Korean J Perinatol.  2013 Dec;24(4):229-236. 10.14734/kjp.2013.24.4.229.

Management of Isolated Oligohydramnios between 34(+0) and 36(+6) Weeks of Gestation

• Oh SY

• KMID: 2072298
• DOI: http://doi.org/10.14734/kjp.2013.24.4.229

Abstract

The optimal management in pregnancies complicated isolated oligohydramnios between 34(+0) and 36(+6) weeks of gestation is not established yet. Although previous studies reported that increased risks of adverse perinatal outcomes were observed in pregnancies with oligohydramnios, it is notable that these studies include cases with maternal or fetal complications such as hypertensive disorders or fetal growth restriction. Therefore, it remains unclear that the increased adverse perinatal outcomes from oligohydramnios are caused from oligohydramnios itself or from maternal or fetal complications. Meanwhile, recent evidences demonstrated that neonates born at late preterm are also at increased risks for prematurity related complications such as respiratory distress syndrome, intraventricular hemorrhage, neonatal hypoglycemia, necrotizing enterocolitis and cerebral palsy as well compared with term neonates. With this background, this article was aimed to review recent literatures on the optimal management in pregnancies with isolated oligohydramnios between 34(+0) and 36+6 weeks of gestation and to present the results from survey of obstetricians in our country on this topic.

Keyword

Isolated oligohydramnios; 34(+0) and 36(+6) weeks of gestation

MeSH Terms

Cerebral Palsy
Enterocolitis, Necrotizing
Female
Fetal Development
Hemorrhage
Humans
Hypoglycemia
Infant, Newborn
Oligohydramnios*
Pregnancy
Pregnancy*

Reference

1). Hill LM., Breckle R., Wolfgram KR., O'Brien PC. Oligohydramnios: ultrasonically detected incidence and subsequent fetal outcome. Am J Obstet Gynecol. 1983. 147:407–10.

2). Mercer LJ., Brown LG., Petres RE., Messer RH. A survey of pregnancies complicated by decreased amniotic fluid. Am J Obstet Gynecol. 1984. 149:355–61.

3). Chauhan SP., Sanderson M., Hendrix NW., Magann EF., Devoe LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis. Am J Obstet Gynecol. 1999. 181:1473–8.

4). Casey BM., McIntire DD., Bloom SL., Lucas MJ., Santos R., Twickler DM, et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol. 2000. 182:909–12.

5). Manning FA., Hill LM., Platt LD. Qualitative amniotic fluid volume determination by ultrasound: antepartum detection of intrauterine growth retardation. Am J Obstet Gynecol. 1981. 139:254–8.

6). Phelan JP., Platt LD., Yeh SY., Broussard P., Paul RH. The role of ultrasound assessment of amniotic fluid volume in the management of the postdate pregnancy. Am J Obstet Gynecol. 1985. 151:304–48.

7). Morris JM., Thompson K., Smithey J., Gaffney G., Cooke I., Chamberlain P, et al. The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study. BJOG. 2003. 110:989–94.

8). Nabhan AF., Abdelmoula YA. Amniotic fluid index versus single deepest vertical pocket as a screening test for preventing adverse pregnancy outcome. Cochrane Database Syst Rev. 2008. 3:CD006593.

9). Magann EF., Chauhan SP., Doherty DA., Magann MI., Morrison JC. The evidence for abandoning the amniotic fluid index in favor of the single deepest pocket. Am J Perinatol. 2007. 24:549–55.

10). Williams K., Wittmann B., Dansereau J. Intraobserver reliability of amniotic fluid volume estimation by two techniques: amniotic fluid index vs. maximum vertical pocket. Ultrasound Obstet Gynecol. 1993. 3:346–9.

11). Moore TR. The role of amniotic fluid assessment in indicated preterm delivery. Semin Perinatol. 2011. 35:286–91.

12). Chamberlain PF., Manning FA., Morrison I., Harman CR., Lange IR. Ultrasound evaluation of amniotic fluid volume I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gynecol. 1984. 150:245–9.

13). Rutherford E., Phelan JP., Smith CV., Jacobs N. The fourquadrant assessment of amniotic fluid volume: an adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987. 70:353–6.

14). Sarno AP Jr., Ahn MO., Phelan JP. Intrapartum amniotic fluid volume at term. Association of ruptured membranes, oligohydramnios and increased fetal risk. J Reprod Med. 1990. 35:719–23.

15). Chauhan SP., Sanderson M., Hendrix NW., Magann EF., Devoe LD. Perinatal outcomes and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis. Am J Obstet Gynecol. 1999. 181:1473–8.

16). Garmel SH., Chelmow D., Sha SJ., Roan JT., D'Alton ME. Oligohydramnios and the appropriately grown fetus. Am J Perinatol. 1997. 14:359–63.

17). Magann EF., Kinsella MJ., Chauhan SP., McNamara MF., Gehring BW., Morrison JC. Does an amniotic fluid index of </=5 cm necessitate delivery in high-risk pregnancies? A case-control study. Am J Obstet Gynecol. 1999. 180:1354–9.

18). Zhang J., Troendle J., Meikle S., Klebanoff MA., Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG. 2004. 111:220–5.

19). Melamed N., Pardo J., Milstein R., Chen R., Hod M., Yogev Y. Perinatal outcome in pregnancies complicated by isolated oligohydramnios diagnosed before 37 weeks of gestation. Am J Obstet Gynecol. 2011. 205:241. .e1-6.

20). Conway DL., Adkins WB., Schroeder B., Langer O. Isolated oligohydramnios in the term pregnancy: is it a clinical entity? J Matern Fetal Med. 1998. 7:197–200.

21). Rainford M., Adair R., Scialli AR., Ghidini A., Spong CY. Amniotic fluid index in the uncomplicated term pregnancy. Prediction of outcome. J Reprod Med. 2001. 46:589–92.

22). Ek S., Andersson A., Johansson A., Kublicas M. Oligohydramnios in uncomplicated pregnancies beyond 40 completed weeks. A prospective, randomised, pilot study on maternal and neonatal outcomes. Fetal Diagn Ther. 2005. 20:182–5.

23). ACOG practice bulletin. Antepartum fetal surveillance. Number 9, October 1999 (replaces Technical Bulletin Number 188, January 1994). Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet. 2000. 68:17585.

24). Sherer DM. A review of amniotic fluid dynamics and the enigma of isolated oligohydramnios. Am J Perinatol. 2002. 19:253–66.

25). Schwartz N., Sweeting R., Young BK. Practice patterns in the management of isolated oligohydramnios: a survey of perinatologists. J Matern Fetal Neonatal Med. 2009. 22:357–61.

26). Melamed N., Klinger G., Tenenbaum-Gavish K., Herscovici T., Linder N., Hod M, et al. Short-term neonatal outcome in lowrisk, spontaneous, singleton, late preterm deliveries. Obstet Gynecol. 2009. 114:253–60.

27). McIntire DD., Leveno KJ. Neonatal mortality and morbidity rates in late preterm births compared with births at term. Obstet Gynecol. 2008. 111:35–41.

28). Moster D., Lie RT., Markestad T. Long-term medical and social consequences of preterm birth. N Engl J Med. 2008. 359:26273.