Comparison of effects of oral maternal hydration and intravenous infusions on Amniotic Fluid Index in third trimester isolated Oligohydramnios.

Abstract

Objectives: To compare oral maternal hydration and intravenous infusion in women with third trimester isolated oligohydramnios in terms of mean change in amniotic fluid. Study Design: This is a Comparative Study. Setting: The study was conducted in Department of Gynecology, Pakistan Institute of Medical Sciences, Islamabad. Period: Between 1st May, 2015 to 31st July, 2016. Material & Methods: One hundred and fourteen pregnant females with singleton pregnancy, beyond 28 weeks gestation and AFI < 5cm were included. Placental insufficiency was ruled out on Doppler ultrasound of umbilical artery. Basal AFI and routine intake of fluid of all patients was noted. Patients were randomized either to receive oral maternal hydration or intravenous infusion. AFI measurement was repeated at 6th day after hydration therapy. Data was stratified for mean difference in improvement in amniotic fluid index. Results: One hundred and fourteen patients with mean age of 27.33 ± 3.87 years were included. 52 patients (45.6%) were primigravida and remaining 62 patients (54.4%) were multipara. Mean AFI value before treatment in sampled population was 3.35 ± 0.744 in oral hydration and 3.33 ± 0.787 in intravenous hydration (p=0.903). Mean AFI value after treatment was 5.53 ± 0.966 in oral hydration and 5.68 ± 1.490 in intravenous hydration, independent sample test showed non-significant (p=0.903) difference. Mean increase in AFI before and after treatment was cross tabulated and resultant difference was significant (p value=0.001). There is no effect of age, gestational age, history of oligohydramnios on improvement in amniotic fluid index. Conclusion: Both treatment modalities i.e. oral maternal hydration and intravenous infusion are effective in terms of improvement of amniotic fluid index but there is no difference in both treatments in pregnant females with isolated oligohydramnios in 3rd trimester at current sample size.

Effect of Maternal Intravenous Hydration in Management of Oligohydramnios and The Changes in the Fetal Doppler

“…The typical increase in AFI was 87%±33.5. Kiran et al (17) also reported that the acute maternal IV hydration increased the amniotic fluid volume. Lorzadeh et al (18) found that maternal IV fluid therapy more significantly increased AFI when compared to oral therapy.…”

The Effect of Sildenafil on Pregnancy Outcomes in Pregnant Women with Idiopathic Borderline Oligohydramnios: A Randomized Controlled Trial

“…The mechanism of the AFI change after maternal hydration and its duration is still unclear. Some studies suggest that the fetus can respond to AFI changes after maternal hydration ( 21 ).…”

The effect of maternal intravenous hydration on amniotic fluid index in oligohydramnios

“…According to the results of the present maternal hydration significantly increased AFI in women with oligohydramnios. Kiran et al found acute maternal hydration to increase amniotic fluid volume [ 7 ]. In line with the present study, numerous studies have demonstrated the effectiveness of maternal hydration in treating oligohydramnios [ 8 – 10 ].…”

“…Treatment of oligohydramnios includes hospitalization, specialist consultation, bed rest, oral rehydration and intravenous (I/v) hydration [ 7 ]. The effects of oral and infusion fluid therapies on AFI have been differently reported in literature [ 8 ].…”