title: Management of severe idiopathic oligohydramnios: is antepartum transabdominal amnioinfusion really a treatment option?
abstract: OBJECTIVE
  The aim of this study was an evaluation of the role of antepartum transabdominal amnioinfusion (APTA) in the management of severe idiopathic oligohydramnios with a view to improving the pregnancy outcome.
  
  
  METHODS
  The study comprised an analysis of 20 pregnant women with severe oligohydramnios who were treated with APTA in 2009 and 2012. The pregnancy outcomes and the complications of the procedure were analysed.
  
  
  RESULTS
  The mean gestational age at first treatment was 22 weeks 3 days. The preprocedure amniotic fluid index of <5 cm was restored by the treatment to 8 cm. More than a half of the pregnancies (66.7%, 8/12) treated with APTA finished with spontaneous abortion in the second trimester, mostly due to rupture of the membranes (as a consequence of retroamniotic filling with saline in four cases). The later the oligohydramnios developed, the higher the probability of a significant prolongation of the gestation.
  
  
  CONCLUSIONS
  Although APTA is a useful procedure in the management of severe oligohydramnios, it may be followed by a relatively high rate of rupture of the membranes, particularly in the second trimester. Paradoxically, a higher volume of infused saline into the amniotic cavity is associated with a significantly lower risk of rupture.
authors.affiliation: Department of Obstetrics and Gynecology, Blekinge Hospital, Karlskrona, Sweden. kozinszky@gmail.com
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Kozinszky
authors.forename: Norbert
authors.initials: N
authors.lastname: Pásztor
authors.forename: Melinda
authors.initials: M
authors.lastname: Vanya
authors.forename: János
authors.initials: J
authors.lastname: Sikovanyecz
authors.forename: Attila
authors.initials: A
authors.lastname: Pál
mesh_terms: D000328:Adult; D000650:Amnion; D000653:Amniotic Fluid; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D016104:Oligohydramnios / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012965:Sodium Chloride / Q000008:administration & dosage* / Q000009:adverse effects; D012996:Solutions; D016216:Ultrasonography, Prenatal
chemical_list: D012996:Solutions; D012965:Sodium Chloride