DIAGNOSTIC AMNIOINFUSION IN SEVERE OLIGOHYDRAMNIOS

Abstract
Objective: To evaluate the effectiveness of the diagnostic amnioinfusion in severe oligohydramnios. Patients and Methods: Twelve patients with severe oligohydramnios in the second and third trimester of pregnancy were underwent amnioinfusion. The procedure was done using a warm physiologic saline solution at a rate of 20 ml/min following an instillation of 5 ml of contrast. The ILA was measured before the procedure and thirty minutes after and in case of presenting anomalies, it was documented. The gestational age ranged from 18 to 34 weeks (average: 256 weeks ± 4). The average of the initial ILA was 10.3 cm and after the procedure was 16.4 cm. The volume of saline solution infused ranged from 300 to 1 000 ml (605.4 ml ± 224.1). Results: In nine (75%) patients the procedure achieved to an etiologic diagnosis: four cases of premature rupture of membranes and major malformations in five fetus. In two patients the oligohydramnios was considered idiopathic and in one patient the anatomic pathological exam revealed a placental infarct. Nine cases (75%) were interrupted after the diagnosis and three cases continued for 8.8 weeks after the amnioinfusion. All fetus died, seven of them had a neonatal death and the remaining had an intrauterine death. Conclusion: The amnioinfusion is an effective method with high precision, enabling the etiologic diagnosis of the severe oligohydramnios in 75% of the cases.

Key words
Amnioinfusion, oligohydramnios, fetal malformations, premature rupture of membranes, prematurity

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