An Update on Maternal Hydration Strategies for Amniotic Fluid Improvement in Isolated Oligohydramnios and Normohydramnios: Evidence from a Systematic Review of Literature and Meta-Analysis

Gizzo, Salvatore; Noventa, Marco; Vitagliano, Amerigo; Dall’Asta, A.; D’Antona, Donato; Aldrich, C. J.; Quaranta, Michela; Frusca, T.; Patrelli, Tito Silvio

doi:10.1371/journal.pone.0144334

Cited by 34 publications

(31 citation statements)

References 42 publications

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“…11 Another study conducted in 2015 by Salvatore Gizzo was also favoring our results. 7 The hypothesis of the study that "maternal oral hydration is better than routine hydration in terms of mean amniotic fluid index in third trimester oligohydramnios" is justified.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Mean Amniotic Fluid Index in Maternal Oral Hydration Therapy with Routine Hydration in Third Trimester Oligohydramnios

Zafar¹,

Maqsood²,

Niaz³

et al. 2017

APMC

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Objective: The objective of the study was to compare mean Amniotic Fluid Index (AFI) in maternal oral hydration with routine hydration in third trimester oligohydramnios. Study design: Randomized control trial. Settings: Department of Gynea/Obs Faisalabad Medical University, Faisalabad. Duration of study: 6 months from 1 st June to 30 th November 2016. Methodology: A total of 80 cases (40 in each group), were included in the study, Group A was oral hydration group and was enquired about daily water intake. They are bound to take 2 liters of water in addition to their daily intake for 7 days. Group B was routine hydration group and continued to drink water determined by thirst and followed up on OPD basis according to the hospital protocol. Ultrasonography was done by radiology department and reported by radiologist after completion of 7 days and revised amniotic fluid index was noted. All the information was recorded on proforma. Results: In this study, (40 in each group), 65%(n=26) in Group-A and 57.5%(n=23) in Group-B were between 18-30 years and 35%(n=14) in Group-A and 42.5%(n=17) in Group-B were between 31-45 years of age, mean+sd was calculated as 27.88+5.40 years and 28.80+5.72 years respectively, pre-treatment mean AFI volume was in-significant between the two groups. Post-treatment mean AFI volume was recorded as 6.83+0.81 in Group-A and 5.05+0.75 in Group-B, p value was calculated as 0.001 which shows significant difference between the two groups. Conclusion: We concluded that oral hydration appears to be significantly increased in mean AFI as compare to routine hydration in third trimester oligohydramnios, this therapy can be used instead of expectant management or invasive techniques in patients of third trimester oligohydramnios.

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Section: Resultsmentioning

confidence: 99%

Comparison of Mean Amniotic Fluid Index in Maternal Oral Hydration Therapy with Routine Hydration in Third Trimester Oligohydramnios

Zafar¹,

Maqsood²,

Niaz³

et al. 2017

APMC

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“…Some studies from high income countries suggest that treating some cases of oligohydramnios may improve certain outcomes [13,14,23], but whether interventions such as amnioinfusion or early delivery or delivery by cesarean section would achieve similar results in LMICs is unknown [24,25]. The overall trial showed no benefit of ultrasound for any important outcome including maternal death or near- P-value from a logistic regression model for at least one oligohydramnios finding adjusting for site and maternal characteristics using general estimating equations to account for the correlation of outcomes within cluster miss maternal mortality, stillbirth and neonatal mortality [19].…”

Section: Discussionmentioning

confidence: 99%

Oligohydramnios: a prospective study of fetal, neonatal and maternal outcomes in low-middle income countries

