The experience of amnioinfusion for oligohydramnios during the early second trimester.

Hsu Tian-Lun, Hsu Te-Yao, Tsai Ching-Chang, Ou Chia-Yu

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Taiwan J Obstet Gynecol. 2007 Dec;46(4):395-8. doi: 10.1016/S1028-4559(08)60009-1.

OBJECTIVE

In the past, oligohydramnios occurring early during the secondary trimester was the reason to terminate the pregnancy because of poor prognosis. Even though amnioinfusion has been reported for improving the prognosis of the infant, it is still not frequently used because of unfavorable results. We present our experience with amnioinfusion for oligohydramnios with or without preterm premature rupture of membranes.

MATERIALS AND METHODS

A retrospective study was performed from July 2005 to December 2006 in our hospital. Amnioinfusions were performed in pregnant women found with oligohydramnios during their second trimesters. Chromosomal studies were recommended and performed under informed consent. Level II sonography was performed after each amnioinfusion. Magnetic resonance imaging was arranged for those with suggested urinary tract malformations.

RESULTS

Seventeen cases were included in our study. No mother was exposed to drugs that have been associated with oligohydramnios. The women received one to six procedures of amnioinfusion separately with a total of 28 procedures. Only one procedure failed. No chromosomal anomalies were found. Fetal anomalies were found after amnioinfusion in five cases. One woman had preterm delivery within 1 week after amnioinfusion. In the four cases of oligohydramnios with rupture of membranes, one case had a healthy full-term baby delivered. In the 13 cases of oligohydramnios without rupture of membranes, there were two preterm infants delivered before 34 weeks of gestation, including pulmonary hypoplasia in one neonate, and three healthy babies delivered after 35 weeks of gestation.

CONCLUSION

Amnioinfusion performed the first time might provide some benefits for those with early-onset oligohydramnios, such as to provide confirmation of rupture of membranes, detailed sonography examination and further counseling. We would recommend that this procedure be considered once for these cases.