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Treatment:
Women with normal pregnancies who develop oligohydramnios
near term need no treatment and their babies are likely to be
born healthy,they need weekly or more frequent u/s examination
to see if the level of amniotic fluid is decreasing to adangerous
point that necessate termination of pregnancy.
Nearly half the cases of oligohydramnios resolves themselves
without treatment.
Tests of fetal well being such as non stress test,if the test show
that the baby is having difficulties ,then delivery help to prevent
serious problems.
Afetus with poor growth whose mother has oligohydramnios is
at high risk of complication such as asphyxia before and during
birth,mothers with these conditions are monitored very
closely,they sometimes need to be hospitalized.
If awoman has severe oligohydramnios near the time of
delivery,infusing salty water through the cervix into the
uterus(amnioinfusion) may help to reduce complications during
labor and delivery and reduce the need for c/s.
Some studies suggest that women with oligohydramnia can help
increase their level of amniotic fluid by drinking extra water.
Prognosis:
The prognosis of patients with oligohydramnios in the 2nd
trimester is poor because the 2 most common causes,PROM and
fetal congenital anomally are not amenable to successful
treatment.Also pulmonary hypoplasia occurs frequently in
fetuses deprived of amniotic fluid for several weeks.
The best outcomes are obtained in fetuses with severe IUGR
that occasionally can be saved by early delivery and intensive
neonatal care.
Pulmonary hypoplasia is alethal neonatal condition
characterized by small anatomically immature lungs,pulmonary
hypertension and surfactant deficiency,it affects fetuses with
prolonged oligohydramnios before 28wks.
The option of termination of pregnancy should be offered to
patients with lethal fetal abnormalities or PROM before 20wks.
One exception is those patients with PROM following
amniocentesis or CVS in whom recovery is the rule.
For patient with PROM after fetal viability ,the management
will be according to gestational age.