Introduction: Severe oligohydramnios can cause fetal pulmonary hypoplasia, cord compression and hence poor pregnancy outcome. Theoretically antepartum therapeutic amnioinfusion can prevent the complication.
Materials and methods: It is a prospective case control study conducted from July 2015 to December 2018. Women with unexplained oligohydramnios from 16weeks to 34weeks of pregnancy were included the study. Therapeutic transabdominal amnioinfusion (TAI) was offered to them. Patients who opted for amnioinfusion were recruited as cases (n=45) and patients who opted for conservative management were recruited as controls (n=50).
Results: Three women in case group were detected to have fetal malformations and hence were excluded from further analysis. Mean gestational age at presentation was significantly earlier in cases than controls (25.78±4.86 weeks vs 33.36±3.48 weeks, p<0.001). One TAI was done in 40(88.9%) patients, two in four (8.9%) women and three in one (2.2%) woman. Volume of infused fluid ranged from 22ml to 650ml. Mean latency period was significantly more in cases as compared to controls (6.39±6.05weeks vs 3.19±3.09 weeks, p=0.013). Mean gestational age at delivery was significantly earlier in cases than controls (32.18±6.18weeks vs. 36.44±1.72weeks, p=0.001). Vaginal delivery occurred in 29(69%) cases as compared to 19(38.1%) in control group (p=0.003). There was no statistically significant difference in perinatal mortality in both groups.
Conclusion: Transabdominal amnioinfusion during pregnancy in idiopathic severe oligohydramnios can be done as early as sixteen weeks. This may help in diagnosing fetal malformation. It may prolong pregnancy from six to twelve weeks and aid in vaginal delivery.
