DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20214634

Study of mode of delivery and fetal outcome in pregnancies with oligohydramnios

Lavanya B., A. Prajwala

Abstract


Background: The significance of amniotic fluid volume as a marker of fetal status is an ongoing turn of events. Oligohydramnios causes adverse fetal outcomes like meconium-stained liquor, meconium aspiration syndrome, fetal heart rate abnormalities, poor APGAR scores, fetal growth restriction and fetal prematurity. It is associated with maternal hypertension, infections, and placental insufficiency. It causes maternal complication because of increased incidence of induction of labour and operative intervention.

Methods: Hundred cases of oligohydramnios were included in our study conducted at the Navodaya medical research, hospital and research centre, during a period of two years after obtaining the informed consent of patients and institutional ethical clearance. All gravidas were included with a gestational age greater than 28 weeks with singleton pregnancies with oligohydramnios. Associated fetal and maternal risk factors were observed. The amniotic fluid index (AFI) was measured by ultrasound. The nonstress test, the fetal biophysical profile and the Doppler study were carried out to evaluate the fetal condition. Then we have observed for delivery and fetal outcome.

Results: Incidence of oligohydramnios was 2.85% in our study. The 53% of cases had LSCS while 47% had normal delivery. Fetal distress was the commonest indication for LSCS. Poor neonatal APGAR score was 16.9% in LSCS while 36% in vaginal delivery.

Conclusions: From the above study, the caesarean delivery seems to be a safer mode of delivery than vaginal delivery because it is associated with a good perinatal outcome.


Keywords


Oligohydramnios, Fetal outcome, Mode of delivery, Vaginal delivery, Caesarean section

Full Text:

PDF

References


Taylor MF, Fisk NM. Hydramnios and oligohydramnios. In James DK, Steer PJ, Weiner CP, Gonik B, editors. High risk pregnancy, 3rd edition. Philadelphia: WB Saunder publications. 2006;278-85.

Moore TR, Longo J, Leopald GR, Casola G, Gosink BB. The reliability and predic- tive value of an amniotic fluid scoring system in severe second trimester oligohydramnios. Obstet Gynecol. 1989;73:739.

Phelan JP, Smith CV, Broussard P. the four-quadrant assessment of amniotic fluid volume at 36-42 weeks gestation. J Reprod Med. 1986;32:540.

Jeng CJ, Lee JF, Wang KG. Decreased amniotic fluid index in term pregnancies clini cal significance. J Repo Med. 1992;37:789-92.

Ross MG, Shermin DJ, Ervin MG. Stimuli for fetal swallowing: systemic factors. Am J obstet Gynecol. 1984;161:1559.

Manning FA, Hill LM, Platt LD. Qualitative amniotic fluid volume determination by ultrasound in antepartum detection of intrauterine growth retardation. Am J Obst Gy naecol. 1981;139:254-8.

Chauhan SP, Magann EF, Morrison JC, Whitworth NS, Hendrix NW, Devoe LW. Ultrasonographic assessment of amniotic fluid does not reflect actual amniotic fluid volume. Am J Obst Gvnaecol. 1997;177:291-7.

William MG. Amniotic fluid disorders. In Jennifer RN, Joe LS, Henry G, Eric MJ, Laura G, editors. Obstetrics normal and problem pregnancies, 5th edition. Philadelphia: Churchill living stone publications. 2007;834-45.

Lewis S, Kathryn L, Caroline F, Anderson R, Nydia A. Significance of oligo- hydramnios complicating pregnancy. Am J Obstet Gynecol. 1991;164:1597-1600.

Zhang J, Troendle J, Meikle S. Isolated oligohydramnios is not associated with ad- verse perinatal outcome. Brit J Obstet Gynecol. 2004;111:220.

Golan A, Lin G, Evron S, Nivd A. Oligohydramnios maternal complications and fetal outcome in 145 cases. Gynecol Obstet invest. 1994;37(2):91-5.

Crowley P, O' Herlihy C, Boylan P. The value of ultrasound measurement of amniotic fluid volume in the management of prolonged pregnancies. Br J Obstet Gynecol. 1984;91:444-8.

Casey BM, Mc Intire 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.

Sriya R, Singhais. Perinatal outcome in patients with amniotic fluid index <5 cm. J Obstet Gynecol India. 2001;51(5):98-100.

Rutherford SE, Phelan JP, Smith CV, Jacobs N. The four-quadrant assessment of amniotic fluid volume: An adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987;70:353.

Sarno AP Jr, Ahn MO, Phelan JP. Intra partum amniotic amniotic fluid volume at term. Association of ruptured membranes, oligohydramnios and increased fetal risk. J reprod Med. 1990;35(7):719-23.