A clinical study evaluating maternal and perinatal outcomes in patients with decreased amniotic fluid in term pregnancy

Sukanya Nagsen Thorat; Abhyudai Ravooru; Anita Bansal

doi:10.18203/2320-1770.ijrcog20223122

Authors

Sukanya Nagsen Thorat Department of Obstetrics and Gynecology, Nothern Railway Central Hospital, New Delhi, India
Abhyudai Ravooru Assosciate Specialist ,Tata Central hospital, West Bokaro
Anita Bansal Department of Obstetrics and Gynecology, Nothern Railway Central Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20223122

Keywords:

AFI, Borderline AFI, Oligohydramnios

Abstract

Background: Oligohydramnios is the most frequent third trimester complication resulting in a greater number of caesarean sections. This study was carried out to determine the role of oligohydramnios (AFI<5) and borderline amniotic fluid index (AFI between 5.1-8) for term pregnancy and their impact on maternal and perinatal outcomes. Objectives of current investigation were to study incidence of oligohydramnios in term pregnancy and to study maternal and perinatal outcome in cases with oligohydramnios.Methods: Present study is done during August 2018 to May 2019 in department of obstetrics and gynaecology, northern central railway hospital, Delhi on 90 women with singleton term pregnancy (37-41weeks) with cephalic presentation, with no leaking PV. According to the AFI measurements (1 week before delivery), 3 groups were formed AFI 0-5 cm (oligohydramnios), 5.1-8cm (borderline AFI), 8.1-24 cm (normal AFI), AFI >24 cm was excluded. Maternal and fetal outcome were assessed.Results: The incidence of oligohydramnios (AFI<5 cm) was 4.4%. Induction of labour was 50% in AFI <5 cm group, 57.1% in borderline AFI and 13.9% in normal AFI group. In AFI <5 cm group, 75% had LSCS, in AFI5-8 cm group, 71.42% had LSCS. Most common indication of LSCS in AFI <5 cm and AFI 5-8 cm was fetal distress. APGAR score <7 at 1, 5 mins was 50% in AFI <5 cm and AF 5-8 cm group as against 8.9% in Normal group. Babies weighing less than 2.5kg were 50% in AFI <5cm group, 42% in borderline group and 15.1% in normal AFI group.Conclusions: AFI determination helps to identify foetuses at risk of poor perinatal outcome. It is a valuable screening test to predict fetal distress in labor that may need caesarean section.

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Author Biographies

Sukanya Nagsen Thorat, Department of Obstetrics and Gynecology, Nothern Railway Central Hospital, New Delhi, India

DGO , DNB IN OBSTETRICS AND GYNAECOLOGY FROM NORTHERN CENTRAL RAILWAY HOSPITAL , NEW DELHI

PRESENTLY WORKING AS ASSOCIATE SPECIALIST IN OBSTETRICS AND GYNAECOLOGY

Abhyudai Ravooru, Assosciate Specialist ,Tata Central hospital, West Bokaro

MS IN OBSTETRICS AND GYNAECOLOGY FROM GRANT MEDICAL COLLEGE AND JJ GROUP OP HOSPITALS , MUMBAI

PRESENTLY ASSOSCIATE SPECIALIST AT TATA CENTRAL HOSPITAL , WEST BOKARO .

Anita Bansal, Department of Obstetrics and Gynecology, Nothern Railway Central Hospital, New Delhi, India

Head of Department , Obstetrics and Gynaecology, Norhern Central Railway Hospital , New Delhi .

References

Cunningham FG, Leveno KJ. Williams text book of Obstetrics. 24th ed. USA: Nc Graw Hill; 2016.

Crowley P, Herlihy CO, Boylan O. The value of ultrasound measurement of amniotic fluid volume in the management of prolonged pregnancies. Br J Obstet Gynecol. 1984;91:444-8.

Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment with the fourquadrant technique at 36-42 weeks gestation. J Reprod Med. 1987;32(7):540-2.

Baron C, Morgan MA, Garite TJ. The amniotic fluid volume assessed intrapartum on perinatal outcome. Am J Obstet Gynecol. 1995;173:167-74.

Kwon JY, Kwon HS, Kim YH, Park YW. Abnormal Doppler velocimetry is related to adverse pregnancy outcome for borderline amniotic fluid index in the third trimester. J Obstet Gynecol Res. 2006;32:545-8.

Moore TR, Cayle JE: The amniotic fluid index in normal human pregnancy. Am J Obset Gynecol. 2010;162(5):1168.

Suvarna V, Baron C, Morgan MA, Garite TJ. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Am J Obstet Gynecol. 2018; 173(1): 167-74.

Gupta G, Gupta A, Taly A. Amniotic fluid index. Int J Med Res Prof. 2017;3(3);131-5.

Bhagat M, Chawla I. Amniotic fluid index. J Obst Gynaecol India. 2014;64(1):32-5.

Veena V. Amniotic fluid index. Int J Reprod Contracept, Obstet Gynecol. 2015;4(1):152-6.

Casey BM, McIntire DD, Bloom SL, Lucas MJ, Santos R, Twickler DM, Ramus RM, Leveno KJ. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol. 2000;182(4):909-12.

Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis. Am J Obstet Gynecol. 1999;181(6): 1473-8.

Bachhav AA, Waikar M. Low amniotic fluid index at term as a predictor of adverse perinatal outcome. J Obstet Gynaecol India. 2014;64(2):120-3.

Youssef AA, Abdulla SA, Sayed EH, Salem HT, Abdelalim AM, Devoe LD. Superiority of amniotic fluid index over amniotic fluid pocket measurement for predicting bad fetal outcome. South Med J. 1993;86(4):426-9.