DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20214315

Feto-maternal outcome of oligohydramnios in tertiary care hospital

Shetal Prajapati, Sakina Johar

Abstract


Background: The importance of amniotic fluid volume as an indicator of fetal wellbeing has made its assessment an important part of antenatal fetal surveillance. Oligohydramnios complicates 0.5% to 8% of pregnancies and the prognosis for pregnancies complicated by oligohydramnios is dependent on the gestational age and the underlying aetiology. This study aims to determine the feto-maternal outcome of oligohydramnios in a tertiary care hospital.

Methods: In this study, we included 100 patients of oligohydramnios, with AFI ≤5 cm with a singleton pregnancy with intact membranes. The maternal outcome was accessed by mode of delivery and maternal complications and the neonatal outcome was studied by birth weight, APGAR score, NICU admission and perinatal mortality.

Results: PIH was the most common risk factor in 38% of cases followed by IUGR in 29%, doppler changes in 24%. The reduced diastolic flow was the most common abnormal doppler finding in the 23% abnormal doppler cases, from which 39% underwent cesarean section, 9% required NICU admission and 61% had neonatal death. 53% delivered by cesarean section of which 13% had neonatal death. NICU admission is required in 64% of cases.

Conclusions: We conclude that oligohydramnios is a high-risk pregnancy and proper antepartum care, intensive fetal surveillance and intrapartum care are required in a patient with oligohydramnios. Every case of oligohydramnios needs careful antenatal evaluation, parental counselling, individualization, decisions regarding time and mode of delivery. Continuous intrapartum fetal monitoring and good neonatal care are necessary for a better perinatal outcome.


Keywords


Oligohydramnios, AFI, Feto-maternal outcome, IUGR, Perinatal mortality

Full Text:

PDF

References


Moore TR. Amniotic fluid dynamics reflect fetal and maternal health and disease. Obstet Gynecol. 2010;116:759-65.

Hashimoto BE, Kramer DJ, Brennan L. Amniotic fluid volume: fluid dynamics and measurement technique. Semin Ultrasound CT MR. 1993;14:40-55.

Albert SP, Myoung AO, Jeffrey PP. Intrapartum amniotic fluid volume at term. J Reprod Med. 1990;35:719-23.

Dasari P, Niveditta G, Raghavan S. The maximal vertical pocket and amniotic fluid index in predicting fetal distress in prolonged pregnancy. Int J Gynaecol Obstet. 2007;96(2):89-93.

Sultana S, Akbar Khan MN, Khanum Akhtar KA, Aslam M. Low amniotic fluid index in high-risk pregnancy and poor apgar score at birth. J Coll Physicians Surg Pak. 2008;18(10):630-4.

Rainford M, Adair R, Scialli AR, Ghidini A, Spong CY. Amniotic fluid index in the uncomplicated term pregnancy. Prediction of outcome. J Reprod Med. 2001;46(6):589-92.

Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment using the four-quadrant technique in the pregnancy at 36-42 weeks gestation. J Reprod Med. 1987;32(7):540-2.

Marino T. Ultrasound abnormalities of the amniotic fluid, membranes, umbilical cord, and placenta. Obstet Gynecol Clin N Am. 2004;31:177-200.

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.

Modi JY. Int J Reprod Contracept Obstet Gynecol. 2016;5(11):4037-40.

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.

Radhamani S, Babitha. A clinical study of feto-maternal outcome in pregnancies with oligohydramnios. Int J Reprod Contracept Obstet Gynecol. 2017;6:868-71.

Petrozella LN, Dashe JS, McIntire DD, Leveno KJ. Clinical Significance of Borderline Amniotic Fluid Index and Oligohydramnios in Preterm Pregnancy. Obstetrics & Gynecology. 2011;117(2 Pt 1):338-42.

Hitschold T. Weiss 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):545-49.

Jandial C, Gupta S, Sharma S, Gupta M. Perinatal Outcome After Antepartum Diagnosis of Oligohydramnios at or Beyond 34 Weeks of Gestation. JK science. 2007;9(4):213-14.

Umber A. Perinatal Outcome in Pregnancies Complicated by Isolated Oligohydramnios at Term. Annals. 2009;15:35-7.

Manzanares S, Carrillo MP, GonzálezPerán E, Puertas A, Montoya F. Isolated oligohydramnios in term pregnancy as an indication for induction of labor. J Matern Neonatal Med. 2007;20(3):221-4.

Bansal D, Deodhar P. A Clinical Study of Maternal and Perinatal Outcome in Oligohydramnios. J Res Med Den Sci. 2015;3(4):312-6.

Golan A, Lin G, Evron S, Arieli S, Niv D, David MP. Oligohydramnios: maternal complications and fetal outcome in 145 cases. Gynecol Obstet Invest. 1994;37(2):91-5.

Bachhav AA, Waiker M. Low amniotic index at term as a predictor of adverse perinatal outcome. J Obstet Gynaecol India. 2014;64(2):120-3.

Nazlima N, Fathima B. Oligohydromnios at third trimester and perinatal outcome. Bangladesh J Med sci. 2012;11(1):33-6.

Manning FA, Harmon CR, Morrison I. Fetal assessment based on fetal biophysical profile scoring. An analysis of perinatal mortality and morbidity. American Journal of obstetrics and gynecology. 1991;162:703-9.

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

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.