et al. 2020

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Background: Oligohydramnios is a condition of abnormally low amniotic fluid volume that has been associated with poor pregnancy outcomes. To date, the prevalence of this condition and its outcomes has not been well described in low and low-middle income countries (LMIC) where ultrasound use to diagnose this condition in pregnancy is limited. As part of a prospective trial of ultrasound at antenatal care in LMICs, we sought to evaluate the incidence of and the adverse maternal, fetal and neonatal outcomes associated with oligohydramnios. Methods: We included data in this report from all pregnant women in community settings in Guatemala, Pakistan, Zambia and the Democratic Republic of Congo (DRC) who received a third trimester ultrasound as part of the First Look Study, a randomized trial to assess the value of ultrasound at antenatal care. Using these data, we conducted a planned secondary analysis to compare pregnancy outcomes of women with to those without oligohydramnios. Oligohydramnios was defined as measurement of an Amniotic Fluid Index less than 5 cm in at least one ultrasound in the third trimester. The outcomes assessed included maternal morbidity and fetal and neonatal mortality, preterm birth and low-birthweight. We used pairwise site comparisons with Tukey-Kramer adjustment and multivariable logistic models using general estimating equations to account for the correlation of outcomes within cluster.Results: Of 12,940 women enrolled in the clusters in Guatemala, Pakistan, Zambia and the DRC in the First Look Study who had a third trimester ultrasound examination, 87 women were diagnosed with oligohydramnios, equivalent to 0.7% of those studied. Prevalence of detected oligohydramnios varied among study sites; from the lowest of 0.2% in Zambia and the DRC to the highest of 1.5% in Pakistan. Women diagnosed with oligohydramnios had higher rates of hemorrhage, fetal malposition, and cesarean delivery than women without oligohydramnios. We also found unfavorable fetal and neonatal outcomes associated with oligohydramnios including stillbirths (OR 5.16, 95%CI 2.07, 12.85), neonatal deaths < 28 days (OR 3.18, 95% CI 1.18, 8.57), low birth weight (OR 2.10, 95% CI 1.44, 3.07) and preterm births (OR 2.73, 95%CI 1.76, 4.23). The mean birth weight was 162 g less (95% CI -288.6, − 35.9) with oligohydramnios. Conclusions:Oligohydramnos was associated with worse neonatal, fetal and maternal outcomes in LMIC. Further research is needed to assess effective interventions to diagnose and ultimately to reduce poor outcomes in these settings.Trial registration: NCT01990625.

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“…However, a recent meta-analysis has suggested that IO in low-risk pregnancy was associated with adverse outcomes such as neonatal intensive care unit (NICU) admission, cesarean delivery, and meconium aspiration syndrome [ 7 ]. A systematic review and meta-analysis suggested that oral or intravenous maternal hydration improves amniotic fluid volume; however, further evaluation of its clinical application is required [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Management of isolated oligohydramnios in Korea: a questionnaire-based study of clinical practice patterns among the members of the Korean Society of Maternal Fetal Medicine

et al. 2020

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Objective The aim of this survey was to investigate the recommendations and clinical practice patterns of the Korean Society of Maternal and Fetal Medicine (KSMFM) members, regarding management of isolated oligohydramnios (IO). Methods From December 2018 to February 2019, questionnaires were e-mailed to the KSMFM members at 257 institutes that are listed by the Korean Statistical Information Services (KOSIS) as suitable labor premises. Responses to the seven questions on the management of IO, from diagnosis to treatment, were evaluated. Results A total of 72 KSMFM members responded to this survey. Nearly all participants (90.1%) used the amniotic fluid index (AFI) as the primary method for estimating amniotic fluid volume. The majority of the participants (73.6%) believed that IO was a risk factor for adverse pregnancy outcomes, including abnormal fetal heart rate (73.6%), need for cesarean delivery (58.3%), intrauterine fetal demise (52.8%), and meconium aspiration syndrome (50%). Almost 70% of the participants believed that induction of labor might decrease perinatal morbidities, and that late-preterm to early-term period (36–38 gestational weeks) was a suitable timeframe for delivery, if the fetus was sufficiently grown and antenatal testing revealed reassuring results. Less than half of the participants (47.2%) believed that maternal oral or intravenous hydration was a useful intervention for IO management. Conclusions KSMFM members preferred labor induction at late-preterm to early-term, to decrease perinatal morbidity in cases of IO, although it was still uncertain whether labor induction improved the outcomes. Further prospective studies are needed regarding IO management.

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An Update on Maternal Hydration Strategies for Amniotic Fluid Improvement in Isolated Oligohydramnios and Normohydramnios: Evidence from a Systematic Review of Literature and Meta-Analysis

Cited by 34 publications

References 42 publications

Comparison of Mean Amniotic Fluid Index in Maternal Oral Hydration Therapy with Routine Hydration in Third Trimester Oligohydramnios

Comparison of Mean Amniotic Fluid Index in Maternal Oral Hydration Therapy with Routine Hydration in Third Trimester Oligohydramnios

Oligohydramnios: a prospective study of fetal, neonatal and maternal outcomes in low-middle income countries

Management of isolated oligohydramnios in Korea: a questionnaire-based study of clinical practice patterns among the members of the Korean Society of Maternal Fetal Medicine

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