DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20171538

Effect of hydration therapy on oligohydramnios

Cicily T. J., Sherin Sams, Anitha K. Gopal

Abstract


Background: Oligamnios is defined as an AFI <5cm, SDP <2cms or an AFI below the 5th centile for the gestational age and is associated with many maternal and perinatal complications. An effective, non-invasive method of increasing AFV is the hydration therapy. The objective of present study was to determine the impact of hydration therapy in patients complicated by oligamnios and to measure the maternal and perinatal outcome in oligamnios corrected by Intravenous hydration therapy.

Methods: It is a randomised control trial done at Government Medical College, Kottayam, Kerala, India from Jan 2012 to May 2013. 136 singleton pregnant females with gestation age >34 weeks with AFI <5 cms were randomised into an Intervention group who receive 1 litre of ringer lactate i.v given daily for 5 days and nonintervention group who were kept under observation by serial ultrasound and antepartum fetal surveillance. All were followed-up till delivery to obtain maternal and perinatal outcomes.

Results: Among the 68 who were given intervention, 61 responded and 7 were non responders. With hydration therapy, mean increase in AFI was 4 cm and minimum duration needed for improvement was one week. Hydration therapy showed significant improvement in the maternal and fetal outcomes. Intravenous route of maternal hydration has the advantage that a fixed amount of fluid can be infused at a relatively constant rate with ensured compliance.

Conclusions: From the study, it was concluded that Hydration therapy is an excellent method to improve AFI in Oligohydramnios and maternal and perinatal outcome.


Keywords


Amniotic Fluid, Amniotic Fluid Index, Fetal growth retardation, Hydration therapy, Oligohydramnios

Full Text:

PDF

References


Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstap LC, Wenstrom KD. Fetal growth and development. In: Cunningham FG, Leveno KL, Bloom SL et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 4.

Ross MG, Brace R. Amniotic fluid biology- basic and clinical aspects. J Matern Fetal Med. 2001;10:2-19.

Larmon JE, Ross BS. Clinical utility of amniotic fluid volume assessment. Obstet Gynecol Clin North Am. 1998; 25:639-61.

Magann EF, Sanderson M, Martin JN Jr, Chauhan SP. The amniotic fluid index, single deepest pocket, and two-diameter pocket in normal human pregnancy. Am J Obstet Gynecol. 2000;182:1581-8.

Magann EF, Nolan TE, Hess LW, Martin RW, Whitworth NS, Morrison JC. Measurement of amniotic fluid volume: Accuracy of ultrasonography techniques. Am J Obstet Gynecol. 1992;167:1533-7.

Voxman EG, Tran S, Wing DA. Low amniotic fluid index as a predictor of adverse perinatal outcome. J Perinatol. 2002;22:282-5.

Phelan JP, Ahn MO, Smith CV, Rutherford SE, Ander-son E. Amniotic fluid index measurements during preg-nancy. J Reprod Med. 1987;32:601-4.

Manning FA, Harman CR, Morrison I, Menticoglou SM, Lange IR, Johnston JM. Fetal assessment based on fetal biophysical profile scoring IV. An analysis of perinatal morbidity and mortality. Am J Obstet Gynecol. 1990;162:703-9.

Lotgering FK, Wallenburg HCS. Mechanisms of production and clearance of amniotic fluid. Semin Perinatol. 1986;10:94.

Lisa A, Martin, James N. Effect of maternal hydration on amniotic fluid volume. Jr MD Obstet Gynecol. 2003;101(6):1261-5.

Magann EHF, Chauhan SP, Martin JN. Oligohydramnios at term and pregnancy outcome. Fetal Mater Medic Rev. 2001;12(3):209-27.

Ott WJ. Reevaluation of the relationship between amniotic fluid vol and perinatal outcome. Am J Obstet Gynecol. 2005;192:1803-09.

Golan A, Lin G, Evron S. Oligohydramnios: maternal complications and fetal outcome in 145 cases. Gynecol Obstet Invest. 1994;37:91-5.

