 cm at the start of treatment, it was 10.2 cm on the 7th day; on the 14th day after the end of therapy, mild polyhydramnios persisted in 23.33% of patients and moderate polyhydramnios was noted in 16.67% of patients.

Conclusion: It is possible to prescribe combination therapy with indomethacin and immunomodulator Superlymph for patients with polyhydramnios. The results of the study showed a decrease in amniotic fluid volume according to ultrasound data and they did not affect perinatal outcomes.

Full Text

Restricted Access

About the authors

Yulia E. Dobrokhotova

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Author for correspondence.
Email: pr.dobrohotova@mail.ru
ORCID iD: 0000-0002-7830-2290

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Medicine

Russian Federation, Moscow

Ekaterina I. Borovkova

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: Katyanikitina@mail.ru
ORCID iD: 0000-0001-7140-262X

Dr. Med. Sci., Associate Professor, Professor, Department of Obstetrics and Gynecology

Russian Federation, Moscow

Tamara N. Belousova

Vidnovsky Perinatal Center

Email: beltamara1@mail.ru
ORCID iD: 0000-0003-3804-7691

PhD, Chief Physician

Russian Federation, Moscow region

Marina V. Burdenko

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: bmv-0306@rambler.ru
ORCID iD: 0000-0002-0304-4901

PhD, Associate Professor, Department of Obstetrics and Gynecology

Russian Federation, Moscow

Ilyas A. Kulikov

Vidnovsky Perinatal Center

Email: aesculap@inbox.ru
ORCID iD: 0000-0002-2460-1623

PhD, Head of the Obstetric Department of Pregnancy Pathology

Russian Federation, Moscow region

Elena A. Vdovichenko

Vidnovsky Perinatal Center

Email: aesculap@inbox.ru

Obstetrician-Gynecologist, Department of Pregnancy Pathology

Russian Federation, Moscow region

Daria S. Davydova

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: dashadavydova1215@gmail.com
ORCID iD: 0000-0002-6598-9310

