A Randomized Trial of Inpatient and Home-Based Maternal Oral Hydration Therapy in Isolated Oligohydramnios and Its Effect on Amniotic Fluid Index and Perinatal Outcome.

Background Isolated oligohydramnios, without any known fetal/maternal abnormality, may be associated with insufficient oral intake (such as water, glucose, and rehydration therapy). Therefore, the present study was conducted to assess the improvement following maternal hydration. Method A total of 50 cases of isolated oligohydramnios (other high-risk pregnancy conditions not present) were included in the study (25 in each group). Patients were encouraged for an additional 2 liters of oral rehydration solution intake daily along with regular diet. The fluid intake was unsupervised in the home group and supervised in the hospital group. Serial amniotic fluid index (AFI) measurements and fetal monitoring were performed. Birth weight and APGAR scores were recorded, and data were analyzed. Results The two groups were comparable in terms of demographics and baseline laboratory findings. AFI significantly improved in the hospital group compared to the home group (p-value: <0.001). Birth weight, placental weight, and APGAR scores were also significantly better in the hospital group than in the home group. Conclusion Maternal oral hydration therapy improves the amniotic fluid volume and subsequently improves the perinatal outcome. Due to poor compliance with home-based treatment, institution of supervised hydration therapy is recommended.

Huge broad ligament leiomyoma with cystic degeneration: A diagnostic and surgical challenge.

Broad ligament is the common extrauterine site for fibroid. We present a case of huge broad ligament fibroid with cystic degeneration. Patient presented with abdominal swelling and mild pain abdomen. On abdominal examination, a large tense cystic mass of 34 weeks gravid uterus size arising from pelvis was noted. Cervix was pulled up and all fornices were full with mass on pelvic examination. Ultrasound suggested adnexal mass as ovaries were not seen. Contrast-enhanced computed tomography abdomen too reported adnexal mass likely of ovarian origin. On laparotomy, 6 L of straw color fluid drained from the mass which was seen arising from left broad ligament, bilateral ovaries were separate from the mass and appeared healthy. Enucleation of mass was done to ease the hysterectomy and careful evaluation of ureteric course was done throughout the surgery to avoid its injury. Total hysterectomy with bilateral salpingo-opherectomy and pelvic lymphadenectomy was performed. This case is being reported for its rare incidence, diagnostic dilemma and surgical challenge.