Antenatal and intrapartum fetal surveillance in patients with oligohydramnios in a tertiary hospital
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20162258Keywords:
Oligohydramnios, Doppler, CTG, NSTAbstract
Background: The evaluation of amniotic fluid is an important index for the early detection and follow-up of fetal pathology during pregnancy. The objective of the study is to know the nature of Doppler in study (AFI ≤5) and control group (AFI ≥5) and the relationship of AFI with nature of CTG in both groups.
Methods: 50 singleton live pregnancies between 34-40 weeks gestation with well-established dates with AFI 5 or less for the study group. 50 singleton live pregnancies between 34-40 weeks gestation with well-established dates with AFI more than 5 were selected for the control group. Ultrasound examination was done for all women whenever they visited the hospital at/after 34 weeks of gestation. AFI was obtained sonographically. Antenatal fetal surveillance using Doppler, NST tracings and intrapartum fetal surveillance using CTG was done in all patients.
Results: 62 (62%) patients in the study group (AFI ≤5) were found to have deranged Doppler values in contrast to just 30 (30%) patients in the control group (AFI >5). An inverse relationship was found between the amount of amniotic fluid and the number of patients having abnormal Doppler in the study group. Suspicious or pathological CTG was more common in study group (67%) than the control group (22%).
Conclusions: Oligohydramnios has the most consistent association with IUGR. Severe oligohydramnios have more probabilities of having abnormal Doppler due to uteroplacental insufficiency. During intrapartum fetal assessment, suspicious or pathological CTG was more common in patients with oligohydramnios due fetal hypoxia during uterine contractions, cord compression and head compression. Hence patients with oligohydramnios should be put on regular antenatal surveillance to reduce the fetal complications and to improve the labour outcome.
References
Phelan JP, Smith CV, Small M. Amniotic fluid volume assessment with four quadrant technique at 36-42 weeks of gestation. J Repod Med. 1987;32:540-2.
Misra R. Hydramnios and oligohydramnios. In Renu Misra. Ian Donald’s Practical Obstetric Problems. 6th edition. BI Publications Pvt. Ltd;2007:364-375.
Dutta DC. The placenta and the membranes. Textbook of obstetrics. 6th edition. New Central Book Agency (P) Ltd;2004:37-39.
Umber A. Perinatal outcome in pregnancies complicated by isolated oligohydramnios at term. Annals. 2009;15:35-7.
Magann EF, Doherty DA, Lutgendorf MA. Peripartum outcomes of high risk pregnancies complicated by oligohydramnios. J Obstet Gynaecol Res. 2010;36(2):268-77.
Guin G, Punekar S, Lele P, Khare S. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume. J Obstet Gynaecol India. 2011;61(6):652-5
Chauhan SP, Hendrix NW. Intrapartum oligohydramnios does not predict adverse peripartum outcome among high risk parturient. Am J Obstet Gynecol. 1997;176(6):1130-6.
Sadovsky Y, Christensen MW. Cord containing amniotic fluid pocket-a useful measurement in the management of oligohydramnios. Obstet Gynecol. 1992;80(5):775-7.
Carroll BC, Bruner JP. Umbilical artery Doppler as a predictor of perinatal outcome in pregnancies complicated by oligohydramnios. Am J Obstet Gynecol. 1998;178(1):86.
Arora D, Desai SK, Sheth PN, Kania P. Significance of umbilical velocimetry in perinatal outcome of growth retarded fetuses. J Obstet Gynecol. 2005;55(2):138.
Jandial C, Gupta S, Sharma S, Gupta M. Perinatal outcome after antepartum diagnosis of oligohydramnios at or beyond 34 weeks of gestation. JK Science. 2007;9(4):213-4.
Chate P, Khatri M, Hariharan C. Pregnancy outcome after diagnosis of oligohydramnios at term. Int J Reprod Contracept Obstet Gynecol. 2013;2(1):23-6.