Grubb DK, Paul RH. Amniotic fluid index and prolonged antepartum fetal heart rate decelerations. Obstet Gynecol. 1992;79:558-60.

Manning FA, Hill LM, Platt LD. Qualitative oligohydramnios: clinical association and predictive value for amniotic fluid volume determination by ultrasound: antepartum detection of intrauterine growth retardation. Am J Obstet Gynecol. 1981;139:254-8.

Sultana S, Akbar Khan MN, Khanum Akhtar KA, Aslam M. Low amniotic fluid index in high risk pregnancy and poor Apgar score at birth. J Coll Physicians Surg Pak. 2008;18(10):630-4.

Casey BM, McIntire DD, Bloom SL, Lucas MJ, Santos R, Twickler DM et al. Pregnancy outcomes after ante partum diagnosis of oligohydramnios at or beyond 34 weeks’ of gestation. Am J Obstet Gynecol. 2000;182:909-12.

Kawasaki N, Nishimura H, Yoshimura T, Okamura H. A diminished intrapartum amniotic fluid index is a predictive marker of possible adverse neonatal outcome when associated with prolonged labour. Gynecol Obstet Invest. 2002;53:1-5.

Gülmezoglu AM1, Hofmeyr GJ. Bed rest in hospital for suspected impaired fetal growth. Cochrane Database Syst Rev. 2000;(2):CD000034.

Ahmad JK. Intravenous amino acid therapy in Oligohydramnios; Practitioner. 2006;13(3):140-1.

Ross MG, Cedars L, Nijland MJM, Ogundipe A. Treatment of oligohydramnios with maternal 1-deamino-[8-D-arginine] vasopressin-induced plasma hypoosmolality. Am J Obstet Gynecol. 1996;174:1608-13.

Gramellini D, Fieni S, Kaihura C, Piantelli G, Verrotti C. Antepartum amnioinfusion: a review. J Mater Fetal Neonat Medic. 2003;14:291-6.

Suzuki S, Mine K, Sawa R, Yoneyama Y Araki T. 10% maltose infusion therapy for oligohydramnios. Australian New Zealand J Obstet Gynaecol.1991;39:373-5.

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.

Egan JFX. Maternal hydration and its effect on the amniotic fluid index [abstract]. Am J Obstet Gynecol. 1996;174(1 Pt 2):416.

Hofmeyr GJ, Gulmezoglu AM. Maternal hydration for increasing amniotic fluid volume in oligohydramnios and normal amniotic fluid volume. Cochrane Database Syst Rev. 2002;(1):CD 000134.

Battaglia F, Prystowsky H, Smisson C, Hellegers A, Bruns P. Fetal blood studies. XIII. The effect of the administration of fluids intravenously to mothers upon the concentrations of water and electrolytes in plasma of human fetuses. Pediatr. 1960;25:2-10.

Oosterhof H, Hack MC, Aamoudse JG. Acute maternal rehydration increases the urine production rate in the near-term human fetus; Am J Obstet Gynecol. 2000;183(1):226-9.

Flack NJ, Sepulveda W, 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;173:1186-91.

White SA, Goldhill DR. Is Hartmann's the solution?. Anaesthesia. 1997;52(5):422-7.

Doi S, Osada H, Itoh K, Ikeda K, Sekiya S, Takehisa T. Effect of maternal hydration on oligohydramnios: a comparison of three volume expansion methods [abstract]. Am J Obstet Gynecol. 1998;178:S156.

Flack NJ, Sepulveda W, 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;173:1186-91.

Chandra PC, Schiavello HJ, Lewandowski MA. Effect of oral and intravenous hydration on oligohydramnios. J Reprod Med. 2000;45:337-40

Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24(2):266-8.

Royal College of Obstetricians and Gynaecologists; RCOG clinical effectiveness support unit. induction of labour. Evidence-based Clinical. London: RCOG Guideline. 2001;9.