الفهرس 
Introduction
Amniotic fluidOnly 14 pages are availabe for public view
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Abstract
Pregnancy places increased demands on the mother to provide adequate nutrition to the growing conceptus. A number of micronutrients function as essential cofactors for or themselves acting as antioxidants. Oxidative stress is generated during normal placental development; however, when supply of antioxidant micronutrients is limited, exaggerated oxidative stress within both the placenta and maternal circulation occurs, resulting in adverse pregnancy outcomes. Examples of micronutrient antioxidants are selenium, copper, zinc, manganese, and vitamins C and E.
Amniotic fluid is ”inhaled” and ”exhaled” by the fetus. It is essential that fluid be breathed into the lungs in order for them to develop normally. Swallowed amniotic fluid also creates urine and contributes to the formation of meconium. As well, amniotic fluid protects the developing baby by cushioning against blows to the mother’s abdomen, allows for easier fetal movement, promotes muscular/skeletal development, and helps protect the fetus from heat loss.
Oligohydramnios refers to a condition in which there is too little amniotic fluid. Although it is most common in the last trimester, oligohydramnios can develop at any time in pregnancy. About 12 percent of women whose pregnancies last two weeks beyond their due date develop oligohydramnios as amniotic fluid levels naturally decline.
Oligohydramnios can be diagnosed via ultrasound. Doctors measure the depth of amniotic fluid in four sections of the uterus and add them together. This gives them a number known as AFI or amniotic fluid index. If the AFI is less than 5 centimeters, the pregnant woman has oligohydramnios. If the AFI is over 25 cm, she has polyhydramnios.
Antioxidants are substances or nutrients in our foods which can prevent or slow the oxidative damage to our body. When our body cells use oxygen, they naturally produce free radicals (by-products) which can cause damage. Antioxidants act as ”free radical scavengers” and hence prevent and repair damage done by these free radicals. Health problems such as heart disease, macular degeneration, diabetes, cancer are all contributed by oxidative damage. Antioxidants may also enhance immune defense and therefore lower the risk of cancer and infection.
Aim of the work:
1- To study the effect of antioxidants in cases of oligohydramnios.
2- To study the effect of antioxidants on mode of delivery and neonatal outcome.
3- To commence special recommendations from the study about the use of antioxidants in cases of oligohydramnios of unknown cause and cases of oligohydramnios associated with pregnancy induced hypertension.
Type of study:
This is a prospective randomized controlled study that was done in department of obstetrics and gynecology of Assiut University Hospital.
Sampling:
Women participating in the study were selected from women doing ante-natal care in Assiut University Hospital obstetrics outpatient clinic.
All women with eligibility criteria of the study will be counseled to participate in the study.
They were 120 patients with oligohydramnios assigned into two groups:
Group A : oligohydramnios of unknown cause.
Group B : oligohydramnios of pregnancy induced hypertension.
Each group was subdivided into two groups:
Group 1 was given omega -3 plus (Sedico medical company) as antioxidant once daily for two weeks.
Group 2 was given a placebo once daily for two weeks.
Patients with gestational age between 30-34 weeks, we measure amniotic fluid index before giving antioxidants then we give antioxidants for two weeks to group 1 and placebo to group 2 and measure amniotic fluid index after one week then after two weeks. Then follow up patients after three weeks. Then observe mode of delivery and if delivery by CS determine the indication and determine neonatal outcome according to Apgar score.
Biophysical profile was done before and after use of antioxidants.
Inclusion criteria:
Patients with gestational age between 30-34 weeks with:
- Oligohydramnios of unknown cause.
- Oligohydramnios assosiatd with Pregnancy induced hypertension (PIH).
Exclusion criteria:
1- Premature rupture of membranes.
2- Oligohydramnios in postdates pregnancy (>41 weeks).
3- Fetal anomalies.
4- IUGR.
5- Patients using non steroidal anti-inflammatory drugs.
Results:
After studying 120 cases of unexplained oligohydramnios and oligohydramnios due to pregnancy induced hypertension we found that there was significant increase in AFI after one, two, three weeks in patients using antioxidants compared to control group using placebo, As regard mode of delivery there was no effect of using antioxidants, Also giving antioxidants lead to better neonatal outcome .