DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184025

Perinatal outcome in pregnancy complicated with oligohydramnios at term

Abhijeet Kumar, P. S. Rao, Sanjeev Kumar, Binay Mitra

Abstract


Background: Oligohydramnios is defined as AFI of less or equal to five cm. Various methods like NST, acoustic stimulation, and fetal Doppler velocimetry are helpful in assessment of fetal wellbeing and identifying those pregnancies at risk of adverse perinatal outcome. This study was undertaken to know the adverse perinatal outcome in pregnant women with oligohydramnios at term and to evaluate the value of AFI in predicting the subsequent fetal dis-tress and caesarean delivery.

Methods: Analysis of pregnancy outcome in 50 cases with diagnosis of oligohydramnios by USG after 37 completed weeks of gestation compared with 50 controls with no oligohydramnios and matched for other variables. There were some inclusion and exclusion criteria used. The results were statistically analysed using parameters like mean, standard deviation and chi square test sensitivity, specificity, PPV, NPV were used.

Results: There was significant difference between two groups in occurrence of non-reactive and re-active NST pattern. There is increased incidence of labour induction in women with AFI ≤5cm as compared with women with AFI >5cm. Increased occurrence of LBW (≤2.5kg) in women with oligohydraminos and increased LSCS rates in pregnancy complicated by oligohydramnios were observed.

Conclusions: An AFI of ≤ 5cm detected after 37 weeks of gestation is an indicator of adverse perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. AFI is a valuable screening test for predicting fetal distress in labour requiring caesarean section.


Keywords


Amniotic fluid index, Amniotic fluid volume, Fetal acoustic stimulation test, FHR, NST, Oligohydramnios, VAST

Full Text:

PDF

References


Chamberlain PF, Manning FA, Morrison I, Harman CR, Lang CR. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gyencol. 1984;150:245-9.

Bhagat M, Chawla I. Correlation of amniotic fluid index with perinatal outcome. Ind J Obstet Gynecol. 2014;64(1):32-5.

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

Locatelli A, Vergani P, Toso L, Verderio M, Pezzullo JC, Ghidini A. Perinatal outcome associated with oligohydramnios in uncomplicated term pregnancies. Arch Gynecol Obstet. 2004;269:130-3.

Antepartal fetal monitoring. In: Murray M, ed. Antepartal and intrapartal fetal monitoring. New York: Springer Publishing Company; 2006:455-487.

Chandra P, Kaur SP, Hans DK, Kapika AK. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Obstet Gynecol Tod. 2000;5:478-81.

Sriya R, Singhai S. Perinatal outcome in patients with amniotic fluid index ≤5cm. J Obstet Gynecol India. 2001;51:98-100.

Kumar P, Iyer S, Ramkumar V. Amniotic fluid index: a new ultrasound assessment of amniotic fluid. J Obstet Gynecol India. 1991;41:10-2.

Casey BM, Mctire DD, Bloom SL, Lucas MJ, Santos R, Twickler DM, et al. Pregnancy outcome after antepartum diagnosis of oligohydramnios at or beyond 34 weeks gestation. Am J Obstet Gynecol. 2000;1982:909-12.

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(3):353-6.

Morries JM, Thompson K, Smithey J, Gaffney G, Cooke I, Chamberlain P, et al. The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study. Br J Obstet Gynecol. 2003;110(11):989-94.

Grubb DK, Paul RH. Amniotic fluid index and prolonged antepartum fetal heart rate declaration. Obstet Gynaecol. 1992;79(4);558-60.