Perinatal outcome in oligohydramnios and borderline amniotic fluid index: a comparative study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20161699Keywords:
Perinatal outcome, Amniotic fluid index, AFI, Oligohydramnios, Borderline, MarginalAbstract
Background: Oligohydramnios is associated with adverse perinatal outcome in the form of meconium staining, intrauterine growth restriction (IUGR), caesarean section for abnormal fetal heart rate tracing, low Apgar score and neonatal intensive care unit (NICU) admission.
Methods: This was a prospective study of 100 singleton pregnancies beyond 28 weeks of gestation with AFI< 8 cm, delivered within seven days of admission. Patients were divided in two groups, those with AFI ≤ 5 cm and borderline AFI of 5.1 to 8 cm. Perinatal outcome was studied in the form of onset of labor, mode of delivery, fetal heart rate variations, meconium staining and lower segment caesarean section (LSCS) for fetal distress, Apgar score, birth weight, NICU admission and neonatal mortality.
Results: Patients with oligohydramnios with AFI ≤5 cm were significantly associated with IUGR and presence of abnormal umbilical artery Doppler velocimetry (p <0.05). Adverse perinatal outcome was seen in higher percentage of patients having AFI ≤5 cm than with borderline AFI. The difference was statistically significant for overall caesarean delivery rate and LSCS for fetal distress (p <0.05).
Conclusions: Oligohydramnios with AFI of ≤5 cm is associated with high caesarean delivery rate and LSCS for fetal distress.
References
Williams Obstetrics. Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC III, Hauth JC, Wenstrom KD: 21st Edition USA; McGraw Hill. Fetal Growth & Development. Chapter 7: 142-143.
Moore TR. Amniotic fluid dynamics reflect fetal and maternal health and disease. Obstet Gynecol. 2010;116:759-65.
Sarno Albert P, Ahn Myoung O, Phelan Jeffrey P. Intrapartum Amniotic Fluid at Term. J Reprod Med. 1990;35:719-23.
American College of Obstetrician and Gynecologists: Antepartum fetal Surveillance, Practice Bulletin No. 9, October 1999, Reaffirmed 2012.
Phelan AP, Smith CV, Broussard P,Small M. Amniotic fluid volume assessment with the four quadrant technique at 36-42 week`s gestation. J Reprod Med. 1987;32:540-2.
Rutherford SE, Phelan JP, Smith CV, Jacobs N. The four quadrant assessment of amniotic fluid volume: An adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987;70:353-6.
Baron C, Morgan MA, Garite TJ. The impact of 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;32:545-9.
Petrozella LN, Dashe JS, McIntire DD, Leveno KJ. Clinical significance of borderline amniotic fluid index and oligohydramnios in preterm pregnancy. Obstet Gynecol. 2011;117(2 Pt 1):338-42.
Gumus II, Koktener A, Turhan NO. Perinatal Outcome of pregnancies with borderline amniotic fluid index. Arch Gynecol Obstet. 2007;276:17-9.
Banks EH, Miller DA. Perinatal risks associated with borderline amniotic fluid index. Am J Obstet Gynecol. 1999;180:1461-3.
Krieser D, El-Sayed YY, Sorem KA, Chitkara U, Holbrook RH, Druzin ML. Decreased amniotic fluid index in low-risk pregnancy. J Reprod Med. 2001;46:743-6.
Magann EF, Chauhan SP, Hitt WC, Dubil EA, Morrison JC. Borderline or Marginal Amniotic Fluid Index and Peripartum Outcomes. A Review of Literature. J Ultrasound Med. 2011;30:523-8.
Ghike Sunita, Reddy G, Ghike NW. Increasing Severity of Oligohydramnios: A risk factor for outcome. J South Asian Feder Obst Gynae. 2013;5(1):8-10.
Dasari P, Niveditta G, Raghavan S. The maximal vertical pocket and amniotic fluid index in predicting fetal distress in prolonged pregnancy. Int J Gynaecol Obstet. 2007;96:89-93.
Chandra P, Kaur SP, Hans DK, Kapila AK. Aug. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Obstet and Gynae Today. 2000;5(8):478-81.
Chauhan SP, Washburne JF, Magann EF, Perry KG Jr, Martin JN, Morrison JC. A randomized study to assess the efficacy of the amniotic fluid index as a fetal admission test. Obstet Gynecol. 1995;86:9-13.