Improving management strategy for patients with polyhydramnios
Objective: To evaluate the effectiveness of combination therapy in patients with virus-induced polyhydramnios.Dobrokhotova Yu.E., Borovkova E.I., Belousova T.N., Burdenko M.V., Kulikov I.A., Vdovichenko E.A., Davydova D.S.
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.
Authors’ contributions: Dobrokhotova Yu.E. – development of the study design, obtaining data for analysis; Borovkova E.I. – review of publications on the topic of the article, analysis of the data obtained, writing of the text; Belousova T.N. – development of study design, provision of data for analysis; Burdenko M.V. – analysis of the data obtained, writing of the text; Kulikov I.A., Vdovichenko E.A. – collection of material, analysis of the data obtained; Davydova D.S. – collection of material, analysis of the data obtained, writing of the text.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia.
Patient Consent for Publication: All patients signed an informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Dobrokhotova Yu.E., Borovkova E.I., Belousova T.N.,
Burdenko M.V., Kulikov I.A., Vdovichenko E.A., Davydova D.S.
Improving management strategy for patients with polyhydramnios.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (9): 154-162 (in Russian)
https://dx.doi.org/10.18565/aig.2023.171
Keywords
polyhydramnios
indomethacin
coronavirus infection
intrauterine infection of the fetus
amnioreduction
immunomodulator Superlymph
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Received 17.07.2023
Accepted 07.09.2023
About the Authors
Yulia E. Dobrokhotova, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Medicine, Pirogov Russian National Research Medical University, Ministry of Health of Russia, pr.dobrohotova@mail.ru, https://orcid.org/0000-0002-7830-2290, 117997, Russia, Moscow, Ostrovityanov str., 1.Ekaterina I. Borovkova, Dr. Med. Sci., Associate Professor, Professor, Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University, Ministry of Health of Russia, +7(495)722-63-99, Katyanikitina@mail.ru, https://orcid.org/0000-0001-7140-262X, 117997, Russia, Moscow, Ostrovityanov str., 1.
Tamara N. Belousova, PhD, Chief Physician, Vidnovsky Perinatal Center, beltamara1@mail.ru, https://orcid.org/0000-0003-3804-7691, 142700, Russia, Moscow Region, Vidnoye, Zavodskaya str., 17.
Marina V. Burdenko, PhD, Associate Professor, Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University, Ministry of Health of Russia, +7(495)722-63-99, bmv-0306@rambler.ru, https://orcid.org/0000-0002-0304-4901, 117997, Russia, Moscow, Ostrovityanov str., 1.
Ilyas A. Kulikov, PhD, Head of the Obstetric Department of Pregnancy Pathology, Vidnovsky Perinatal Center, +7(916)752-86-97, aesculap@inbox.ru,
https://orcid.org/0000-0002-2460-1623, 142700, Russia, Moscow Region, Vidnoye, Zavodskaya str., 17.
Elena A. Vdovichenko, obstetrician-gynecologist, Department of Pregnancy Pathology, Vidnovsky Perinatal Center, +7(905)169-10-87, aesculap@inbox.ru, 142700, Russia, Moscow Region, Vidnoe, Zavodskaya, 17.
Daria S. Davydova, Clinical Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Pirogov Russian National Research Medical University, Ministry of Health of Russia, +7(910)304-48-36, dashadavydova1215@gmail.com, https://orcid.org/0000-0002-6598-9310, 117997, Russia, Moscow, Ostrovityanov str., 1.
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