The association between oligohydramnios and intrauterine growth retardation

Article Abstract:

Oligohydramnios is a condition in which the amount of amniotic fluid is abnormally small; when diagnosed in the second trimester of pregnancy, the fetal prognosis is poor. The relationship between oligohydramnios and intrauterine growth retardation (IUGR) is not clear; one possibility is that oligohydramnios occurs in association with IUGR. To learn more about this issue, 147 fetuses with suspected IUGR (based on abdominal circumference measurements), and 316 fetuses without this probable diagnosis, were studied. IUGR fetuses underwent additional ultrasound evaluation, and all fetuses were evaluated for anomalies, movement, and volume of amniotic fluid. Fifty-six infants from the suspected IUGR group were growth-retarded when born; the remaining 91 were not. Eight control fetuses were IUGR at birth. Oligohydramnios was present in 29 percent of the IUGR fetuses; 9 percent of the non-IUGR group; and 0.6 percent of control fetuses. Fetal outcomes were not different for IUGR fetuses with or without oligohydramnios. The results indicate that oligohydramnios occurs more often in IUGR than non-IUGR pregnancies. It appears to develop during the third trimester of pregnancy, starting two weeks after the first signs of IUGR are visible on ultrasound. Predictions of IUGR are more accurate if oligohydramnios and small abdominal circumference are present; thus, if IUGR is suspected, determining the volume of amniotic fluid can enhance diagnostic accuracy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fetus, Development and progression, Fetal growth retardation, Oligohydramnios

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Diabetes insipidus associated with craniopharyngioma in pregnancy

Article Abstract:

The case report is presented of a pregnant woman with symptoms of two years' duration of visual disturbances, headache, and excessive thirst. Throughout pregnancy she had suffered from nausea and vomiting. At 25 weeks' gestation, the patient underwent removal of the gallbladder, but the symptoms persisted. Further examination revealed the presence of a tumor located in such a position in the head that it caused diabetes insipidus (imbalance in water retention, associated with frequent urination and intense thirst). This was the result of abnormalities of function of the hypothalamus, a center in the brain that regulates hormone production. The patient underwent hormonal treatment to restore her levels to normal, and the symptoms became less troublesome. At 31 weeks' gestation, the patient's symptoms recurred. Treatment was only partially successful. By 34 weeks' gestation, her vision was markedly impaired; labor was induced and a healthy boy was delivered. Three days later, the patient underwent surgery to remove the mass. Hormonal therapy was continued after the surgery, and patient and baby were discharged 10 days later. Diagnostic considerations in diabetes insipidus are discussed. In pregnant women, tumors of this sort can produce abnormalities in many endocrine systems. The goal is management of the tumor until after delivery, or until the fetus reaches an age of reduced risk for mortality and morbidity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Causes of, Diabetes insipidus, Pituitary gland tumors

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The reliability and predictive value of an amniotic fluid scoring system in severe second-trimester oligohydramnios

Article Abstract:

The accuracy and reliability of a scoring system which measured amniotic fluid, the fluid which surrounds the fetus, was tested in 62 cases of severe oligohydramnios, low amounts of amniotic fluid, during the second trimester of pregnancy. Oligohydramnios is diagnosed when amniotic fluid drops to or below 300 ml, while normal levels of amniotic fluid range from 500 to 2000 ml. Oligohydramnios was diagnosed by ultrasonography, the use of soundwaves to make an image of internal organs and tissues. Three experienced ultrasonographers used a subjective scale to rate the oligohydramnios as mild, moderate, severe, or anhydramniotic (nonexistent amniotic fluid). Complications of the condition included underdeveloped lungs (pulmonary hypoplasia), the suppression of urinary secretion by kidneys, and death. Subjective rating of oligohydramnios by experienced observers is reliable and can predict the outcome of the condition. Research is needed to identify the causes of and appropriate interventions for severe oligohydramnios, since poor fetal outcome usually results from severe cases of reduced amniotic fluid in the second trimester. Less severe conditions of oligohydramnios may be successfully treated.

Evaluation, Lung diseases, Diagnosis, Ultrasonic, Diagnostic ultrasonography

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