A clinical study on maternal and fetal outcome in pregnancy with oligohydromnios
Keywords:Fetal outcome, Maternal outcome, Oligohydromnios, Pregnancy
Background: Oligohydramnios is associated with various maternal and fetal complication. It’s correlated fetal complications like FGR, increased risk of meconium aspiration syndrome, Birth asphyxia, low APGAR scores and increased congenital abnormalities in fetus. It’s also associated with maternal morbidities in view of operative interventions for delivery. To study effect of oligohydramnios in mother in form of, operative delivery and progress of labour. To study effect of oligohydramnios in fetus in form of fetal compromise i.e. FGR, fetal distress, altered APGAR score, need for NICU admission. congenital anomaly and perinatal death.
Methods: 50 patients with ≥ 28 weeks POG with oligohydramnios, confirmed by ultrasonographic measurement of AFI using four quadrant technique; were selected randomly after fulfilling inclusion and exclusion criteria.
Results: Incidence of oligohydramnios were more found in primigravida (56%) in present study. Most common cause of oligohydramnios was idiopathic (62%) followed by PIH (20%). Most common cause of caesarean was fetal distress (23%) either due to cord compression or FGR. oligohydramnios was related to higher rate of Fetal Growth restriction and NICU admission (24%).
Conclusions: Oligohydramnios is very common encounter during pregnancy, Because of its frequent occurrence; it demands intensive fetal monitoring and systemic approach to antepartum and intrapartum fetal surveillance. There is increased risk of intrapartum complication, perinatal morbidity, perinatal mortality; thus, the rate of caesarean increasing day by day.one should always know the fine line between vaginal delivery and caesarean section; move ahead with best option without hampering fetal wellbeing and avoid unnecessary operative morbidity.
Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment with four quadrant technique at 36–42 weeks of gestation. J Reprod Med. 1987;32(7):540-54.
Moore IR. Clinical assessment of amniotic fluid. Clin Obstet Gynaecol. 1997;40(2):303-13.
Sherer DM, Langer O. Oligohydramnios: use and misuse in clinical management. Ultrasound Obstet Gynaecol. 2001;18(5):410-1.
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
Jagatia K, Singh N, Patel S. Maternal and fetal outcome in oligohydramnios: A study of 100 cases. Int J Med Sci Public Health 2013; 10(40):724-7.
Casey BM, McIntire DD, Bloom SL, Lucas MJ, Santos R, Twickler DM, et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol. 2000;182(4):909-12.
Golan A, Lin G, Evron S, Arieli S, Niv D, David MP. Oligohydramnios: maternal complications and fetal outcome in 145 cases. Gynecol Obstet Investigat. 1994;37(2):91-5.
Bansal D, Deodhar P. A Clinical Study of Maternal and Perinatal Outcome in Oligohydramnios. J Res Med Den Sci. 2015;3(4):312-6
Sriya R, Singhai S. Perinatal outcome in patients with amniotic fluid index < 5cm. J Obstet Gynaecol India 2001;51:98-100.
Marks AD, Divon MY : Longitudinal study of the amniotic fluid index in post-dates pregnancy. Obstet Gynecol 1992;79(2):229-33
Bhat S, Kulkarni V. Study of effect of oligohydramnios on maternal and fetal outcome. Int J Med and Dent Sci. 2015;4(1):582-8.
Kumar P, Iyer S, Ramkumar V. Amniotic fluid index a new ultrasound assessment of amniotic fluid. J Obstet Gynaecol India. 1991;41(1):10-2.
Chandra P, Kaur SP, Hans DK, Kapila AK. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Obstet Gynaecol. 2000;5(8):178-81
Hitschold T, Weiss E, Berle P, Muntefering H. Histologic placenta findings in prolonged pregnancy: correlation of placental retarded maturation, fetal outcome and Doppler sonographic findings in the umbilical artery. Z Geburtshilfe Perinatol 1989;193(1):42-6
Kwon JY, Kwon HS, Kim YH, Park YW. Abnormal Doppler Velocimetry is related to adverse perinatal outcome for borderline amniotic fluid index during third trimester. J Obstet Gynecol Res 2006:32(6):545-9.
Johnson JM, Chauhan SP, Ennen CS, Niederhauser A, Magann EF. A comparison of 3 criteria of oligohydramnios in identifying peripartum complications: a secondary analysis. Am J Obstet Gynecol 2007;197(2):207.e1-7
Philipson EH, Sokol RJ, Williams T. Oligohydramnios: Clinical Associations and Predictive Value for Intrauterine Growth Retardation. Am J Obstet Gynecol 1983;146(3):271-8.
Manning FA, Hill LM, Platt LD. Qualitative amniotic fluid volume determination by ultrasound: Antepartum detection of intrauterine growth retardation. Am J Obstet Gynecol 1981;139(3):254- 8.