Effect of oral hydration therapy on amniotic fluid index and maternal-neonatal outcomes in pregnant women with oligohydramnios: a systematic review and meta-analysis.

Abstract

Objectives: Maternal oral hydration therapy is a non-invasive approach to improving AFI, but its effectiveness remains uncertain. This systematic review and meta-analysis were therefore undertaken to assess the effectiveness of maternal oral hydration therapy in increasing AFI in pregnancies complicated by oligohydramnios and to evaluate its impact on maternal and neonatal outcomes.

Methods: A systematic search of Cochrane Library, Embase, PubMed, Scopus, and Web of Science was conducted. Eligible studies included randomized controlled trials (RCTs), quasi-experimental studies, and analytical observational studies. All studies published till 22 November 2024 in the above databases were included. No restrictions were placed on geographic location or study setting. Two reviewers independently undertook the screening. Relevant studies were identified, screened, and duplicates removed using NESTED Knowledge. Risk of bias was assessed using NOS, JBI, and ROBINS-I tools. Statistical analyses, including meta-analysis using a random-effects model, were conducted in R Studio and Comprehensive Meta-Analysis (CMA) software. Heterogeneity was assessed using the I² statistic.

Results: Out of the 12 included studies four qualified for meta-analysis. Pooled results showed a significant increase in AFI at 2 hours (mean difference: 0.996; 95 % CI: 0.781-1.210), 1 day (0.853; 95 % CI: 0.532-1.174), 2 days (1.649; 95 % CI: 0.943-2.356), and 1 week (2.232; 95 % CI: 0.943-3.520). However, high heterogeneity was observed due to variations in fluid type, volume, and frequency.

Conclusions: It can be concluded that oral hydration therapy significantly increases AFI and is a simple intervention for managing oligohydramnios, especially in resource-limited settings.