Effects of intravenous hydration with hypotonic saline in oligohydramnios

Gopika Senthilvel; Sailatha Ramanujam

doi:10.18203/2320-1770.ijrcog20242068

Authors

Gopika Senthilvel Department of Obstetrics and Gynaecology, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India
Sailatha Ramanujam Department of Obstetrics and Gynaecology, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20242068

Keywords:

Oligohydramnios, AFI, Hypotonic saline, Amniotic fluid

Abstract

Background: The amniotic fluid encloses and protects the fetus within the amniotic cavity in uterus. Amniotic fluid allows room for fetal growth, movement and development. The abnormal amniotic fluid either high or low volumes helps to diagnose the reduced fetal outcomes. This fluid is an important predictive tool for assessing the development of pregnancy.

Methods: The present study is done to assess the effectiveness of intravenous (IV) hypotonic saline fluid maternal hydration on oligohydramnios. This study was conducted in department of obstetrics and gynecology, CHRI for 18 months. About 30 participants of third trimester with amniotic fluid index (AFI)<8 cm with the gestational age of 34-40 weeks were included. The study was done on pregnant mothers with AFI<8 cm and gestational age of 34-40 weeks. Measurement of AFI was done for all participants. The patients received 2 liters of hypotonic saline fluid over 4 hours. AFI was measured again 24 hours after baseline measurement. Treatment with IV infusion of hypotonic saline fluid is resulted in better increase in AFI in oligohydramnios.

Results: After hypotonic saline infusion, the patient’s AFI level was 7.14±1.31 with the p=0.000*** and it was statistically significant.

Conclusions: The blood parameters and the electrolytes showed no notable changes before and after the infusion of hypotonic saline with regular antenatal visits, oligohydramnios can be detected early by clinical examination and routine ultrasonography and the proper treatment will help in preventing the complications of oligohydramnios.

Metrics

Metrics Loading ...

References

Mckinne ES, James SR, Murray SH, Ashwil J. Maternal-Child Nursing. 3rd ed. Philadelphia: Elsevier Health Sciences; 2008:245-322.

Cunningham FG, Williams JW, Leveno KJ, Bloom S, Hauth JC. Williams Obstetrics. 23rd ed. New York: McGraw-Hill Medical; 2009:495.

Gibbs RS, Danforth DN, Karlan BY, Haney AF. Danforth's Obstetrics and Gynecology. 10th ed. New York: Lippincott Williams and Wilkins; 2008:142.

Calhoun S. Focus on fluids. Examining maternal hydration and amniotic fluid volume. AWHONN Lifelines. 1999;3(6):20-4.

Magann EF, Doherty DA, Chauhan SP, Barrilleaux SP, Verity LA, Martin JN Jr. Effect of maternal hydration on amniotic fluid volume. Obstet Gynecol. 2003;101(6):1261-5.

Doi S, Osada H, Seki K, Sekiya S. Effect of maternal hydration on oligohydramnios: a comparison of three volume expansion methods. Obstet Gynecol. 1998;92(4-1):525-9.

Flack NJ, Sepulveda W, Bower S, Fisk NM. Acute maternal hydration in third -trimester oligohydramnios: effects on amniotic fluid volume, uteroplacental perfusion, and fetal blood flow and urine output. Am J Obstet Gynecol. 1995;173(4):1186-91.

Shahnazi M, Meli MS, Hamoony F, Sadrimehr F, Samani FG, Koshavar H. The effects of intravenous hydration on amniotic fluid volume and pregnancy outcomes in women with term pregnancy and oligohydramnios: A randomized controlled trial. J Caring Sci. 2012;1(3):123-8.

Leeman L, Almond D. Isolated oligohydramnios at term: is induction indicated? J Fam Pract. 2005;54(1):25-32.

Ghosh R, Oza H, Padhiyar B. Maternal and foetal outcome in oligohydramnios: study from tertiary care hospital, Ahmedabad, India. Int J Reprod Contracept Obstet Gynecol. 2018;7(3):907-10.

Shinde A, Kamlesh C, Deepika D, Deepti S. Effect of Amino Acid Infusion on Amniotic Fluid Index in Pregnancies Associated with Oligohydramnios and Fetal Growth Restriction. Cureus. 2023;15(5):e39027.

Doi S, Osada H, Seki K, Sekiya S. Effect of maternal hydration on oligohydramnios: a comparison of three volume expansion methods. Obstet Gynecol. 1998;92(4 Pt 1):525-9.

Flack NJ, Sepulveda W, Bower S, Fisk NM. Acute maternal hydration in third-trimester oligohydramnios: effects on amniotic fluid volume, uteroplacental perfusion, and fetal blood flow and urine output. Am J Obstet Gynecol. 1995;173(4):1186-91.

Kilpatrick SJ, Safford KL. Maternal hydration increases amniotic fluid index in women with normal amniotic fluid. Obstet Gynecol. 1993;81(1):49-52.