Disease relevance of Oligohydramnios

• After administration of indomethacin and terbutaline from 16 to 30 weeks' gestation, serial prenatal ultrasound examinations ultimately showed oligohydramnios in twin B and resolution of polyhydramnios in twin A [1].
• We emphasize the correlation between aneuploidy and the presence of low maternal serum alpha-fetoprotein, oligohydramnios, and midgestational intrauterine growth retardation [2].
• Thirty-five pregnancies had complications (21 with preterm labor, 7 with pregnancy-induced hypertension, 6 with growth restriction or oligohydramnios, 1 with abruptio placentae, and 1 with vasa previa) [3].
• Indomethacin may induce oligohydramnios and transient renal insufficiency in humans and renal dysgenesis in fetal monkeys; it might have induced the abnormalities in this patient [1].
• These data challenge the contention that prostaglandin activity protects the renal vascular bed of the fetus from vasoconstriction during hypoxia and they also do not support the hypothesis that prostaglandin synthesis inhibition causes oligohydramnios through reduction of fetal renal blood flow [4].

High impact information on Oligohydramnios

• Raised maternal serum alpha-fetoprotein, oligohydramnios, and the fetus [5].
• Inhaled nitric oxide in congenital hypoplasia of the lungs due to diaphragmatic hernia or oligohydramnios [6].
• Among the 61 patients who received indomethacin, there were 2 cases of oligohydramnios (3.3%; 95% CI, 0.03%, 11.3%) [7].
• Although the AFI identification of polyhydramnios was helpful in identifying LGA fetuses and fetuses at risk for congenital abnormalities, oligohydramnios was a rather weak predictor of poor perinatal outcome [8].
• OBJECTIVE: The objective of this study was to determine the frequency of oligohydramnios in term pregnancies during the Paris heat wave of 2003 (August 4-14) [9].

Chemical compound and disease context of Oligohydramnios

• Indomethacin-induced oligohydramnios [10].
• Oligohydramnios associated with prostaglandin synthetase inhibitors in preterm labour [11].
• Treatment of oligohydramnios with maternal 1-deamino-[8-D-arginine] vasopressin-induced plasma hypoosmolality [12].
• A cause-and-effect relationship was established by restarting the Motrin and observing the same development of oligohydramnios, which again returned to normal with discontinuation of the drug [13].
• STUDY DESIGN: In a retrospective case-controlled review we examined cases in which prostaglandin E2 (Prepidil) was inserted intracervically for gravid women requiring an induction of labor in the presence of either oligohydramnios (amniotic fluid index < or = 5.0) or adequate fluid (amniotic fluid index 5.1 to 23.9) [14].

Biological context of Oligohydramnios

• Elevated maternal serum alpha-fetoprotein, second-trimester oligohydramnios, and pregnancy outcome [15].
• We prospectively evaluated the reproducibility of amniotic fluid diameter measurement and studied various threshold definitions of oligohydramnios as predictors of small for gestational age fetuses or fetuses with low ponderal index values [16].
• Chronic indomethacin administration was associated with continuing fetal and placental growth, a 50% fetal mortality rate, oligohydramnios, and meconium staining, and maternal anemia but normal bleeding times [17].
• Because of its prognostic relevance, we advocate molecular genetic testing of LAMB2 in any case of prenatally detected nephrotic syndrome with negative results of NPHS1 mutational screening, especially in the presence of the typical sonomorphologic findings of the kidneys and the development of oligohydramnios [18].
• Since placental trisomy 16 as well as cases with increased alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) are associated with (intrauterine growth retardation (IUGR), oligohydramnios, and fetal demise, at least some cases with this atypical biochemical profile could be explained by this chromosomal abnormality [19].

Anatomical context of Oligohydramnios

• CONCLUSIONS: Second-trimester but not third-trimester maternal serum alpha-fetoprotein is significantly elevated with preterm premature rupture of the membranes, preterm birth, and low birth weight; in this cohort study no association was found with preeclampsia, oligohydramnios, or polyhydramnios [20].
• Within placentas from patients with oligohydramnios the expressions of adrenomedullin and adrenomedullin receptor messenger ribonucleic acid did not differ statistically between the tissue components [21].
• 2) Single umbilical artery, ambiguous genitalia, abdominal wall defects, diaphragmatic hernia, and anomalies that are secondary to VACTERL components (intestinal and respiratory anomalies, and oligohydramnios sequence defects) are frequent enough to be considered an "extension" of VACTERL, and cardiac defects should be included in this category [22].
• Chorionic villus (CV) sampling had been performed at 30 weeks because oligohydramnios and atrioventricular septal defect were noted on fetal ultrasound [23].
• It may also indirectly support the theory that there are factors other than oligohydramnios that interfere with early lung development, such as reduced production of a pulmonary growth factor by the kidney or reduced proline production by malformed kidneys, that may cause decreased collagen formation and result in hypoplastic lung mesenchyme [24].

Gene context of Oligohydramnios

• The increased adrenomedullin messenger ribonucleic acid expression in the umbilical artery and the elevated adrenomedullin receptor messenger ribonucleic acid expression in the cotyledons of placentas from patients with oligohydramnios may represent a local fetoplacental physiologic adaptive response to vascular compromise [21].
• Increased echogenicity and renal enlargement are the main ultrasonographic signs of ARPKD; oligohydramnios is characteristic but not always present [25].
• Severe oligohydramnios in both amniotic sacs appeared as well [26].
• The finding of oligohydramnios can be associated with fetal anomalies, PROM, uteroplacental insufficiency (eg, growth retardation, postdatism, abruptio placenta, significant maternal illness), abnormalities of twinning, and idiopathic oligohydramnios [27].
• BACKGROUND: Renal agenesis causes severe oligohydramnios, which results in compression effects, lung hypoplasia, and rapid neonatal death [28].

Analytical, diagnostic and therapeutic context of Oligohydramnios

• Elevated maternal serum alpha-fetoprotein levels and oligohydramnios: poor prognosis for pregnancy outcome [29].
• Patients receiving indomethacin were converted to terbutaline at 34 weeks or with the occurrence of fetal ductal constriction or oligohydramnios [30].
• The use of prostaglandin synthetase inhibitors (indomethacin and ibuprofen) for greater than 72 h in women with preterm labour (n = 67) was significantly (P less than 0.001) associated with ultrasound-recorded oligohydramnios compared with the use of ritodrine or magnesium sulphate (control group, n = 67) [11].
• Outcome of mid-trimester pregnancies complicated by oligohydramnios. Quantitative evaluation of the prognostic value of maternal serum alpha-fetoprotein level [31].
• REVIEWER'S CONCLUSIONS: Simple maternal hydration appears to increase amniotic fluid volume and may be beneficial in the management of oligohydramnios and prevention of oligohydramnios during labour or prior to external cephalic version [32].

References