Syringe or Continuous Amnioreduction for Symptomatic Polyhydramnios. A Prospective Randomized Study. - Full Text View

Purpose

To compare the efficiency and maternal and fetal tolerance of two techniques of amnioreduction used in cases of symptomatic second and third trimester polyhydramnios: syringe manual aspiration technique (S group) and continuous suction technique (C group) set to – 250 mmHg

Condition	Intervention	Phase
Polyhydramnios	Device: syringe aspiration Device: Wall suction	Phase III

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study

Official Title:	Syringe or Continuous Amnioreduction for Symptomatic Polyhydramnios. A Prospective Randomized Study.

Further study details as provided by Institut National de la Santé Et de la Recherche Médicale, France:

Primary Outcome Measures:

maternal pain (Analogic visual scale)

Secondary Outcome Measures:

Volume of amniotic fluid drained, duration of the drainage, uterine activity,frequency of significative alterations of FHR and histologic evidence of placental abruption.

Estimated Enrollment:	80
Study Start Date:	January 2002
Study Completion Date:	February 2005

Detailed Description:

Polyhydramnios is defined as more than 2 liters of amniotic fluid. Ultrasound diagnosis is made either by measurement of a deepest vertical pocket exceeding 8 cm, or by use of an amniotic fluid index (AFI) exceeding 25 cm. Potential complications of polyhydramnios are preterm labor, premature rupture of membranes, altered utero-placental perfusion, and maternal discomfort.

Amniodrainage has become an established technique to improve maternal comfort and reduce the risks of severe polyhydramnios in both singleton and twin pregnancies, decreasing uterine contractility, as well as over-stretching of membranes and uterus. It also acts on the pathological processes of twin to twin transfusion syndrome.

Several techniques are used to reduce symptomatic polyhydramnios. Passive gravitational drainage is long, does not allow to evacuate larger amounts of amniotic fluid and continuous maternal and fetal monitoring is difficult. The standard syringe technique is often a source of discomfort for both the patient and the operator. Continuous aspiration is faster and limits patient's discomfort.

The aim of this study was to compare the efficiency and maternal and fetal tolerance of these two latter techniques of amnioreduction.

A preliminary study permitted to assess the depression value created at the tip of the needle during amniodrainage: the syringe aspiration technique showed large depression variations from 0 to – 300 millimeters of mercury (mmHg). The continuous wall suction was thus chosen to be set to – 250 mmHg: depression at the needle's tip didn't vary during the procedure.

Eligibility

Ages Eligible for Study:	18 Years to 40 Years
Genders Eligible for Study:	Female
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Pregnant women with abdomen discumfort and ultrasound diagnosis of polyhydramnios (AFI>25cm)
Single or twin pregnancies

Exclusion Criteria:

Multiple pregnancy (more than 3 fetuses)
Maternal history of placental abruptio
Fetus with IUGR
Pregnancy complicated with pre-eclampsia
Unability to give informed consent

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00236340

Locations


France, Centre
	CHU Bretonneau
	Tours, Centre, France, 37000

Sponsors and Collaborators

Institut National de la Santé Et de la Recherche Médicale, France

Investigators


Study Director:	Franck Perrotin, MD PhD	Institut National de la Santé Et de la Recherche Médicale, France

Principal Investigator:	Andrea Wagner, MD	Institut National de la Santé Et de la Recherche Médicale, France

Study Chair:	Gilles Body, MD PhD	CHU Bretonneau TOURS

More Information

Publications:

Leung WC, Jouannic JM, Hyett J, Rodeck C, Jauniaux E. Procedure-related complications of rapid amniodrainage in the treatment of polyhydramnios. Ultrasound Obstet Gynecol. 2004 Feb;23(2):154-8.

Jauniaux E, Holmes A, Hyett J, Yates R, Rodeck C. Rapid and radical amniodrainage in the treatment of severe twin-twin transfusion syndrome. Prenat Diagn. 2001 Jun;21(6):471-6.

Elliott JP, Sawyer AT, Radin TG, Strong RE. Large-volume therapeutic amniocentesis in the treatment of hydramnios. Obstet Gynecol. 1994 Dec;84(6):1025-7.

Dolinger MB, Donnenfeld AE. Therapeutic amniocentesis using a vacuum bottle aspiration system. Obstet Gynecol. 1998 Jan;91(1):143-4.

Study ID Numbers:	AMNIO-2000
First Received:	October 11, 2005
Last Updated:	April 18, 2007
ClinicalTrials.gov Identifier:	NCT00236340
Health Authority:	France: Ministry of Health

Keywords provided by Institut National de la Santé Et de la Recherche Médicale, France:

Amniodrainage

Pregnancy

Amniocentesis

Study placed in the following topic categories:

Pregnancy Complications

Polyhydramnios

ClinicalTrials.gov processed this record on October 10, 2008

Sponsored by:	Institut National de la Santé Et de la Recherche Médicale, France
Information provided by:	Institut National de la Santé Et de la Recherche Médicale, France
ClinicalTrials.gov Identifier:	NCT00236340