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

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.

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Oral versus intravenous maternal hydration in isolated third trimester oligohydramnios

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20204214 ◽

2020 ◽

Vol 8 (10) ◽

pp. 3449

Author(s):

Humaira Zafar ◽

Mubashra Naz ◽

Umber Fatima ◽

Uzma Shahzad ◽

Anees Fatima ◽

...

Keyword(s):

Amniotic Fluid ◽

P Value ◽

Amniotic Fluid Index ◽

Oral Hydration ◽

Non Invasive ◽

Invasive Method ◽

Intravenous Hydration ◽

Group A ◽

Group B ◽

Hydration Therapy

Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria. Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al. In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method.

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Maternal (oral) hydration increases amniotic fluid volume

Annals of King Edward Medical University ◽

10.21649/akemu.v12i2.893 ◽

2016 ◽

Vol 12 (2) ◽

Author(s):

Aneela Umber

Keyword(s):

Specific Gravity ◽

Amniotic Fluid ◽

Fluid Volume ◽

Urine Specific Gravity ◽

P Value ◽

Percentage Increase ◽

Third Trimester ◽

Amniotic Fluid Index ◽

Oral Hydration ◽

Amniotic Fluid Volume

Objective:To determine the effect of maternal (oral) hydration on amniotic fluid volume in patients with third trimester oligohydramnios. Design: Interventional study. Place and Duration of Study: Department of Obs & Gynae Unit III, Sir Ganga Ram Hospital, Lahore from May 2002 to October 2002. Patients and Methods: Twenty five women with third trimester oligohydramnios (AFI ?5.0cm) and twenty five controls with normal amniotic fluid volume (AFI 8-24 cm) were prospectively recruited for this study. Maternal urine specific gravity and amniotic fluid index were determined before and after maternal hydration by asking them to drink 2 L of water in 2-4 hours before repeat amniotic fluid index and recorded on printed proformas. Results: Hydration increased amniotic fluid volume in women with oligohydramnios (mean change in amniotic fluid index 4.3 cm, 95% confidence interval 4.02 to 5.06; P value <0.001); as well as in women with normal fluid volume (mean change in Amniotic fluid index 2.7 cm, 95% confidence interval 2.23 to 3.21; P value <0.01). However, percentage increase in mean AFI was 58.6% in the oligohydramnios group, which was significantly greater (P value <0.05) than the percentage increase of 28.4% in control group. Hydration was associated with decrease in urine specific gravity in both groups. Conclusion: Maternal (oral) hydration increases AFV in women with oligohydramnios as well as in women with normal AFV and may be beneficial in the management of oligohydramnios.

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EFFECTS OF ORAL FLUIDS AND INTRAVENOUS FLUIDS IN THE IMPROVEMENT OF AMNIOTIC FLUID INDEX DURING THIRD TRIMESTER OF PREGNANCY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i1.2790 ◽

2021 ◽

Vol 71 (1) ◽

pp. 179-83

Author(s):

Mehwish Malik ◽

Samina Irshaad ◽

Nadia Ahmed Bokhari ◽

Wardah Ajaz Qazi ◽

Asia Raza ◽

...

Keyword(s):

Amniotic Fluid ◽

Gestational Age ◽

Sampling Technique ◽

Intravenous Fluids ◽

Third Trimester ◽

Amniotic Fluid Index ◽

Singleton Pregnancy ◽

Oral Fluids ◽

Group A ◽

Group B

Objective: To assess the effects of oral fluids and intravenous fluids in terms of frequency of improving Amniotic Fluid Index during third trimester of pregnancy having oligohydramnios.Study Design: Comparative prospective survey. Place and Duration of Study: Obstetrics and Gynaecological Department of Fauji Foundation HospitalRawalpindi, from Apr 2018 to Oct 2018. Methodology: A total of 100 patients with singleton pregnancy (50 in each group) at gestational age of 28-37weeks and AFI of 5cm or less than 5cm were included. Non probability consecutive sampling technique wasused. Ethics approval from hospital ethical committee and research board was taken. Patients were randomizedinto 2 groups (50 patients each) by lottery method. Group A was instructed to drink 2 liters of water per day fora time period of seven days and patients in group B was given 2 liters of 5% D/W which was in addition to theirnormal fluids intake. Amniotic fluid index was measured pre hydration and post hydration in both groups. Datawas analyzed using SPSS-21. Results: Mean age of the patients was 33.62 ± 5.45 years and 34.70 ± 4.76 years for groups A and B respectively.In group A and group B mean gestational age was 34.28 ± 1.85 weeks vs 34.32 ± 1.82 weeks. In group A, 44 (88%)..............

