Amnioreduction

The procedure is similar to an amniocentesis but on a larger scale.

While an amniocentesis takes only 20ml of fluid for testing, an amnioreduction can remove anywhere from 1 to 3 liters of fluid. We use a vacuum-seal system or a controlled pump to ensure the fluid is removed at a steady pace, preventing sudden changes in pressure that could distress the baby.

Amnioreduction is recommended when:

• The mother is in significant pain or having difficulty breathing due to the size of her belly.
• The uterus is extremely tense, causing 'irritable' contractions that could lead to early labor.
• In cases of Twin-to-Twin Transfusion Syndrome (TTTS), where one twin has a massive amount of fluid.
• When the cause of polyhydramnios cannot be corrected immediately and the pregnancy is still far from term.

Before the procedure, we perform a detailed fluid assessment:

1. Amniotic Fluid Index (AFI): Measuring the fluid in all four quadrants of the uterus.
2. Deepest Vertical Pocket (DVP): A pocket over 8-10cm is usually considered significant.
3. Fetal Anatomy Scan: Checking for any reasons why the baby might not be swallowing correctly (a common cause of extra fluid).

The procedure is performed under local anesthesia in a comfortable setting:

• Continuous Monitoring: We watch the baby's heart rate and movements throughout the process.
• Needle Guidance: A thin needle is guided into a large pocket of fluid away from the baby.
• Controlled Drainage: Fluid is slowly drawn out into specialized containers. This usually takes between 30 and 60 minutes.
• Immediate Relief: Mothers often feel an instant reduction in pressure and find it much easier to breathe before they even leave the procedure room.

The primary outcome is the prolongation of the pregnancy.

• Success: Amnioreduction can often 'buy' an extra 2 to 4 weeks (or more) for the baby to develop.
• Post-Care: After the procedure, we monitor the fluid levels weekly. In some cases, the fluid may re-accumulate, and the procedure might need to be repeated.
• Risks: The risks are low, including a 1% risk of infection or water breaking, which is significantly lower than the risk of spontaneous premature labor if the fluid is left untreated.

If your 'belly is growing too fast' or your doctor has told you the fluid levels are 'off the charts,' you should be evaluated by a Maternal-Fetal Medicine specialist.

At the MFM Unit, Dr. Leanne Bricker and our team provide the gentle care and technical precision required for amnioreductions. We focus on both your comfort and your baby's safety, ensuring that you are supported through this challenging part of your pregnancy.