Clinico-radiological evaluation of oligohydramnios with special reference to pregnancy outcome

Apurba Kumar Bhattacharya; Runjun Doley; Abhinab Bhattacharjee

doi:10.18203/2320-1770.ijrcog20220563

Authors

Apurba Kumar Bhattacharya Department of Obstetrics and Gynecology, Jorhat Medical College and Hospital, Jorhat, Assam, India
Runjun Doley Department of Obstetrics and Gynecology, Assam Medical College and Hospital, Dibrugarh, Assam, India
Abhinab Bhattacharjee Department of Obstetrics and Gynecology, Jorhat Medical College and Hospital, Jorhat, Assam, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20220563

Keywords:

Oligohydramnios, AFI, Caesarean section, NICU admission, Meconium-stained liquor, Perinatal outcome

Abstract

Background: Oligohydramnios is defined as amniotic fluid index of less than 5cm^.It is thought to be associated with increased fetal and maternal morbidity. Studies are not clear whether the adverse perinatal outcome merely reflects the sequel of other conditions or if, reduced amniotic fluid volume itself contributes to adverse outcomes.

Methods: A total of 150 pregnant women with gestational age >34 weeks having clinically diagnosed oligohydramnios were enrolled in this observational prospective clinical study, during the study period of 12 months,1June 2020 to 31May 2021. Patients were first subjected to ultrasonographic AFI estimation, divided into two groups (oligohydramnios and borderline AFI) and then followed up for maternal and fetal outcome. Data was statistically analyzed.

Results: A total 72.66% had AFI less than 5 cm. 97 (64.66%) were primigravida. 68% were prepared for Caesarean section irrespective of gestational period, the most common indication being fetal distress. 66.66% babies had good APGAR score at 1 minute after birth.41.06% delivered babies who required NICU admission, although only 2% neonatal deaths were recorded.

Conclusions: Our study shows that isolated decreased AFI after 34 weeks of gestation is associated with satisfactory perinatal outcome. Both groups in the study, when compared statistically, were relatively similar in their pregnancy outcome. Significant association was found between oligohydramnios and increased rate of caesarean section, NICU admission and abnormal fetal heart rate tracing.

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References

Keilman C, Shanks AL. Oligohydramnios. In: Stat Pearls. Treasure Island (FL): Stat Pearls Publishing; 2021.

Hill LM, Breckle R, Wolfgram KR, O'Brien PC. Oligohydramnios: ultrasonically detected incidence and subsequent fetal outcome. Am J Obstet Gynecol. 1983;147(4):407-10

McCurdy CM, Seeds JW. Oligohydramnios: problems and treatment. Semin Perinatol. 1993; 17(3):183-96.

Phelan JP, Ahn MO, Smith CV, Small M. Amniotic fluid volume assessment with four quadrant technique at 36 to 42 weeks’ gestation. J Reprod Med. 1987;32:540-2.

Garmel SH, Chelmow D, Sha SJ. Oligohydramnios and the appropriately grown foetus. Am J Perinatal. 1997;14:359.

Jandial C, Gupta S, Sharma S, Gupta M. Perinatal outcome after antepartum diagnosis of oligohydramnios at or beyond 34 weeks of gestation. 63, Sri Niketan, New Rehari, Jammu: JK Science; 2019.

NFHS-4 National Family Health Survey-4-2015-16-India fact sheet. Available at: http://rchiips.org/nfhs/ pdf/NFHS4/India.pdf. Accessed on 20 September 2020.

Reddy MV. Appropriately grown foetus Int J Reprod Contracept Obstet. 2013;2(4):577-80.

Conway DL, Adkins WB, Schroeder B, Langer O. Isolated oligohydramnios in the term pregnancy: is it a clinical entity? J Matern Fetal Med. 1998;7(4):197-200.

Golan A, Lin G, Evron S, Arieli S, Niv D, David MP. Oligohydramnios: maternal complications and fetal outcome in 145 cases. Gynecol Obstet Invest. 1994;37(2):91-5.