10% Maltose Infusion Therapy for Oligohydramnios

• Published in: Australian & New Zealand journal of obstetrics & gynaecology 1999-08, Vol.39 (3), p.373-375
• Main Authors: Suzuki, Shunji, Mine, Katsuya, Sawa, Rintaro, Yoneyama, Yoshio, Araki, Tsutomu
• Format: Article
• Language: English
• Subjects: Adult; Female; Humans; Infusions, Intravenous; Maltose - administration & dosage; Maltose - therapeutic use; Oligohydramnios - diagnostic imaging; Oligohydramnios - therapy; Pregnancy; Ultrasonography, Prenatal
• ISSN: 0004-8666; 1479-828X
• DOI: 10.1111/j.1479-828X.1999.tb03422.x

EDITORIAL COMMENT: We accepted this case report for publication because any method that may be successful in the treatment of fetal growth retardation, with or without oligohydramnios, must be of interest to obstetricians who manage these high‐risk pregnancies. There are now many methods that have been used in the antenatal management of uteroplacental insufficiency and this topic has been briefly reviewed in a previous editorial comment (A). It is interesting that this paper from Japan using an intravenous infusion of 10% maltose refers to this technique being used 17 years ago in Japan. Similarly at the Mercy Hospital for Women in Melbourne, Victoria, there was great commitment to the treatment of these high‐risk pregnancies with intravenous infusion of 25% dextrose and more recently of 10% dextrose and amino acids. These studies were first reported in the 1970's (B) and were in favour for about 15 years. The regimen has largely been discontinued because controlled trials did not show superiority of one fluid over another (C). In the studies reported from the Mercy Hospitut for Women the regimen was based on the philosophy of continuing the pregnancies until, fetal viability, then considered to be about 37 weeks' gestation, in the absence qf maternal complications, such as preeclampsia and uncontrollable hypertension, so long as the, fetal cardiotocograph remained normal. It is possible that more modern ultrasonographic techniques are a better way to evaluate fetal condition. Hopefully this editorial comment will encourage some readers to consider reintroducing this very simple, safe therapy for both mother and child. Follow‐up studies of surviving infiints, from these pregnancies showed a satisfactory long‐term prognosis (D, E). One of the problems in cases of severe, fetal growth retardation, especially when the mother has a past history of intrauterine deaths, is that management is anecdotal because it is dificult to set up controlled trials of such extreme high‐risk pregnancies.