S Doi1, H Osada, K Seki, S Sekiya. 1. Department of Obstetrics and Gynecology, Chiba University School of Medicine, Chiba City, Japan. dois@ho.chiba-u.ac.jp
Abstract
OBJECTIVE: To determine the effect of maternal hydration with intravenous (i.v.) isotonic fluid, i.v. hypotonic fluid, and oral water on amniotic fluid index (AFI) in women with oligohydramnios. METHODS:Patients with low AFI and gestational age over 35 weeks without maternal complications were randomized into four groups (2 L/2 h i.v. isotonic fluid, 2 L/2 h i.v. hypotonic fluid, 2 L/2 h oral water, control). Maternal plasma osmolality, AFI, hematocrit, and hemoglobin concentration were measured before and after hydration. RESULTS: Eighty-four patients (n=21/group) completed the study without any maternal adverse effects. The mean increase in AFI after hydration was significantly greater in the i.v. hypotonic and oral water groups (2.8+/-1.9, P < .001; 3.8 +/-1.9, P < .001, respectively), but not in the i.v. isotonic group (0.5+/-1.1), compared with the control group (0.5+/-1.1). Significant decreases in maternal hematocrit and hemoglobin concentration were found only after i.v. isotonic hydration (32.0+/-2.9 to 29.5+/-2.3, P < .001; 11.0+/-1.6 to 10.1+/-1.4, P < .001, respectively). Changes in maternal osmolality correlated with the changes in AFI in both the i.v. hypotonic group (r=.58, P < .001) and oral water group (r =.63, P < .001). CONCLUSION:Maternal hydration with either i.v. hypotonic fluid or oral water increases AFI in oligohydramnios. Maternal osmotic change rather than maternal volume expansion had a more direct impact on increasing amniotic fluid volume with short-term acute hydration.
RCT Entities:
OBJECTIVE: To determine the effect of maternal hydration with intravenous (i.v.) isotonic fluid, i.v. hypotonic fluid, and oral water on amniotic fluid index (AFI) in women with oligohydramnios. METHODS:Patients with low AFI and gestational age over 35 weeks without maternal complications were randomized into four groups (2 L/2 h i.v. isotonic fluid, 2 L/2 h i.v. hypotonic fluid, 2 L/2 h oral water, control). Maternal plasma osmolality, AFI, hematocrit, and hemoglobin concentration were measured before and after hydration. RESULTS: Eighty-four patients (n=21/group) completed the study without any maternal adverse effects. The mean increase in AFI after hydration was significantly greater in the i.v. hypotonic and oral water groups (2.8+/-1.9, P < .001; 3.8 +/-1.9, P < .001, respectively), but not in the i.v. isotonic group (0.5+/-1.1), compared with the control group (0.5+/-1.1). Significant decreases in maternal hematocrit and hemoglobin concentration were found only after i.v. isotonic hydration (32.0+/-2.9 to 29.5+/-2.3, P < .001; 11.0+/-1.6 to 10.1+/-1.4, P < .001, respectively). Changes in maternal osmolality correlated with the changes in AFI in both the i.v. hypotonic group (r=.58, P < .001) and oral water group (r =.63, P < .001). CONCLUSION: Maternal hydration with either i.v. hypotonic fluid or oral water increases AFI in oligohydramnios. Maternal osmotic change rather than maternal volume expansion had a more direct impact on increasing amniotic fluid volume with short-term acute hydration.