Dynamic thiol/disulphide homeostasis and ischemic modified albumin levels in isolated oligohydramnios.

OBJECTIVE: Oligohydramnios is defined as amniotic fluid index in ultrasonographic measurement is less than 5 percentile according to gestational age, the amniotic fluid volume is ≤ 5 cm, or if the single deepest dial is < 2 cm. The condition of oligohydramnios that not with fetal structural/chromosomal abnormalities, intrauterine growth retardation, intrauterine infection and maternal disease is described as isolated oligohydramnios (IO). The aim of this study is to examine whether oxidative stress and reactive oxygen species (ROS) have a place in the pathophysiology of IO. MATERIALS AND METHODS: In this prospective case-control study, a total of 126 participants were included. The patient group consisted of 65 patients who were diagnosed IO, and the control group consisted of 61 healthy normal pregnants. Native thiol (-SH), total thiol (-SH + -SS), dynamic disulfide (-SS), IMA values from maternal serum were measured and compared between groups. RESULTS: Maternal serum -SH and -SH + -SS values were significantly lower in the IO group than in the control group (409.47 ± 55.36 µmol/L vs. 437.40 ± 48.68 µmol/L, p = 0.03 and 457.40 ± 63.01 µmol/L vs. 484.59 ± 52.75 µmol/L, p = 0.01). In the IO group when -SS/-SH and -SS/-SH + -SS ratio was found to be statistically significantly higher than control group (5.84 ± 1.1 vs 5.41 ± 0.71, p = 0.01 and 5.2 ± 0.88 vs 4.8 ± 0.58, p = 0.01), -SH/-SH + -SS ratio was significantly lower (89.56 ± 1.7 vs 90.24 ± 1.16, p = 0.01). There was no significant difference in terms of -SS value (p = 0.66). IMA value was significantly higher in the IO group than control group (0.76 ± 0.10 ABSU vs 0.68 ± 0.06, p < 0.01). It is seen as a result of ROC analysis that -SH, -SH + -SS, -SS/-SH, -SS/-SH + -SS, -SH/-SH + -SS and IMA values have a diagnostic value for IO (p < 0.05). CONCLUSION: The thiol/disulfide balance shifted towards oxidative stress in IO compared to control group. So oxidative stress and ROS have a place in the pathophysiology of IO.

Two Cases of Amnioinfusion for the Midtrimester Oligohydroamnios / 대한산부인과학회잡지

Reduced amniotic fluid volume generally leads to a poor perinatal outcome, especially when it is observed in the second trimester. The recent obstetric literatures have been reporting on various applications of amnioinfusion in the diagnostic, prophylactic and therapeutic management of oligohydroamnios. We experienced two cases of amnioinfusion, which were used to diagnose or to manage the midtrimester oligohydroamnios and we report them with a brief review.

The Clinical Utility of Amnioinfusion in Oligohydroamnios following PPROM / 대한산부인과학회잡지

OBJECTIVE: This study was performed to evaluate the clinical utility of transabdominal prophylactic amnioinfusion on oligohydroamnios caused by preterm premature rupture of membrane(PPROM). METHODS: There were 59 singleton pregnant women with oligohydroamnios caused by PPROM who were treated by transabdominal amnioinfusion at the department of from March 1997 to December 1998. Nineteen pregnant women who underwent prophylactic amnioinfusion were designated as study group and 40 pregnant women who did not undergo prophylactic amnioinfusion were designated as control group. Clinical data were drawn from medical records, such as time interval from amnioinfusion to deliver, birth weight, incidence of variable deceleration, Apgar score at 1 minute, Apgar score at 5 minutes, and so on. Statistical analyses were performed by means of Student t test, Mann Whitney U-test, Fisher's exact test where appropriate. P value below 0.05 was considered significant. RESULTS: The median interval from amnioinfusion to delivery w as longer in study group than in control group (13.0 29.3 days vs. 5.0 13.0 days, p<0.05). The incidence of variable deceleration during labor in study group was 16% and that in control group was 43%(p<0.05). The incidence of Apgar score at 5 minutes below 7 was lower in study group than that in control group(39% vs. 43%, p<0.05). The incidence of respiratory distress syndrome was lower in study group than that in control group(16% vs. 83%, p=0.05) However, there were no significant difference in the incidence of respiratory distress syndrome between them who did not undergo dexamethasone treatment, in mode of delivery, birth weight, and incidence of chorioamnionitis between two groups. CONCLUSION: Transabdominal prophylactic amnioinfusion may have a positive role in the management of PPROM.