The impact of hydramnios on pregnancy outcome in twin gestations.

ABSTRACT

OBJECTIVE: To compare pregnancy outcome in twin pregnancies with and without hydramnios. STUDY DESIGN: A database of women receiving outpatient preterm labor surveillance services was studied for the period 1988 to 2002. Included were women with twin gestations under 30 weeks' gestation at start of outpatient services. We compared pregnancy outcomes for twin gestations with hydramnios (n=201) to twin gestations that had normal amniotic fluid volume (n=13,111). RESULTS: Obstetrical and perinatal outcomes in twin pregnancies were adversely affected by the presence of hydramnios. Delivery was shifted to earlier gestations in women with hydramnios (32.8 vs 35.1 weeks, p<0.001), especially under 32 weeks (38.3 vs 12.7%). Perinatal loss was notable in women with hydramnios stillbirths (12.7 vs 1.1%, p<0.001) and neonatal mortality (7.5 vs 1.1%, p<0.001). CONCLUSIONS: Hydramnios in twin gestations negatively impacts gestational age at delivery. The incidence of perinatal mortality is significantly increased in the presence of hydramnios.