Acute maternal hydration in third-trimester oligohydramnios: effects on amniotic fluid volume, uteroplacental perfusion, and fetal blood flow and urine output

Flack, Nicola J., Sepulveda, Waldo, Bower, Sarah and Fisk, Nicholas M. (1995) Acute maternal hydration in third-trimester oligohydramnios: effects on amniotic fluid volume, uteroplacental perfusion, and fetal blood flow and urine output. American Journal of Obstetrics and Gynecology, 173 4: 1186-1191. doi:10.1016/0002-9378(95)91350-5


Author Flack, Nicola J.
Sepulveda, Waldo
Bower, Sarah
Fisk, Nicholas M.
Title Acute maternal hydration in third-trimester oligohydramnios: effects on amniotic fluid volume, uteroplacental perfusion, and fetal blood flow and urine output
Journal name American Journal of Obstetrics and Gynecology   Check publisher's open access policy
ISSN 0002-9378
1097-6868
Publication date 1995-01-01
Sub-type Article (original research)
DOI 10.1016/0002-9378(95)91350-5
Open Access Status Not Open Access
Volume 173
Issue 4
Start page 1186
End page 1191
Total pages 6
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Formatted abstract
Objective: Our purpose was to determine whether acute maternal hydration in pregnancies with third-trimester oligohydramnios (1) increases amniotic fluid index and hourly fetal urine production rate and (2) alters uteroplacental perfusion and fetal blood flow.

Study Design: Ten women with third-trimester oligohydramnios (amniotic fluid index ≤ 5 cm) and 10 controls with normal amniotic fluid volume (amniotic fluid index >7 cm) were prospectively recruited for this study. Maternal plasma and urine osmolality, amniotic fluid index, hourly fetal urine production rate, and Doppler flow velocimetry of maternal uterine artery and fetal umbilical, descending aorta, middle cerebral, and renal arteries were determined before and after oral hydration by having the patient drink 2 L of water over 2 hours.

Results: There was a significant reduction in maternal plasma (p < 0.05) and urine osmolality (p < 0.0001) in both groups after short-term oral hydration. Hydration increased amniotic fluid volume in women with oligohydramnios (mean change in amniotic fluid index 3.2 cm, 95% confidence intervals 1.1 to 5.3; p < 0.02) but not in those with normal amniotic fluid volume (mean change in amniotic fluid index -2.0, 95% confidence intervals -4.1 to +0.2). The hourly fetal urine production rate, however, did not increase in either group (mean change in hourly fetal urine production rate 3.5 ml/hr, 95% confidence intervals -11.7 to +18.7 and -6.8 ml/hr, 95% confidence intervals -2.9 to - 10.7, respectively). Hydration was associated with an increase in uterine artery mean velocity in the oligohydramnios group (mean change in mean velocity 16.7 cm/sec, 95% confidence intervals 8.0 to 25.3; p < 0.008) but not in controls (mean change in mean velocity 1.2 cm/sec, 95% confidence intervals -19.7 to +22.1). There was no change in pulsatility index or in velocity in any of the fetal vessels studied in either group.

Conclusions: Short-term maternal oral hydration increases the amniotic fluid index in women with third-trimester oligohydramnios. Although the mechanism for this effect remains unclear, it could not be accounted for by fetal urination in this study but instead was associated with improved uteroplacental perfusion.
Keyword Oligohydramnios
Amniotic fluid volume
Maternal oral hydration
Color doppler ultrasonography
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Faculty of Health and Behavioural Sciences -- Publications
 
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