Abstract
ObjectiveThe aim of this study was to evaluate the hourly fetal urine production rate (HFUPR) via three-dimensional ultrasonography in women with isolated oligohydramnios and compare with normal pregnant women at term.Materials and methodsThis was a prospective observational cohort study of 112 women from 34 to 40 6/7 weeks’ gestation. They were classified into three groups according to the amniotic fluid index (AFI) and ultrasonographic estimated fetal weight (EFW) as isolated oligohydramnios (defined as AFI below 5% and appropriate EFW corresponding to gestational age) (n = 34) and IUGR (defined as EFW below 5% corresponding to gestational age irrespective amniotic fluid) (n = 17), and normal pregnancy (n = 61). HFUPR was measured using three-dimensional virtual organ computer-aided analysis. Adverse perinatal outcomes in all participants were examined.ResultsThere was no significant difference in HFUPR between patients with isolated oligohydramnios and women with normal pregnancies (median, 40.0 mL/h [interquartile range [IQR] 31.0–66.5] vs. 48.6 [31.5–81.2], p = 0.224). HFUPR was significantly decreased in the IUGR group (13.8 mL/h [IQR 10.1–24.8]), compared to the normal pregnancy group (p<0.001) and the isolated oligohydramnios group (p<0.001). HFUPR was significantly decreased in neonates with adverse perinatal outcomes compared to the control (24.7 mL/h [IQR 13.4–47.4] vs. 43.6 [29.8–79.0], p = 0.016).ConclusionHFUPR was not decreased in patients with isolated oligohydramnios but was decreased in patients with IUGR when compared to normal controls at term.
Highlights
Oligohydramnios is associated with uteroplacental insufficiency and fetal compromise and has been a component of fetal wellbeing tests for three decades [1]
There was no significant difference in hourly fetal urine production rate (HFUPR) between patients with isolated oligohydramnios and women with normal pregnancies
HFUPR was significantly decreased in the intrauterine growth restriction (IUGR) group (13.8 mL/h [interquartile range (IQR) 10.1–24.8]), compared to the normal pregnancy group (p
Summary
Oligohydramnios is associated with uteroplacental insufficiency and fetal compromise and has been a component of fetal wellbeing tests for three decades [1]. It is associated with perinatal morbidity and mortality [2, 3] and cesarean delivery due to fetal distress [4]. Adverse perinatal outcomes were generally reported if oligohydramnios was combined with intrauterine growth restriction (IUGR) or if it developed in an earlier gestation [5,6,7] It is usually called isolated oligohydramnios when only the amniotic fluid was decreased at term without any other fetal or maternal abnormality such as IUGR, fetal anomaly, and maternal hypertensive disease. It has been reported that perinatal morbidity of isolated oligohydramnios might be iatrogenic due to labor induction than oligohydramnios itself [12]
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