Acute oral hydration is a noninvasive, easily accessible and cheap intervention, and an effective way of increasing AFI.

BACKGROUND: For any radiologist, intra-observer agreement in observing and decision making in diagnosis of any disease is of great importance

Oligohydramnios occurs in about 2.3% of pregnancies and is threatening to fetal health. Hydration has been hypothesized to be an effective way of decreasing the occurrence of the condition because the likelihood for oligohydramnios increases with maternal dehydration. Several studies have shown that both serum and oral hydration therapies are effective treatments for oligohydramnios. The amniotic fluid index (AFI) is the most commonly used quantitative indicator of amniotic fluid volume. This randomized controlled clinical trial evaluated the efficacy of acute maternal hydration on increasing AFI in 44 pregnant Iranian women who were diagnosed by sonography to have oligohydramnios (defined as 2.1 Ͻ AFI Ͻ 6 cm). The participants were randomly divided into 2 groups: an intervention group (n ϭ 22) receiving oral hydration (2 liters of water within 2 hours) and a control group (n ϭ 22) receiving routine amounts of water. AFI and urinary specific gravity were measured in both groups at baseline and following intervention.Before treatment, the mean AFI was 50.8 in the intervention group and 52.1 in the control group. After treatment, the mean AFI increased to 67.2 in the intervention group whereas the AFI in the control group (52.5) remained close to the baseline value (P Ͻ 0.001, t test ϭ 3.827). There was a marked increase in the mean urinary specific gravity after treatment (intervention: 13.4 vs. control: 1.68) (P Ͻ 0.001, t test ϭ 3.956).These findings are consistent with previous studies showing that acute oral hydration is an effective, noninvasive, easily accessible and inexpensive treatment to increase AFI. EDITORIAL COMMENT(Whether maternal hydration increases amniotic fluid volume has been evaluated in relatively few randomized studies. The first was performed by Kilpatrick et al. They randomized 40 women who had an AFI of less than 6 cm, but greater than 2 cm to one of 2 groups. The first group was instructed to drink 2 liters of water 2 to 4 hours before a repeat assessment of amniotic fluid volume which was performed either the same day as the initial assessment, or on the following day. Women in the second group were counseled to drink only their usual amount of liquid or just slightly more, and also underwent repeat amniotic fluid volume assessment the same or the following day. The involved sonographers were blinded to treatment group. Compliance with the interventions was reasonable but not perfect. Women in the 2 liters hydration group had a very modest improvement in their AFI, from a mean of 4.8 cm to 6.3 cm, whereas the AFI in the control group went from 4.8 cm to 5.1 cm (Obstet Gynecol 1991;78:1098).Yan-Rosenberg et al evaluated the effect of intravenous hydration on AFI. They randomized 44 women who were in the third trimester with an AFI of less than 6 cm to 2 L of intravenous normal saline, or to 20 mL of 1 ⁄2 normal saline. In both groups, the fluid was administered over 2 hours and a repeat AFI performed by the same sonographer 1 hour after the infusions were completed. In both groups, the ...