Amniotic fluid volume and pregnancy outcomes in twin pregnancies: A systematic review and meta-analysis.

Autor: Whitcombe D; Department of Obstetrics & Gynecology University of Arkansas for Medical Sciences Little Rock Arkansas USA., Magann E; Department of Obstetrics & Gynecology University of Arkansas for Medical Sciences Little Rock Arkansas USA., Steelman S; Department of Library Sciences University of Arkansas for Medical Sciences Little Rock Arkansas USA., Hu Z; Department of Biostatistics University of Arkansas for Medical Sciences Little Rock Arkansas USA., Ounpraseuth S; Department of Biostatistics University of Arkansas for Medical Sciences Little Rock Arkansas USA.
Jazyk: angličtina
Zdroj: Australasian journal of ultrasound in medicine [Australas J Ultrasound Med] 2023 Sep 04; Vol. 26 (4), pp. 249-257. Date of Electronic Publication: 2023 Sep 04 (Print Publication: 2023).
DOI: 10.1002/ajum.12361
Abstrakt: Objective: To analyse amniotic fluid volume (AFV), specifically oligohydramnios or polyhydramnios, and associated pregnancy and neonatal outcomes in twin gestations through systematic review and meta-analysis.
Methods: We utilised systematic review methodology to identify items within published and grey literature resources. Prospective and retrospective studies with a control group were included. Inclusion criteria were as follows: studies in English, twin pregnancy in which AFVs and associated pregnancy and/or neonatal outcomes were evaluated. Exclusion criteria included the presence of an anomalous fetus, chromosome abnormality, monochorionic diamniotic twin pregnancy complicated by twin-twin transfusion syndrome or twin-reversed arterial perfusion, twin gestations undergoing therapeutic interventions ( i.e. fetoscopic laser photocoagulation and serial amniocentesis) and monochorionic monoamniotic twin pregnancy.
Results: The literature search identified 1068 abstracts, only four met criteria for inclusion and analysis. The pooled data (two studies per outcome) revealed no significant difference in rate of pre-term delivery (OR: 2.94; CI: 0.20-43.81), pre-term delivery less than 32 weeks (OR: 1.97; CI: 0.43-9.12), umbilical cord pH < 7 (OR: 2.66; CI: 0.22-32.51), rate of stillbirth (OR: 4.13; CI: 0.40-42.70), neonatal death (OR: 1.48; CI: 0.05-43.94), rate of NICU admission (OR: 1.38; CI: 0.61-3.11) or rate of small-for-gestational-age (SGA) infants (OR: 1.39; CI: 0.33-5.94).
Conclusion: Based on the pooled data (two studies per outcome), there was no difference in the fate of pre-term delivery, umbilical cord pH < 7, stillbirth, neonatal death or SGA infants. What is disturbing is the lack of studies (1946-2020) that analysed the association between AFV and pregnancy outcomes in twin pregnancies.
Competing Interests: The authors report no conflict of interest related to this work.
(© 2023 Australasian Society for Ultrasound in Medicine.)
Databáze: MEDLINE
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