A study of fetomaternal outcome in induction of labour in third trimester oligohydramnios
Keywords:Amniotic fluid index, Induction, Oligohydramnios, Neonatal outcomes, Term gestation, Vaginal delivery
Background: The Induction of labor in oligohydramnios poses a dilemma for obstetrician. Studies are limited with variable results. This study aims at finding whether isolated oligohydramnios is an indication for operative delivery or labor induction followed by vaginal delivery is possible.
Methods: A prospective study carried out on females delivered in study duration in Umaid Hospital, Jodhpur, Rajasthan. Outcomes studied were gestational age at delivery, colour of amniotic fluid, FHR tracings, mode of delivery, indication for cesarean section or instrumental delivery, Apgar score at one minute and five minutes, birth weight, admission to Neonatal Intensive Care Unit (NICU), perinatal morbidity and perinatal mortality. Descriptive statistics were applied and data was represented on frequency tables, graphs and diagrams.
Results: 40% of subjects had amniotic fluid index (AFI) <5 cm and 60% demonstrated AFI between 5-7 cm. 60% of patients induced delivered vaginally with (38.33%) having AFI <5 cm. Operative delivery was resorted to in 40% of patients. Perinatal outcomes resulted in total 97% of babies discharged in healthy condition.
Conclusions: Labor induction is feasible in idiopathic oligohydramnios. Fetal distress is the most feared and predicted outcome with labor induction in oligohydramnios. This study deduced that in majority- reason for c-sections was failed labor induction due the poor Bishop's score, not fetal reasons. We hope by putting at rest apprehensions of obstetrician regarding this notion rate of c-sections could be reduced.
Jagatia K, Singh N, Patel S. Maternal and fetal outcome in oligohydramnios- study of 100 cases. Int J Med Sci Public Health. 2013;2(3):724-7.
Guin G, Punekar S, Lele A, Khare S. Evaluating feto-maternal outcome in pregnancies with abnormal liquor volume. J Obstet Gynaecol India. 2011;61(6):652-5.
Zhang J, Troendle, J, Meikle, S. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG. 2004;111:220-5.
Shrestha D. Study of fetal outcome in oligohydramnios. Bir hospital Mahaboudha, Kathmandu. 2009.
Rossi AC, Prefumo F. Perinatal outcomes of isolated oligohydramnios at term and post term pregnancy:a systematic review of literature with meta-analysis. Eur J Obs Gynec Reprod Biol.2013;169:149-54.
Alchalabi HA, Obeidat BR, Jallad MF, Khader YS. Induction of labor and perinatal outcome: the impact of the amniotic fluid index. Eur J Obstet Gynecol Reprod Biol. 2006;129(2):124-7.
Locatelli A, Vergani P, Toso L, Verderio M. Perinatal outcome associated with Oligohydramnios in uncomplicated term pregnancy. Arch Gynecol Obstet. 2004;269(2):130-3.
Danon D, Ben-Haroush A, Yogev, Y. Prostaglandin E2 induction of labour for isolated oligohydramnios in women with unfavourable cervix at term. Fetal Diagn Ther. 2007;22:75.
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.
Melamed N, Pardo J, Milstein R, Chen R. Perinatal outcome in pregnancies complicated by Isolated hydramnios diagnosed before 37 weeks of gestation. Am J Obstet Gynecol. 2011;205(3):241e.1-241e.6.
Ahmad H, Munim S. Isolated oligohydramnios is not an indicator for adverse perinatal outcome. J Pak Med Assoc. 2009;59(10):691-4.
Bangal VB, Giri PA, Sali BM. Incidence of oligohydramnios during pregnancy and its effects on maternal and perinatal outcome. J Pharm Biomed Sci. 2011;12(5):1-4.
Chhabra S, Dargan R, Bawaskar R. Oligohydramnios: a potential marker for serious obstetric complications. J Obstet Gynaecol. 2007;27(7):680-3.