Hourly fetal urine production rate in isolated oligohydramnios at term

Abstract

Objective The aim of this study was to evaluate the hourly fetal urine production rate (HFUPR) via three-dimensional ultrasonography in women with isolated oligohydramnios and compare with normal pregnant women at term. Materials and methods This was a prospective observational cohort study of 112 women from 34 to 40 6/7 weeks’ gestation. They were classified into three groups according to the amniotic fluid index (AFI) and ultrasonographic estimated fetal weight (EFW) as isolated oligohydramnios (defined as AFI below 5% and appropriate EFW corresponding to gestational age) (n = 34) and IUGR (defined as EFW below 5% corresponding to gestational age irrespective amniotic fluid) (n = 17), and normal pregnancy (n = 61). HFUPR was measured using three-dimensional virtual organ computer-aided analysis. Adverse perinatal outcomes in all participants were examined. Results There was no significant difference in HFUPR between patients with isolated oligohydramnios and women with normal pregnancies (median, 40.0 mL/h [interquartile range [IQR] 31.0–66.5] vs. 48.6 [31.5–81.2], p = 0.224). HFUPR was significantly decreased in the IUGR group (13.8 mL/h [IQR 10.1–24.8]), compared to the normal pregnancy group (p<0.001) and the isolated oligohydramnios group (p<0.001). HFUPR was significantly decreased in neonates with adverse perinatal outcomes compared to the control (24.7 mL/h [IQR 13.4–47.4] vs. 43.6 [29.8–79.0], p = 0.016). Conclusion HFUPR was not decreased in patients with isolated oligohydramnios but was decreased in patients with IUGR when compared to normal controls at term.

Die Betreuung im Geburtszeitraum – eine Herausforderung an Geduld, Sorgfalt und Kompetenz

“…Wenn jedoch quasi über Nacht das Fruchtwasser verschwindet, etwa wie bei einem Blasensprung, dann ist dies ein absolut ernst zu nehmendes Alarmzeichen. Das Phänomen entsteht durch die Ausschüttung des Hormons Epinephrin, das in lebensbedrohlichen Situationen die Diurese des Kindes blockiert [7].…”

Amniotic Fluid Disorders: From Prenatal Management to Neonatal Outcomes

“…One of the possible pathophysiological mechanisms is an increased absorption of AF due to alterations in the expression of aquaporins, rather than decreased fetal renal blood flow. Indeed, no significant difference was found in the hourly fetal urine production between isolated oligohydramnios and normal AFV [ 43 ]. Conversely, a decrease in the fetal urine production rate has been observed in neonates with adverse perinatal outcomes and in growth-restricted fetuses [ 44 ].…”