ABSTRACT
Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria. Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al. In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method.
ABSTRACT
Background: The aim of this study is to evaluate the maternal and perinatal outcome in term primigravida with isolated oligohydramnios.Methods: A retrospective, case–control study was carried out in the department of OBG, School of Medical Sciences and Research, Sharda Hospital, Greater Noida from November 2014 to October 2017. The study population comprised of low-risk primigravida with singleton, term pregnancy, with vertex presentation and intact membranes. After meeting the inclusion and exclusion criterion, the study population was divided into cases (n = 51) and control group (176) and the results were analyzed in reference to rate of induction of labour, C. Section rate and the perinatal outcome.Results: Isolated oligohydramnios is associated with increased rate of induction of labour and increased operative interference, but perinatal outcome in terms of mean birth weight, Apgar score at 5 min and NICU admissions for over 24 hours, are not statistically significant in comparison with control group.Conclusions: Isolated oligohydramnios is not an indicator of adverse perinatal outcome.
ABSTRACT
The optimal management in pregnancies complicated isolated oligohydramnios between 34(+0) and 36(+6) weeks of gestation is not established yet. Although previous studies reported that increased risks of adverse perinatal outcomes were observed in pregnancies with oligohydramnios, it is notable that these studies include cases with maternal or fetal complications such as hypertensive disorders or fetal growth restriction. Therefore, it remains unclear that the increased adverse perinatal outcomes from oligohydramnios are caused from oligohydramnios itself or from maternal or fetal complications. Meanwhile, recent evidences demonstrated that neonates born at late preterm are also at increased risks for prematurity related complications such as respiratory distress syndrome, intraventricular hemorrhage, neonatal hypoglycemia, necrotizing enterocolitis and cerebral palsy as well compared with term neonates. With this background, this article was aimed to review recent literatures on the optimal management in pregnancies with isolated oligohydramnios between 34(+0) and 36+6 weeks of gestation and to present the results from survey of obstetricians in our country on this topic.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Pregnancy , Cerebral Palsy , Enterocolitis, Necrotizing , Fetal Development , Hemorrhage , Hypoglycemia , OligohydramniosABSTRACT
El oligohidramnios u oligoamnios es la disminución del líquido amniótico a cifras patológicas con un índice de líquido amniótico (ILA) menor o igual a 5 cm, y constituye un alto riego fetal y secundariamente materno. OBJETIVO: demostrar a través de un ensayo clínico controlado la efectividad de la hidroterapia materna parenteral en oligoamnios aislados, en el aumento del ILA y consecutivamente su repercusión en esos resultados perinatológicos. MÉTODOS: se realizó un ensayo clínico controlado para valorar la efectividad de la hidroterapia materna parenteral (HMP) en gestantes con oligoamnios aislado, de 28 sem o más de embarazo, en el Hospital Ginecoobstétrico Docente de Guanabacoa, entre el 1ro de enero del 2000 y el 31 de diciembre de 2004. La muestra fue de 141 oligoamnios aislados y se dividió en 2 grupos: grupo estudio: 56 y el grupo control: 85. Al grupo estudio se le aplicó HMP con 2000 mL de solución salina isotónica al 0,9 por ciento, y con el grupo control se mantuvo conducta expectante. RESULTADOS: el oligoamnios aislado es más frecuente en el embarazo a término. Al administrar HMP aumenta el ILA en un 43 por ciento (grupo estudio) y solo en un 22 por ciento de los casos del grupo control. Igualmente, se logra aumentar la edad gestacional en 2 sem desde el diagnóstico. Fue mayor el parto transpelviano en el grupo estudio; la principal causa de cesárea fue el sufrimiento fetal agudo en ambos, principalmente en el grupo control. En el grupo estudio no hubo recién nacidos con Síndrome de distress respiratorio ni bronconeumonía congénita. CONCLUSIONES: la HMP parece ser efectiva en el manejo del oligoamnios aislado, lo cual disminuye la morbilidad y mortalidad perinatal y secundariamente el bienestar materno.
Oligohydramnios or oligoamnios is the amniotic fluid decrease to pathological figures with a high amniotic fluid rate (AFR) less or similar to 5 cm, and it is a fetal high risk, and secondarily maternal. OBJECTIVE: To demonstrate through a controlled clinical assay the effectiveness of parenteral maternal hydrotherapy (PMH) in isolated oligoamnios, in increase of AFR, and consecutively its repercussion on those perinatal results. METHODS: We made a controlled clinical assay to assess effectiveness of PHM in pregnants with isolated oligoamnios of 28 weeks or more of pregnancy in Gynecology and Obstetrics Teaching Hospital of Guanabacoa municipality from January 1, 2000 to December 31, 2004. Sample included 141 isolated oligoamnios and it was divided in two groups: study group with 56 patients and control-group with 85 patients. In study group, we administered PHM with 2000 mL of 0,9 percent isotopic saline solution, and in control-group there was an expectant behavior RESULTS: Isolated aligoamnios is more frequent in term pregnancy. Administration of PHM increases AFR in 43 percent (study group), and only in 22 percent of cases from control- group. Likewise, it was possible to increase gestational age in two weeks from diagnosis. In study group, transpelvic pregnancy; main cause of cesarean section was the acute fetal suffering in both groups, mainly in the control one. In study group there were not newborns presenting with neither respiratory syndrome nor congenital bronchopneumonia. CONCLUSIONS: PMH looks to be effective in management o isolated oligoamnios, decreasing perinatal morbidity and mortality, and secondarily, maternal wellbeing.