Focus on fluids. Examining maternal hydration and amniotic fluid volume

The effects of intravenous hydration on amniotic fluid volume and pregnancy outcomes in women with term pregnancy and oligohydramnios: a randomized clinical trial

INTRODUCTION

Amniotic fluid is an important factor in the prediction of fetal survival. The aim of this research was to evaluate the effects of intravenous hydration of mothers on amniotic fluid volume and in turn on pregnancy outcomes.

METHODS

The current single blind controlled clinical trial was conducted on 20 pregnant mothers with amniotic fluid index of lower or equal to 5 cm and gestational age of 37-41 weeks. The subjects were divided into two groups of case and control through simple random sampling. Amniotic fluid index was measured in all participants. The case group received one liter of isotonic saline during 30 minutes by the bolus method. Reevaluations of amniotic fluid index in both groups were made 90 minutes after baseline measurement. Independent t-test and paired t-test were used to compare the two groups and mean amniotic fluid index before and after treatment, respectively.

RESULTS

Hydration of mothers significantly increased the amniotic fluid index in the case group (mean change: 1.5 cm; 95%CI: 0.46 - 2.64; P = 0.01). The mean change of amniotic fluid index in the control group did not significantly increase (P = 0.06). The elevation of amniotic fluid index in the hydration group (32%) was significantly higher than the control group (1%) (P = 0.03).

CONCLUSION

In this study intravenous hydration increased amniotic fluid index of mothers with term pregnancy and oligohydramnios. Since it caused no complications for the mother and the fetus, it can be used as an effective method in management of oligohydramnios.

Prenatal nutrition and birth outcomes

The complex relationship between maternal nutritional and birth outcomes emphasizes the need for consistent and thorough assessments of women's diet throughout pregnancy and individualized nutritional education to promote positive birth outcomes. The purpose of this article is to examine the influence of prenatal nutrition on birth outcomes, describe research on the effects of macro- and micronutrients on birth outcomes, and discuss strategies for monitoring diet and implementing nutrition education during pregnancy.

Comparing pregnant women's nutritional knowledge to their actual dietary intake

PURPOSE

The purpose of this study was to describe differences between low-and middle-income pregnant women's general nutritional knowledge, usual dietary intake and weight gain.

STUDY DESIGN AND METHODS

A descriptive design employing a questionnaire with a convenience sample of women (N = 109) from both childbirth education classes and a free prenatal clinic.

RESULTS

Women with a low prepregnant body mass index (BMI) gained less weight, and women with high BMI tended to gain more weight than recommended. Most women had inadequate general nutritional knowledge, and their dietary intake did not meet all the nutritional requirements of pregnancy. Women attending the free prenatal clinic had more accurate knowledge of the recommended number of servings for some food groups (fruits and vegetables, meats and dairy) than women in childbirth education classes. No differences were noted between the groups in total weight gain.

CLINICAL IMPLICATIONS

Further research is needed to evaluate pregnant women's nutritional knowledge and actual dietary practices, to develop effective strategies designed to promote adequate nutritional intake in pregnant women, and to help women remain within the Institute of Medicine (IOM) weight gain recommendations. Consistent individualized nutritional assessment and counseling during pregnancy could provide a foundation for continued healthy eating habits during the postpartum period and possibly throughout the woman's life.