Title: Evidence Based Management of Oligohydramnios

Bibliography: Modi, J. (2018). Evidence Based Management of Oligohydramnios.

Open Access Journal of Gynecology. Retrieved January 26, 2020 from
https://medwinpublishers.com/OAJG/OAJG16000160.pdf
Summary
The amniotic fluid is known to protect the developing baby by cushioning against
blows to the mother's abdomen, allowing for easier fetal movement and promoting
muscular/skeletal development. Without amniotic fluid, the fetus cannot survive and the
mother will lose the pregnancy. In this article, it focuses on the deficiency in the amount
of amniotic fluid in the gestational sac which is called oligohydramnios.

This condition complicates approximately 1 to 2 percent of pregnancies. It poses

a risk to the fetus by contributing to perinatal morbidity and mortality, and due to
iatrogenic preterm delivery. The risks associated with this depend on the time of
pregnancy at which it is diagnosed. In this case, the earlier the diagnosis, the less
serious the complications are. Some of the complications are birth defects, preterm birth
and IUGR.

Therefore in order to prevent the complications mentioned above, the author

suggested different managements for mothers with uncomplicated pregnancy based on
the gathered evidences. The author focused its management to the mothers who do not
have an identifiable etiology of their condition and they are termed as “isolated
oligohydramnios”. The treatments mentioned in the article include oral and intravenous
hydration therapy, drugs and timing of delivery. In the end, the author suggested to use
the safest, inexpensive management and does not require any admission which is the
oral hydration therapy.
Reaction
After reading the article, I could say that I agree with the author. I agree that
therapeutic interventions must be applied to cases like oligohydramnios because of the
undesirable effects it may bring to the pregnancy especially if the condition is diagnosed
late. Moreover, the effects of oligohydramnios can be lessened if it is diagnosed early
and if there is an intervention. I have the same thoughts with the author that oral
hydration therapy is the best treatment strategy for oligohydramnios. Although, the
intravenous hydration therapy resulted to be effective but compared administering in
orally, it is costs more and needs admission. I believe that as a health care provider, I
would choose the safest and the inexpensive way to lessen the condition of the patient
wherein the risks does not outweigh the benefits.

Initially, I really have no idea that there are interventions to alleviate the condition
of the mother when it comes to its amniotic fluid. After reading the article, I learned the
importance of delivering the baby with a normal volume of amniotic fluid. I read that
there are a lot of risks associated with oligohydramnios like birth defects, intrauterine
growth retardation, preterm birth and worse are miscarriage or stillbirth. After reading all
the treatments presented by the author, I realized how imperative water is in increasing
the fluid volume in oligohydramnios. Another hydration therapy can also be given
intravenously but compared to oral hydration, it is transitory and for me, I would rather
choose the oral route because it does not require hospitalization. One of the treatments
mentioned is the use of drugs which I believe is quite risky because as we all know,
many drugs could affect the pregnancy especially if not prescribed. In this case, the
drug recommended is called L-arginine and Sildenafil citrate which is effective but has
known and unknown side effects Personally, I will not suggest the use of drugs in
treating oligohydramnios. The last treatment mentioned is the timing of delivery so that
the risks will be lessened. I realize that it is imperative to diagnose oligohydramnios if it
is mild, moderate or severe so that the doctor would be able to recommend the age of
gestation on when you are expected to deliver.

I have no experiences or know other experiences related to oligohydramnios but

I have read stories about cases regarding the delivery of a mother experiencing
oligohydramnios. Most of them had a hard time delivering the baby and once delivered
it has birth defects like improperly working kidneys. For me, the article gave a positive
impact because its goal is to impart knowledge to the health care providers as well as
the mothers that oligohydramnios is a fatal condition and there are easy and convenient
ways to prevent the worst from happening.

The article is significant to the nursing practice because it concerns a large

percentage of health care providers especially nurses. According to the article,
oligohydramnios affect 1% to 2% of pregnancies so it is quite common. As a nurse, it is
our job to reduce the risks the patient may experience in her entire pregnancy thus, it is
significant to know different managements in treating oligohydramnios. In nursing
education, the article is significant because if ever the patient asks us about these
things, we are knowledgeable of the different managements for oligohydramnios case.
We will not remain ignorant that this condition can be prevented or alleviated. For the
nursing research, this article is significant as well because it could help the future
researchers to study more about other managements mentioned such as the IV
hydration therapy and the use of drugs which in this article showed some lapses. This
will open the understanding of the people that although oligohydramnios is fatal for the
baby, it can still be managed through proper interventions.