Pregnancy imposes a considerable physiological stress on the mother-to be, and a number of potential complications can arise. Among these is a failure to form sufficient amniotic fluid, a condition referred to as oligohydramnios. This condition can adversely affect the wellbeing of the foetus and can give rise to a number of complications in late pregnancy.

 

This paper reports the results of a study to investigate the effects of additional fluid therapy in the form of either intravenous or oral hydration therapy on pregnant women with oligohydramnios. Women with oligohydramnios were identified on the basis of an ultrasound scan to determine the amount of amniotic fluid. Two groups were identified: 66 women with oligohydramnios (Group A) and 71 women with normal pregnancies without oligohydramnios (Group B). Women in Group A underwent 6 days of intravenous infusion of 1500 mL of an isotonic solution per day. Group A was randomized into subgroups A1 and A2. Subgroup A1 was prescribed home oral hydration therapy of 1500 mL/d and subgroup A2 2500 mL/d. Measures of amniotic fluid status and other markers were made using ultrasound techniques.

 

The data showed that in pregnancies complicated by isolated oligohydramnios, hydration therapy significantly improved the quantity of amniotic fluid. The questions of whether this had any functional consequences and whether it improved the outcome for the mother or the baby were not assessed in the study. While the results suggest that pregnant women with insufficient amniotic fluid should perhaps be encouraged to increase fluid intake, further study is required before this can become a strong recommendation.

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Abstract   [button text=”View at PubMed” url=”http://www.ncbi.nlm.nih.gov/pubmed/22298867″ target=”_blank” color=”blue”][/button]

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OBJECTIVES:

Amniotic fluid is important for the maintenance of fetal well-being; therefore, an amniotic fluid deficiency, ie, oligohydramnios, can have multiple impacts on the prognosis of the pregnancy. In some cases, there are no evident fetal or maternal causes, and the condition is called isolated oligohydramnios. The aim of our study was to validate maternal intravenous and oral hydration therapy as a means for improvement of isolated oligohydramnios in the third trimester of pregnancy.

METHODS:

We conducted a prospective randomized controlled study on pregnancies complicated by idiopathic oligohydramnios (group A, 66 women) with a control group of women with normal pregnancies without oligohydramnios (group B, 71 women). Oligohydramnios was diagnosed using the amniotic fluid index (AFI; <5 cm). Sonographic examinations were performed with a convex 3.5-MHz probe. Group A underwent 6 days of intravenous infusion of 1500 mL of an isotonic solution per day. An AFI measurement, a nonstress test, and a fetal biophysical profile were performed at 0 and 7 days. Group A was randomized into subgroups A1 and A2. Subgroup A1 was prescribed home oral hydration therapy of 1500 mL/d and subgroup A2 2500 mL/d. We considered the AFI to compare the effectiveness of the therapy.

RESULTS:

General features did not reveal any significant differences between the two groups. In group A, the mean AFI ± SD at recruitment was 39.68 ± 11.11 mm; in group B, it was 126.92 ± 10.59 mm (P < .001). In group A, the mean AFI at 7 days was 77.70 ± 15.03 mm; in group B, it was unchanged. In subgroup A1, the mean AFI at birth was 86.21 ± 16.89 mm; in subgroup A2, it was 112.45 ± 14.92 mm (P < .001).

CONCLUSIONS:

Our data show that in pregnancies complicated by isolated oligohydramnios, hydration therapy significantly improves the quantity of amniotic fluid.

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