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Titolo:
Prevention of premature birth by a transabdominal puncture procedure before the birth. Drainage of amniotic sac
Autore:
Strauss, A; Burges, A; Hasbargen, U; Heer, I; Hepp, H;
Indirizzi:
Univ Munich, Klinikum Grosshadern, Klin & Poliklin Frauenheilkunde & Geburtshilfe, D-81377 Munich, Germany Univ Munich Munich Germany D-81377 Geburtshilfe, D-81377 Munich, Germany
Titolo Testata:
GYNAKOLOGE
fascicolo: 11, volume: 32, anno: 1999,
pagine: 823 - 831
SICI:
0017-5994(199911)32:11<823:POPBBA>2.0.ZU;2-K
Fonte:
ISI
Lingua:
GER
Soggetto:
TWIN TRANSFUSION SYNDROME; FLUID VOLUME; THERAPEUTIC AMNIOCENTESIS; ULTRASOUND EVALUATION; INDOMETHACIN THERAPY; PRETERM LABOR; FETAL URINE; POLYHYDRAMNIOS; PRESSURE; OLIGOHYDRAMNIOS;
Keywords:
fetal therapy; ultrasound; polyhydramnios; transabdominal intrauterine needle procedure; amniondrainage;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Strauss, A Univ Munich, Klinikum Grosshadern, Klin & Poliklin Frauenheilkunde & Geburtshilfe, Marchioninistr 15, D-81377 Munich, Germany Univ Munich Marchioninistr 15 Munich Germany D-81377 , Germany
Citazione:
A. Strauss et al., "Prevention of premature birth by a transabdominal puncture procedure before the birth. Drainage of amniotic sac", GYNAKOLOGE, 32(11), 1999, pp. 823-831

Abstract

Amniotic fluid is a major factor of the intrauterine environment, and deviation from the normal volume is associated with an increased perinatal morbidity and mortality. Polyhydramnios occurs in 0.2 to 1.6% of pregnancies. It may be due to a number of congenital anomalies, an abnormal karyotype, maternal diabetes, Rh-disease or intrauterine infections potentially requiring noninvasive or invasive measures. However, the most common indication forprenatal intervention due to polyhydramnios is the Twin-Twin-Transfusion Syndrom (TTTS). Treatment of polyhydramnios may focus on correction of the causative lesion, or symptomatic relief through drainage of amniotic fluid. Maternal administration of cyclooxygenase inhibitors represents a further, non-invasive therapeutic option. Indomethacin, Sulindac, or Nimesulide reduce the fetal urine output thus decreasing amniotic fluid volume over time without the risks associated with invasive procedures. However, potentially serious ductal constriction as well asa delay in the onset of amniotic fluid reduction have limited its application. Percutaneous amniotic fluid drainage may provide immediate reduction of intrauterine pressure, but is associated with a complication rate of 1 to 1.5%. The hemodynamic characteristicsof monochorionic pregnancies complicated by TTTS have led to the development of endoscopic laser coagulation of placental vascular anastomoses as a definitive treatment. Treatment is only required in a small minority of pregnancies pregnancies with polyhydramnios. Mild cases can be managed expectatively. Intrauterine pressure increases with an excessive increase in amniotic fluid Volume (AFI > 400 mm or MVP > 150 mm) leads to the elevation of intrauterine pressure. Complications such as preterm premature rupture of membranes and preterm labor may lead to premature delivery. The main goal of prenatal treatment of polyhydramnios is thus the improvement of fetal outcome through prolongation of gestation and/or the alleviation of maternal symptoms.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 10:29:19