Fetal outcome following transabdominal amnioinfusion in various causes of oligohydramnios

Jung, Sang Hee; Han, Jung Yeol; Choi, Eun Hwa; Sung, Suk Joo; Jo, Joon Hyung; An, Hyun Gyung; Kim, Moon Young; Choi, Gyu Hong; Yang, Jae Hyuk

Abstract

OBJECTIVE
To evaluate the efficiency and fetal outcome following antepartum transabdominal amnioinfusion in various causes of oligohydramnios.
MATERIALS AND METHODS
Forty four transabdominal amnioinfusion were performed in twenty seven cases of singleton pregnancy with severe oligohydramnios. Severe oligohyadrmnios defined as amnionic fliud index of 5cm or less than. In all cases, high resolution sonographies were done before and after amnioinfusion in order to detect fetal anomalies. Transabdominal amnioinfusion was performed through a closed system with warmed normal saline.
RESULTS
Infusion (mean volume 435.9ml) of normal saline significantly increased the amniotic fluid index from 3.2cm to 7.5cm. The causes of oligohydramnios were as follows, premature rupture of membranes was 8 cases (29.6%), intrauterine growth restriction was 10 cases (37.0%), congenital anomaly was 4 cases (14.8%) and idiopathic was 5 cases (18.5%). The gestational weeks were prolonged significantly from 26.8 weeks to 29.5 weeks. The overall survival rate except congenital anomalies was 67%. Babies with idiopathic oligohydramnios were heavier and required less hospitalization dates than those of badies with oligohydramnios of other causes, but it was not statistically significant. There were several complications as follows, chorioamnionitis 2 cases, neonatal sepsis 2 cases, meconium aspiration syndrome 2 cases and fetal bradycardia 1 case. All of the babies discharged healthy without sequele.
CONCLUSION
These results show that antepartum transabdominal amnioinfusion is a relatively safe procedure. And it can significantly increase the amnionic fluid index and prolong the gestational age which is optimal for neonatal survival in oligohydramnios of idiopathic cause or with intrauterine growth restriction.