Severe oligohydramnios with intact membranes: an indication for diagnostic amnioinfusion.
OBJECTIVE
To quantify the improvement in ultrasonographic fetal imaging following diagnostic amnioinfusion for the indication of unexplained midtrimester oligohydramnios.


METHODS
Patients referred for unexplained midtrimester oligohydramnios were retrospectively reviewed. Videotapes of those undergoing diagnostic antenatal amnioinfusion were analyzed for quality of visualization of routinely imaged structures before and after the infusion procedure.


RESULTS
The overall rate of adequate visualization of fetal structures improved from 50.98 to 76.79% (p < 0.0001). In fetuses having preinfusion-identified obstructive uropathy, there was improvement in identification of associated anomalies from 11.8 to 31.3%.


CONCLUSIONS
Several authors have suggested that diagnostic amnioinfusion can facilitate fetal imaging and increase diagnostic precision in the setting of unexplained severe oligohydramnios. We have quantified the improvement in the rate of optimal visualization of fetal structures which likely translates, in experienced hands, into this observed improved diagnostic precision. Of particular importance is the improvement in appreciation of associated anomalies in cases of obstructive uropathy in which such findings may determine whether or not invasive fetal therapy is indicated.
Pryde
P G
PG
Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Hutzel Hospital and Wayne State University, Detroit, Mich., USA. pgpryde@facstaff.wisc.edu
Hallak
M
M
Lauria
M R
MR
Littman
L
L
Bottoms
S F
SF
Johnson
M P
MP
Evans
M I
MI
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging; D000650:Amnion; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage*; D016104:Oligohydramnios / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D000077325:Ringer's Lactate; D016216:Ultrasonography, Prenatal / Q000009:adverse effects / Q000379:methods*; D014570:Urologic Diseases / Q000000981:diagnostic imaging
D007552:Isotonic Solutions; D000077325:Ringer's Lactate