A prospective clinical study of foetomaternal outcome in relation to amniotic fluid index in pregnant females beyond 36 weeks of gestation at tertiary centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20202299Keywords:
Amniotic fluid index, Oligohydramnios, Polyhydramnios, Single vertical pocketAbstract
Background: Amniotic fluid plays a vital role during foetal life. The main purpose of this study was to evaluate the foetomaternal outcome in relation to amniotic fluid index in pregnant females beyond 36 weeks of gestation.
Methods: This prospective type of study was conducted for one-year duration from May 2018 to May 2019 in 350 pregnant females beyond 36 weeks of gestation with clinically significant abnormal liquor volume. Clinical diagnosis was later on confirmed with ultrasonography and patients were categorized in three categories as patients with Amniotic fluid index (AFI) 5 to 24, AFI <5 and AFI > or = 25. Complete labour record was made and fetomaternal outcome was assessed.
Results: In this study, incidence of oligohydramnios was found to be more than polyhydramnios at term. No significant differences were found in relation to age, parity, religion, residence and booking status in all the study groups. Mostly patients 119 (52%) delivered by caesarean section in oligohydramnios group whereas vaginal delivery was commonly seen in patients with normal AFI (80%) and polyhydramnios (55%). Growth restriction 59 (26%) and malpresentation 18 (8%) were commonly seen with oligohydramnios. In the polyhydramnios group, 14 (35%) babies had malformations whereas only 6 (3%) babies had malformations in patients with oligohydramnios. Significant differences were found in the foetal outcome between the patients with oligohydramnios and polyhydramnios in comparison to patients with normal AFI.
Conclusions: In pregnant females with abnormal liquor volume increases the chances of maternal morbidity and perinatal morbidity and mortality.
Metrics
References
Queeran JT, Gadow EC. Polyhydramnios: chronic versus acute. Am J Obstet Gynecol. 1970;108:349-52
Magann EF, Doherty DA, Chauhan SP, Busch FW, Mecacci F, Morrison JC. How well do the amniotic fluid index and single deepest pocket indices (below the 3rd and 5th and above the 95th and 97th percentile) predict oligohydramnios and hydramnios? Am J Obstet Gynecol. 2004;190:164-9.
Sowmya K, Varghese B, Borkar YB. Effect of isolated oligohydramnios in otherwise normal term pregnancy. Int J Biomed Res. 2014;5(2):98-101.
Chamberlain PF, Manning FA, Morrison I, Harman CR, Lange IR. Ultrasound evaluation of amniotic fluid volume: I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gynecol. 1984;150(3):245-9.
Phelan JP, Ahn MO, Smith CU, Rutherford SE. Amniotic fluid index in normal human pregnancy. J Reprod Med. 1987;32:601-4.
Moore TR. Clinical assessment of amniotic fluid. Clin Obstet Gynaecol. 1997;40(2):303-13.
Yoshimura S, Masuzaki H, Gotoh H, Ishimara T. Fetal redistribution of blood flow and amniotic fluid volume in growth retarded foetuses. Early Hum Dev. 1997;47:297.
Voxman EG, Tran S, Wing DA. Low amniotic fluid index as a predictor of adverse fetal outcome. J Perinatol. 2000:22(4):282-5.
Casey BM, McIntire DD, Bloom SL, Lucas MJ, Santos R. Pregnancy outcome after antepartum diagnosis of oligohydramnios at or beyond 34weeks gestation. Am J Obstet Gynecol. 2001:82(4);909-12.
Brady K, PolzinWJ, Kopelman JN, Read JA. Risk of chromosomal abnormalities in patients with idiopathic polyhydramnios. Obstet Gynecol. 1992;79:234-8.
Bundagard A, Anderson BR, Rode L, Lebech M, Tabor A. Prevalence of polyhydramnios at a Danish hospital-a population-based study. Acta Obstet Gynecol Scand. 2007;86(12):1427-31.
Chen M, Chen CP. Invasive fetal therapy, global status and local development. Taiwanese J Obstet Gynecol. 2004;439:185-92.
Magann EF, Chauhan SP, Doherty DA, Lutgendorf MA, Magann MI, Morrison JC. A review of idiopathic hydramnios and pregnancy outcomes. Obstet Gynecol Surv. 2007;62:795-802.
Magann EF, Doherty DA, Lutgendorf MA, Magann MI, Chauhan SP, Morrison JC. Peripartum outcomes of high-risk pregnancies complicated by oligo- and polyhydramnios: a prospective longitudinal study. J Obstet Gynaecol Res. 2010;36:268.
Queenan JT. Recurrent acute polyhydramnios. Am J Obstet Gynaecol. 1970;106:625.
Guin G, Punekar S, Lele A, Khare S. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume. J Obstet Gynecol India. 2011;61(6):652-5.
Kaur T, Sood R. Feto-maternal outcome in pregnancies with abnormal AFI. IOSR J Dent Med Sci. 2016;15(4):31-5.
Ghimire S, Ghimire A, Chapagain S, Paudel S. Pregnancy cases in patients with oligohydramnios after 28 weeks of gestation. Int J Adv Med Health Res. 2016;3:68-72.
Ahmar R, Parween S, Kumari S, Kumar M. Neonatal and maternal outcome in oligohydramnios: a prospective study. Int J Contemp Pediatr. 2018;5(4):1409-13.
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.
Lallar M, ul Haq A, Nandal R. Perinatal outcome in idiopathic polyhydramnios. J Obstet Gynecol India. 2015;65(5):310-4.