DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20151608

A study on the perinatal outcome in cases of oligohydramnios

Pawanpreet Kaur, Deepak A. Desai, Aartee Taraiya

Abstract


Background: Amniotic fluid has an important role in the fetal growth and development. It provides the fetus, with a protective low resistance environment which is suitable for the growth and development. With normal amount of amniotic fluid index ranging from 5 to 24 cms, Amniotic fluid index of <5 cm defines oligohydramnios as, originally described by Phelan et al1. Many studies show that oligohydramnios is associated with variety of ominous pregnancy outcomes, such as fetal distress, low birth weight, increased incidence of caesarean section,   higher perinatal morbidity, and perinatal mortality. Since, these disorders of liquor amnii has a significant impact on pregnancy and fetus, it prompted us to carry out this study with sincere efforts to find out its effect on pregnancy outcome.

Methods: The study was done in Dhiraj Hospital in Obstetrics and Gynecology department. The study duration was period of 18 months  from February 2014 to July 2015. It was a prospective study, comprising of patients, who had reported to hospital for regular antenatal visits. The study group was taken on sole criteria of AFI <5cms. It is considered as a contributing factor for intranatal and perinatal morbidity. To prove our point, in control group, patients with AFI >5 cms were taken. AFI >10 cms was considered to be normal. Various outcome measures recorded were, induced Vs spontaneous labor, gestational age at delivery, nature 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, perinatal morbidity and perinatal mortality.

Results: Normal quantity of liquor amnii is essential for normal and successful outcome of pregnancy, as it provides a safe milieu interior for the foetus in utero. Deprivation of required quantity, will adversely affect the neonatal outcome. Oligohydramnios, in itself is enough to cause such damage, by creating chronic hypoxic situation.

Conclusions: The fetal morbidity and mortality increases if additional antenatal complications of   preeclampsia and post-term pregnancy are present along with oligohyrdramnios.


Keywords


Oligohydramnios, Perinatal outcome

Full Text:

PDF

References


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

Casey BM, MC Intire DD, Donald D. Pregnancy outcome after diagnosis of oligohydramnios at or beyond 34 weeks of gestation. Am J Obstet Gynecol. 2000;182:902-12.

Magann EF, Chauhan SP, Barrilleaux PS, Whitworth NS, Martin JN. Amniotic fluid index and single deepest pocket: Weak indicators of abnormal amniotic volumes. Obstet Gynecol. 2000;96:737-40.

Manning FA, Hill LM, Platt LD. Quantitative amniotic fluid volume determination by ultrasound: Antepartum detection of intrauterine growth retardation. Am J Obstet Gynecol 1981;139:254-8.

Halperin ME, Fong KW, Zalev AH. Reliability of amniotic fluid volume estimation from ultrasonograms: intra-observer and interobserver variation before and after the establishment of criteria. Am J Obstet Gynecol. 1985;153:264-7.

Brace RA, Wolfe EJ. Normal amniotic fluid volume changes throughout pregnancy. Am J Obstet Gynecol. 1989;161:382-8.

Manning FA, Harmon CR, Morrison I. Fetal assessment based on fetal biophysical profile scoring. IV> An analysis of perinatal morbidity and mortality. Am J Obstet Gynecol. 1990;162:703-9.

Moore TR, Cayle JE. The amniotic fluid index in normal human pregnancy. Am J Obstet Gynecol. 1990;162:1168-73.

Jeng CJ, Lee JF, Wang KG. Decreased amniotic fluid index in term pregnancy: clinical significance. J reprod Med. 1992;37:789-92.

Magann EF, Nolan TE, Hess LW. Measurement of amniotic fluid volume: accuracy of ultrasonography techniques. Am J Obstet Gynecol. 1992;167:1533.

Horsager R, Nathan L, Leveno KJ. Correlation of measured amniotic fluid volume and sonographic predictions of oligohydramnios. Obstet Gynecol. 1994;83:955.

Chandra P, Kaur SP, Hans DK, Kapila AK. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Obstet and Gynae Today. 2000;5(8):478-81.

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

Kumar P, Iyer S, Ramkumar V. Amniotic fluid index - A new ultrasound assessment of amniotic fluid. J Obstet and Gynaecol of India. 1991;41(1):10-2.

Rutherford SE, Jeffrey P, Phelan J, 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.

Baron C, Morgan MA, Garite TJ. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Am J obstet Gynecol. 1995;173(1):167-74.

Magann EF, Chauhan SP, Kinsella MJ, McNamara MF, Whitworth NS, Morrison JC. Antenatal testing among 1001 patients at high risk: The role of ultrasonographic estimate of amniotic fluid volume. Am J Obstet Gynecol. 1999;180:1330-6.