Changes in Amniotic Fluid Index after Maternal Oral Hydration in Pregnancies with Fetal Gastroschisis: Initial Observations

Abstract

Objective: To evaluate the effect of maternal oral hydration on amniotic fluid index (AFI) in pregnancies with fetal gastroschisis. Methods: AFI was evaluated at 24-hour intervals, during 4 consecutive days, under a continuous maternal oral water hydration regimen, in singleton pregnancies with isolated fetal gastroschisis. Results: Nine pregnancies were examined at a mean gestational age of 31.6 weeks (±1.4) and mean maternal daily oral water intake was 3,437 (±810) ml. Mean AFI on days 0–3 were 13.2 (±2.9), 14.8 (±3.3), 14.5 (±3.1) and 14.8 (±2.6), respectively. AFI on day 0 was significantly lower compared to all the other 3 days (p = 0.01 and 0.02). Significant correlation was found in relative difference in AFI between day 0 and day 1 and gestational age (r = –0.67, p = 0.05) and the amount of water intake in the previous 24 h (r = 0.76, p = 0.02). Conclusion: Maternal oral water hydration significantly increases AFI in pregnancies with isolated fetal gastroschisis.

Abdominal wall defects: Prenatal diagnosis, newborn management, and long-term outcomes

“…A simple and innocuous method to correct the tendency to oligohydramnios seems to be the maternal oral hydration. 43 It has been suggested, indeed, that a glass of water per hour while awake would significantly increase the amount of amniotic fluid.…”

Effects of the Maternal Position and Rest on the Fetal Urine Production Rate

“…Conflict between a study conducted by Yan‐Rosenberg et al 15 and previous studies led us to design this study. Previous studies showed the beneficial effect of maternal hydration in pregnancies with normal and decreased amniotic fluid volumes 6 – 12 , 19 – 24 . Yan‐Rosenberg et al 15 found that hydration increased the amniotic fluid index, as did the authors of the other studies.…”

“…Several studies have been conducted to support the use of oral or intravenous maternal hydration to increase the amount of amniotic fluid, with the research being performed under a variety of clinical scenarios, including normal pregnant volunteers, maternal hypovolemia, third‐trimester oligohydramnios, preterm rupture of membranes, and pregnancies complicated by anomalies such as gastroschisis 6 – 12 . The authors of those studies found an increased amniotic fluid index after hydration treatment.…”

Fetal Growth Pattern and Prediction of Low Birth Weight in Gastroschisis

“…Detailed fetal anomaly and echocardiography scans were performed to confirm the abnormality and investigate associated malformations. Follow-up scans were scheduled to reevaluate the abdominal wall defect, bowel aspect, fetal growth, amniotic fluid volume and fetal well-being [3,10]. At each visit, fetal biparietal diameter, occipitofrontal diameter, head circumference (HC) and AC as well as femur length (FL) measurements were obtained according to standard techniques [11] and recorded in a computer database.…”