OUTCOME AFTER ARTIFICIAL FLUID INSTILLATI ON (AFI) IN EARLY OLIGOHYDRAMNIOS

We report on the foetal outcome of 50 pregnancies with severe oligohyd ramnios in the second and early third trimesters in which artificial f luid instillation (AFI) had been performed. Through the AFI, rapid dia gnosis was possible or was made easier or additional malformations wer e detected or could be excluded. The AFI-associated risk was an induct ion of labour and a possible iatrogenic rupture of membranes in 3 / 50 cases. A total of 47 pregnancies could be evaluated to the end, 37 en ded in intrauterine death, spontaneous abortion or, in case of a diagn osed lethal malformation, in induced abortion. Ten babies were born al ive, but within a period of six months 6 of them died. From the total group, 4 children (8 %) are alive and healthy. Survivors are from preg nancies with PROM, with severe IUGR or from the group of idiopathic ol igohydramnios. Twenty-seven foetuses had structural, chromosomal or fu nctional anomalies (urogenital, intestinal, heart, skeletal, central n ervous, complex malformations). Our data demonstrate a poor prognosis in case of early oligohydramnios. AFI enables early and correct diagno sis. It provides a better basis for counselling and managing of these pregnancies. The risk of AFI with possible induction of labour and iat rogenic rupture of membranes has to be considered both in indication a nd counselling. However, the risk is limited with regard to the very p oor prognosis even without invasive diagnosis.