DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20196034

Study of perinatal outcomes in normal and borderline oligamnios

Divya R. Prasad, Neelima V. Nair

Abstract


Background: Oligamnios is a common cause of perinatal mortality and morbidity, but the outcome of borderline oligamnios, defined as Amniotic Fluid Index (AFI) between 5 and 8, is less clear. This study aims to find out the effect of borderline oligamnios on perinatal outcomes in pregnancies beyond 37 weeks.

Methods: An observational prospective study of 131 antenatal mothers with AFI between 5 and 8, after 37 weeks of gestation was conducted in Sree Gokulam Medical College and Research Foundation from October 2017 to September 2019. These observations were compared with that of 131 antenatal mothers with normal AFI beyond 37 weeks of gestation. The observations according to fetal heart rate abnormalities, meconium staining of amniotic fluid, mode of delivery, low birth weight babies, APGAR score, the need of neonatal intensive care unit (NICU) admissions due to neonatal complications were statistically analysed.

Results: Both groups were comparable with respect to age, parity and gestational age. In those with borderline oligamnios, fetal heart rate abnormality was seen in 21% (28), meconium stained amniotic fluid in 18% (23), 70% (91) delivered vaginally and 30% (40) underwent caesarean section, 31% (41) babies weighed below 2.5 kg and 21% (27) neonates needed NICU admissions. In those with normal AFI, none showed fetal heart rate abnormality, 2% (3) showed meconium staining, 93% (122) delivered vaginally and 7% (9) underwent caesarean section, 11% (14) babies weighed below 2.5 kg and 3% (4) neonates needed NICU admissions.

Conclusions: Borderline oligamnios is associated with poor perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. It helps to identify those infants at risk of poor perinatal outcome.

Keywords


Borderline oligamnios, Fetal distress, Fetal surveillance, Hypertension in pregnancy, Meconium staining, Perinatal outcome, Stillbirths

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References


Brace RA. Physiology of amniotic fluid regulation. Clin Obstet Gynecol.1997;40(2):280-9.

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

Ross MG, Nijland MJ. Fetal swallowing: Relation to amniotic fluid regulation. Clin Obstet Gynecol. 1997;40(2):352-65.

Gaikwad PR, Oswal MS, Gandhewar MR, Bhatiyani PR. Perinatal outcome in oligohydramnios and borderline amniotic fluid index: a comparative study. Int J Reprod Contracept Obstet Gynecol. 2016;5:1964-8.

Ghike S, Reddy G, Ghike NW. Increasing severity of oligohydramnios: a risk factor for outcome. J South Asian Feder Obstet Gynecol. 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 Gynecol Obstet. 2007;96:89-93.

Wood Lindsay S, Michael Newton J, Liwang, Lesser K. Borderline AFI and its relation to fetal intolerance of labour. J Ultrasound Med. 2014;33:705-11.

Petrozella LN, Dashe JS, McIntire DD, Leveno KJ. Clinical significance of borderline amniotic fluid index and oligohydramnios in preterm pregnancy. Obstet Gynecol. 2011;117:338-42.

Sriya R, Singhai S, Rajan M. Perinatal outcome in patients with amniotic fluid index less than 5 cm. J Obstet and Gynecol of India. 2011;51(5):98-100.

Guin G, Punekar S, Leila A, Khare S. Prospective clinical study of fetomaternal outcome in pregnancies with abnormal liquor volume. J Obstet Gynecol. 2012;32(1):50-3.

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.