Abstract from The Cochrane Library, Issue 1, 2003. Click here to order the full review.

Maternal hydration for increasing amniotic fluid volume in oligohydramnios and normal amniotic fluid volume (Cochrane Review)

Hofmeyr GJ, Gülmezoglu AM

ABSTRACT

A substantive amendment to this systematic review was last made on 01 September 2001. Cochrane reviews are regularly checked and updated if necessary.

Background: Oligohydramnios (reduced amniotic fluid) may be responsible for malpresentation problems, umbilical cord compression, concentration of meconium in the liquor, and difficult or failed external cephalic version. Simple maternal hydration has been suggested as a way of increasing amniotic fluid volume in order to reduce some of these problems.

Objectives: The objective of this review was to assess the effects of maternal hydration on amniotic fluid volume and measures of pregnancy outcome.

Search strategy: The Cochrane Pregnancy and Childbirth Group trials register (September 2001) and the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2001).

Selection criteria: Randomised trials comparing maternal hydration with no hydration in pregnant women with reduced or normal amniotic fluid volume.

Data collection and analysis: Eligibility and trial quality were assessed by both reviewers.

Main results: Two studies of 78 women were included. The women were asked to drink two litres of water before having a repeat ultrasound examination. Maternal hydration in women with and without oligohydramnios was associated with an increase in amniotic volume (weighted mean difference for women with oligohydramnios 2.01, 95% confidence interval 1.43 to 2.60; and weighted mean difference for women with normal amniotic fluid volume 4.5, 95% confidence interval 2.92 to 6.08). Intravenous hypotonic hydration in women with oligohydramnios was associated with an increase in amniotic fluid volume (weighted mean difference 2.3, 95% confidence interval 1.36 to 3.24). Isotonic intravenous hydration had no measurable effect. No clinically important outcomes were assessed in any of the trials.

Reviewers' conclusions: Simple maternal hydration appears to increase amniotic fluid volume and may be beneficial in the management of oligohydramnios and prevention of oligohydramnios during labour or prior to external cephalic version. Controlled trials are needed to assess the clinical benefits and possible risks of maternal hydration for specific clinical purposes.

Citation: Hofmeyr GJ, Gülmezoglu AM. Maternal hydration for increasing amniotic fluid volume in oligohydramnios and normal amniotic fluid volume (Cochrane Review). In: The Cochrane Library, Issue 1 2003. Oxford: Update Software.



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