Clinical Resident, Department of Obstetrics and Gynecology, Faculty of Medicine

Russian Federation, Moscow

References

  1. Dashe J.S., McIntire D.D., Ramus R.M., Santos-Ramos R., Twickler D.M. Hydramnios: anomaly prevalence and sonographic detection. Obstet. Gynecol. 2002; 100(1): 134-9. https://dx.doi.org/10.1016/s0029-7844(02)02013-6.
  2. Муминова Г.Ш., Аюпова Д.А., Муминова З.А. Акушерские и перинатальные исходы у беременных с многоводием. Журнал теоретической и клинической медицины. 2021; 3: 105-8. [Muminova G.Sh., Ayupova D.A., Muminova Z.A. Obstetric and perinatal outcomes in pregnant women with polyhydramus. Journal of Theoretical and Clinical Medicine. 2021; (3): 105-8. (in Russian)].
  3. Туманова У.Н., Шувалова М.П., Щеголев А.И. Нарушение объема околоплодных вод в генезе мертворождения. Международный журнал прикладных и фундаментальных исследований. 2017; 12(1): 94-7. [Tumanova U.N., Shuvalova M.P., Shchegolev A.I. Disorders of amniotic fluid volume in the genesis of stillbirth. International Journal of Applied and Fundamental Research. 2017; 12(1): 94-7. (in Russian)].
  4. Pri-Paz S., Khalek N., Fuchs K.M., Simpson L.L. Maximal amniotic fluid index as a prognostic factor in pregnancies complicated by polyhydramnios. Ultrasound Obstet. Gynecol. 2012; 39(6): 648-53. https://dx.doi.org/10.1002/uog.10093.
  5. Bauserman M., Nathan R., Lokangaka A., McClure E.M., Moore J., Ishoso D. et al. Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study. BMC Pregnancy Childbirth. 2019; 19(1): 258. https://dx.doi.org/10.1186/ s12884-019-2412-6.
  6. Abele H., Starz S., Hoopmann M., Yazdi B., Rall K., Kagan K.O. Idiopathic polyhydramnios and postnatal abnormalities. Fetal Diagn. Ther. 2012; 32(4): 251-5. https://dx.doi.org/10.1159/000338659.
  7. Pasquini L., Seravalli V., Sisti G., Battaglini C., Nepi F., Pelagalli R., Di Tommaso M. Prevalence of a positive TORCH and parvovirus B19 screening in pregnancies complicated by polyhydramnios. Prenat. Diagn. 2016; 36(3): 290-3. https://dx.doi.org/10.1002/pd.4769.
  8. Odibo I.N., Newville T.M., Ounpraseuth S.T., Dixon M., Lutgendorf M.A., Foglia L.M., Magann E.F. Idiopathic polyhydramnios: persistence across gestation and impact on pregnancy outcomes. Eur. J. Obstet. Gynecol. Reprod. Biol. 2016; 199: 175-8. https://dx.doi.org/10.1016/j.ejogrb.2016.02.018.
  9. Wax J.R., Cartin A., Craig W.Y., Pinette M.G. Transient idiopathic polyhydramnios: maternal and perinatal outcomes: maternal and perinatal outcomes. J. Ultrasound Med. 2022; 41(11): 2859-66. https://dx.doi.org/ 10.1002/jum.15974.
  10. Karahanoglu E., Ozdemirci S., Esinler D., Fadıloglu E., Asiltürk S., Kasapoglu T. et al. Intrapartum, postpartum characteristics and early neonatal outcomes of idiopathic polyhydramnios. J. Obstet. Gynaecol. 2016; 36(6): 710-4. https://dx.doi.org/10.3109/01443615.2016.1148126.
  11. Wiegand S.L., Beamon C.J., Chescheir N.C., Stamilio D. Idiopathic polyhydramnios: severity and perinatal morbidity. Am. J. Perinatol. 2016; 33(7): 658-64. https://dx.doi.org/10.1055/s-0036-1571320.
  12. Khazaei S., Jenabi E. The association between polyhydramnios and the risk of placenta abruption: a meta-analysis. J. Matern. Fetal Neonatal Med. 2020; 33(17): 3035-40. https://dx.doi.org/10.1080/14767058.2019.1566898.
  13. Polnaszek B., Liang B., Zhang F., Cahill A.G., Raghuraman N., Young O.M. Idiopathic polyhydramnios and neonatal morbidity at term. Am. J. Perinatol. 2021; Nov 14. https://dx.doi.org/10.1055/s-0041-1739435.
  14. Dashe J.S., Pressman E.K., Hibbard J.U.; Society for Maternal-Fetal Medicine (SMFM). Electronic address: pubs@smfm.org. SMFM Consult Series #46: Evaluation and management of polyhydramnios. Am. J. Obstet. Gynecol. 2018; 219(4): B2-B8. https://dx.doi.org/10.1016/j.ajog.2018.07.016.
  15. Dickinson J.E., Tjioe Y.Y., Jude E., Kirk D., Franke M., Nathan E. Amnioreduction in the management of polyhydramnios complicating singleton pregnancies. Am. J. Obstet. Gynecol. 2014; 211(4): 434.e1-7. https://dx.doi.org/10.1016/j.ajog.2014.05.036.
  16. Harman C.R. Amniotic fluid abnormalities. Semin. Perinatol. 2008; 32(4): 288-94. https://dx.doi.org/10.1053/j.semperi.2008.04.012.
  17. Leung W.C., Jouannic J.M., Hyett J., Rodeck C., Jaunaux E. Procedure-related complications of rapid amniodrainage in the treatment of polyhydramnios. Ultrasound Obstet. Gynecol. 2004; 23(2): 154-8. https://dx.doi.org/10.1002/uog.972.
  18. Pilliod R.A., Page J.M., Burwick R.M., Kaimal A.J., Cheng Y.W., Caughey A.B. The risk of fetal death in nonanomalous pregnancies affected by polyhydramnios. Am. J. Obstet. Gynecol. 2015; 213(3): 410.e1-6. https://dx.doi.org/10.1016/ j.ajog.2015.05.022.
  19. American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice, Society for Maternal-Fetal Medicine. Medically indicated late-preterm and early-term deliveries: ACOG Committee Opinion, Number 831. Obstet. Gynecol. 2021; 138(1): e35-9. https://dx.doi.org/10.1097/AOG.0000000000004447.
  20. Низяева Н.В. Гистологические критерии воспалительных изменений ворсинчатого дерева плаценты. Международный журнал прикладных и фундаментальных исследований. 2018; 2: 202-7. [Nizyaeva N.V. Histological criteria of the inflammatory diseases of the placentаl villus tree. International Journal of Applied and Basic Research. 2018; (2): 202-7. (in Russian)].

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Figure. Dynamics of amniotic fluid volume changes in the patients of the main group

Download (178KB)
Indexing metadata

Copyright (c) 2023 Bionika Media