Alterations of the Uteroplacental and Fetal Pulmonary Circulation Following Amnioinfusion
Severe Oligohydramnios
About this trial
This is an interventional diagnostic trial for Severe Oligohydramnios focused on measuring amnioinfusion, severe idiopahic oligohydramnios
Eligibility Criteria
Inclusion Criteria:
- Patients above 18 years, who are able to consent;
- Singleton pregnancy;
- Normal structural examination between 16 and 20 weeks of gestation;
- Gestation between 18 and 34 weeks (the pregnancy duration determined by ultrasound verification within the 20th week);
- At least two US examinations at the presentation for confirmation and for the diagnosis of persistent oligohydramnios;
- Follow up ultrasound examinations weekly in both groups.
Exclusion Criteria:
1. pPROM; 2. Fetal structural anomaly detected at prenatal ultrasonography, or fetal chromosomal abnormalities involving autosomes; 3. Symptoms referring incomplete abortion before 24 weeks of gestation; 4. Maternal contraindications to intervention or prolongation of pregnancy, including severe medical conditions in pregnancy that make the intervention riskful; 5. No active premature labor (shortened cervix <15 mm, <3 cm of cervical dilatation; >6/hour uterine contractions) after 24 weeks of gestation; 6. Cervical cerclage in place; 7. Clear signs of maternal or fetal infection (2 or more of the following: maternal tachycardia >100/min, maternal temperature >38°C, maternal white blood count cells (WBC) >15,000/ml, maternal C-reactive protein (CRP) >20 mg/l, uterine tenderness, foul-smelling vaginal discharge, fetal tachycardia >160 bpm); 8. Suspicion of placental abruption (uterine tenderness and bleeding episodes); 9. Previous invasive procedure in the pregnancy; 10. Fetal condition mandating immediate delivery; 11. Severe bleeding at present; 12. Maternal HIV and HBV/HCV infection; 13. Multiple gestation.
-
Sites / Locations
- University of Szeged, Department of Obstetrics and Gynecology
Arms of the Study
Arm 1
Experimental
amnioinfusion
The investigators propose an open trial comparing baseline Doppler waveforms in the uteroplacental and fetal pulmonary circulation in patients presenting with severe, idiopathic olighydramnios (AFI<5, no apparent ethiopathology), managed either with single or with serial amnioinfusions. The patients will be followed up weekly in the fetomaternal unit, Dept. of ObGyn for measuring AFI repeatedly to assess the need for further infusions. These will be carried out when the AFI falls below 5cm again