Oral and Intravenous Maternal Hydration in third trimester Idiopathic Oligohydramnios:Effects and Duration.

Abstract

Objective:To study the effects of oral and intravenous maternal hydration in third trimester idiopathic or isolated oligohydramnios, and to determine the duration of actions. Design: Prospective clinical study. Setting:OB/GYN department, Benha Teaching Hospital, Benha, Egypt.; Patient(s):34 pregnant patients, about 35 weeks gestation, with idiopathic oligohydramnios. Intervention(s):acute oral and intravenous maternal hydration. Main Outcome Measure(s):The current study was conducted on 34 pregnant mothers with amniotic fluid index (AFI) of < 6 cm and gestational age of about 35 weeks. The pregnant women were equally divided into two groups, A and B. Just before starting hydration and for all the participants, amniotic fluid index and urine specific gravity had been measured.Group A, received two liters of water over 2 hours. Group B, received intravenous 2 liters of isotonic saline over 2 hours. Reevaluations of AFI and urine specific gravity in both groups had been made 2 hours after finishing hydration. Then, AFIwas rechecked again every 2 days for a week. Independent t-test and paired t-test were used to compare the two groups and mean AFI before and after treatment, respectively. Result(s):Hydration of mothers, oral or parenteral, significantly increased the AFI. In group A: (mean change: 1.5 cm; percentage 25%; paired t test: 11.77; P<0.001). In group B: (mean change: 2.64±0.9cm; percentage 28%; paired t test: 9.27; P<0.001). There was a decrease in urine specific gravity in both groups. Two days post hydration, 11women (64.7%) from group A and 10 women (58.8%) from group Btheir AFI were <6cm. The maximum duration of actionof acute hydration was about one week. Conclusion(s): Oral hydration is effective as intravenous hydration in significantly increase the AFI in third trimester idiopathic oligohydramnios. Oral hydration is more convenient. It is cheaper, non-invasive and does not need special arrangement.The advantageous effect of maternal hydration is temporary; and oral hydration every two days may be recommended till delivery.