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

Annals of Punjab Medical College ◽

10.29054/apmc/17.435 ◽

2017 ◽

Vol 11 (3) ◽

pp. 257-260

Author(s):

Alfreed Zafar ◽

Sehrish Maqsood ◽

Ammara Niaz ◽

Shagufta Noor ◽

Naureen Javed

Keyword(s):

Amniotic Fluid ◽

Third Trimester ◽

Amniotic Fluid Index ◽

Oral Hydration ◽

Hydration Therapy

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Correction with oral hydration improves maternal and perinatal outcome in women with third trimester isolated oligohydramnios

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180192 ◽

2018 ◽

Vol 7 (2) ◽

pp. 671

Author(s):

Pragati Aggarwal ◽

Sharda Patra

Keyword(s):

Amniotic Fluid ◽

Perinatal Outcome ◽

Fluid Intake ◽

Fetal Outcome ◽

Third Trimester ◽

Amniotic Fluid Index ◽

Oral Hydration ◽

Significant Difference ◽

Fetal Complications ◽

The Mean

Background: Oligohydramnios is related to serious maternal and fetal complications. In case of isolated oligohydramnios in third trimester maternal oral hydration has shown promising results in improving maternal and perinatal outcome.Methods: This study was conducted on 50 pregnant women complicated by idiopathic oligohydramnios (AFI<5) in third trimester. Their pre hydration daily fluid intake was noted and they were advised to take oral fluids more than their usual intake (according to their convenience). The daily fluid intake and AFI was measured on day1, day2, day3 then weekly till delivery. At delivery maternal and fetal outcome were measured.Results: The mean AFI of the study population at the time of enrolment was 4.25±1.01 and daily mean fluid intake was 1.46±0.41. The post hydration fluid intake per day was significantly high as compared to pre hydration fluid intake (4.40±0.51 litres vs 1.46±0.41 litres, p<0.001). A significant difference in the amniotic fluid index was seen post hydration. The mean AFI on day 1, day 2, day 3 was 6.19±0.93, 7.33±1.13, 8.0±1.07 as compared to pre hydration AFI 4.25±1.01 (p<0.001). The amniotic fluid index post hydration normalized (AFI>8) in 6%, 30%, 61% and 100% of women on day1, day2, day3 and after a week. The perinatal outcome was favourable in all the women with 100% live births and a mean birth weight of 2.77±0.29 kg.Conclusions: A simple correction of maternal dehydration by an adequate and sustained daily oral fluid intake in pregnancies complicated by isolated third oligohydramnios in third trimester significantly improves amniotic fluid index, maternal outcome and perinatal outcome.

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TO STUDY THE CORRELATION BETWEEN PLACENTAL THICKNESS AND AMNIOTIC FLUID INDEX IN THIRD TRIMESTER OF UNCOMPLICATED PREGNANCY IN INDIAN FEMALES

Journal of Anatomical Sciences - Volume 27(2), December 2019 ◽

10.46351/jas.v26i2pp74-77 ◽

2018 ◽

Vol 26 (2) ◽

Author(s):

Mumal Nagwani ◽

P.K. Sharma ◽

Anita Rani ◽

Urmila Singh ◽

Seema Mehrotra

Keyword(s):

Amniotic Fluid ◽

Inverse Correlation ◽

Fluid Volume ◽

Third Trimester ◽

Amniotic Fluid Index ◽

Singleton Pregnancy ◽

Healthy Baby ◽

Uncomplicated Pregnancy ◽

Amniotic Fluid Volume ◽

Placental Thickness

Introduction: Placenta is the most important temporary organ during pregnancy. Healthy placenta is utmost needed for a healthy baby. Ultrasonography is the preferred modality for antenatal evaluation of placenta. Amniotic fluid plays a major role in fetal growth and development and for adequate amniotic fluid volume, a normally developed placenta is required. Thus, Placental parameters may indirectly affect the amniotic fluid volume which plays a crucial role for fetal development. Material & Methods: One hundred (100) antenatal cases were recruited for the present study. Those women who were with uncomplicated, singleton pregnancy of more than 26 weeks and gave their written informed consent, were taken as subjects. Thickness of the placenta was measured at the level of cord insertion. Amniotic Fluid Index (AFI) was obtained by adding the vertical lengths of deepest fluid pockets in four uterine quadrants. Results: The mean placental thickness in third trimester was found as 3.90±1.1cm and mean AFI as 125.20±38.5. Conclusion: A linear but inverse correlation was observed between placental thickness and amniotic fluid index.

