Effect of maternal hydration on the increase of amniotic fluid index

V.T.M Borges,J.F Abbade,J.C Peraçoli,J Rososchansky,M.V.C Rudge,A Dias

doi:10.1590/s0100-879x2011007500009

V.T.M Borges, J.F Abbade + Show 4 more

Open Access

https://doi.org/10.1590/s0100-879x2011007500009

Copy DOI

Abstract

The objective of this study was to determine the effect of maternal hydration with oral isotonic solution and water on the amniotic fluid (AF) index of women with normohydramnios. Women with a normal AF index and gestational age between 33 and 36 weeks without maternal complications were randomized into three groups [isotonic solution (Gatorade(®)), water, control]. The isotonic solution and water groups were instructed to drink 1.5 L of the respective solution and the control group was instructed to drink 200 mL water over a period of 2 to 4 h. AF index was measured before and after hydration by Doppler ultrasonography. The investigator performing the AF index measurement was blind to the subject's group. Ninety-nine women completed the study without any adverse maternal effects. The median increase in AF index after hydration was significantly greater for the isotonic solution and water groups than for the control group. There was no significant difference between the isotonic solution and water groups. Hydration with isotonic solution and water caused a 10-fold (95%CI: 2.09-49.89) and 6-fold (95%CI: 1.16-30.95) increase in the chance of a 20% increase of AF index, respectively. Maternal hydration with isotonic solution or water increased the AF index in women with normohydramnios.

Highlights

Adequate amniotic fluid (AF) volume is considered to be important for fetal well-being [1,2]
The determination of an association between oligohydamnios and poor fetal outcome requires the investigation of the factors involved in the maintenance of AF volume, and maternal hydration, among these, seems to play a relevant role [3]
An investigator who had not determined the AF index randomized each subject to the isotonic group (Gatorade®; N = 34), water group (N = 30) or control group (N = 35) using opaque envelope selection

Summary

Introduction

Adequate amniotic fluid (AF) volume is considered to be important for fetal well-being [1,2]. The determination of an association between oligohydamnios and poor fetal outcome requires the investigation of the factors involved in the maintenance of AF volume, and maternal hydration, among these, seems to play a relevant role [3]. Maternal hydration has been the focus of studies in women with oligohydramnios. Kilpatrick et al [2] and Kilpatrick and Safford [4] reported that maternal water hydration increased the AF index both in pregnancies with oligohydramnios and in those with a normal AF index [4]. An alternative route of maternal hydration is intravenous fluid loading. Dói et al [5] compared the effects of maternal hydration with oral water, intravenous hypotonic fluid and isotonic fluid on AF volume in women with oligohydramnios and found an increase of AF index only in the hypotonic fluid and water groups

Objectives

Methods

Results

Conclusion