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Maternal and fetal outcome in oligohydramnios after 34 weeks of gestation

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184515 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4604

Author(s):

Mahantappa A. Chiniwar ◽

Joe Kaushik M. ◽

Sharada B. Menasinkai

Keyword(s):

Amniotic Fluid ◽

Fetal Outcome ◽

Morbidity And Mortality ◽

Research Centre ◽

Control Group ◽

P Value ◽

Study Group ◽

Perinatal Morbidity ◽

Amniotic Fluid Index ◽

Chi Square

Background: Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. It is a clinical condition characterized by Amniotic Fluid Index (AFI) ≤5 cm by sonographic assessment. The aim of present study is to know the maternal and fetal outcome in oligohydramnios after 34 weeks of gestation compared with women who had normal volume of amniotic fluid.Methods: Study was done for the period of 21 months from November 2014-July 2016 at Adichunchanagiri Institute of Medical Sciences, Hospital and Research Centre Bellur. 50 antenatal cases with > 34 weeks of gestation with AFI ≤5 cm by ultrasonographic estimation were included as study group and 50 women with normal AFI were included as control group. Maternal and fetal outcome of the women with oligohydramnios were analyzed and compared with control group.Results: Results were analyzed statistically using parameters like mean, SD, Chi Sq test, P value. Amniotic fluid was clear in 32% in study and 78% in control group, thin meconium stained in 30% in study group and 14%in control group and was thick meconium stained in 38% in study group and 8% in control group (Chi square =22.31, p<0.0001). Induction of labour was done in 54% in study group and 20% in control group. Cesarean delivery was done in 58% in study group women and 28% in control group women. Regarding the birth weight of babies 62% were < 2.5 kg in study group and 18% in control group with p<0.001. 10% of babies in study group required NICU admission and perinatal mortality was 2%.Conclusions: Due to increased perinatal morbidity and mortality and increased rate of LSCS, timely decision during labour is important to reduce perinatal morbidity and mortality.

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Perinatal outcome of term pregnancies with borderline amniotic fluid index: a prospective case control study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201803 ◽

2020 ◽

Vol 9 (5) ◽

pp. 2047

Author(s):

Devika V. Desai ◽

Nigamananda Mishra ◽

Gayatri V. Savani

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Amniotic Fluid ◽

Perinatal Outcome ◽

Research Centre ◽

P Value ◽

Amniotic Fluid Index ◽

Chi Square ◽

Test Analysis ◽

Chi Square Test

Background: It has been since antiquity that the importance of amniotic fluid and fetal growth with perinatal outcome is being documented. But the lacunae lies in studying the relationship between borderline amniotic fluid and perinatal outcome. The following study was undertaken to provide recent data that would help predict perinatal outcome in borderline AFI pregnancies.Methods: About 144 patients were considered in the study OPD/IPD patients in obstetrics and gynecology department in Bhabha Atomic Research Centre and Hospital, with about 72 cases with borderline amniotic fluid index (5-8 cm) and controls with amniotic fluid index ≥9-25 cm. Patients were selected and subjected to history taking, examination, ultrasound test with doppler studies and perinatal outcome documented over a period of one year.Results: The incidence of borderline AFI in my study was 16%. 58% were primigravidas. Meconium stained liquor was found in 18% cases compared to 7% controls. Low birth weight was found in 12.5% cases and 2.7% in controls. On applying statistical test analysis chi square test, it was found that borderline amniotic fluid index in relation to presence of meconium stained amniotic fluid and low birth weight, p value was found to be statistically significant (<0.05).Conclusions: Borderline amniotic fluid and perinatal outcome had significant relationship in terms of meconium stained liquor and birth weight while rest had no significance. Thus, borderline amniotic fluid patients require vigilant fetal surveillance.

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Perinatal outcome in uncomplicated pregnancies with oligohydramnios

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185426 ◽

2018 ◽

Vol 8 (1) ◽

pp. 215

Author(s):

Snehal Gaware ◽

V. B. Bangal

Keyword(s):

Birth Weight ◽

Amniotic Fluid ◽

Perinatal Outcome ◽

Perinatal Outcomes ◽

Induction Of Labor ◽

P Value ◽

Amniotic Fluid Index ◽

Medical College ◽

Time Of Admission ◽

Singleton Pregnancies

Background: Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. We aimed to assess the perinatal outcomes in pregnancies with oligohydramnios.Methods: The prospective study was conducted in the Department of Obstetrics and Gynecology, Pravara Medical College, Loni in which 200 consecutive singleton pregnancies delivered vaginally, with intact membranes were included. Amniotic fluid index was determined using the Phelan’s technique at the time of admission and women were diagnosed with oligohydramnios if AFI was five or less, which formed the first group and the rest of mother formed the second group. Perinatal outcomes were noted in the proforma as well.Results: Of the 200 mothers included in the study, 38 had AFI ≤ 5. Baseline characteristics was similar in both the groups. Most common antenatal risk factors studies were pregnancy induced hypertension (29% vs 12%; p value <0.05), intrauterine growth restriction (34% vs 10%; p value <0.001) and severe anemia (21% vs 9%; p value <0.05). Proportion of pregnancies needing induction of labor and birth weight less than 2.5 kgs were significantly higher among mothers with oligohydramnios.Conclusions: Authors observed that induction of labor and low birth weight were significantly associated with oligohydramnios. Prospective randomized trials are needed to establish whether early induction of labor in the presence of a oligohydramnios improves perinatal outcome.

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