Perinatal outcome in cases of severe oligohydramnios
Keywords:Abruption, Amniotic fluid index, Color Doppler, IUGR (intrauterine growth restriction), NICU (neonatal intensive care unit), Oligohydramnios, Pregnancy induced hypertension, TSVD (term spontaneous vaginal delivery), VBAC (vaginal birth after caesarean)
Background: Oligohydramnios is defined as when on ultrasonography the single largest pocket in horizontal and vertical diameter is less than 2cm or amniotic fluid index is less than 5cm. Normal amniotic fluid index is 5-25cm. The overall incidence is 0.5 to more than 5%. However, the incidence increases in post dated pregnancies as many as 11%. It is increasing these days because of changes in lifestyle and also reduced maternal fluid intake.
Methods: A prospective randomized study was done in Dept of Obstetrics and Gynaecology, MGMMC and MYH, Indore during the period of 6 months from 1st July 2017 to 31st December 2017. It included 200 cases from all the antenatal patients attending Antenatal OPD in routine and emergency and who are admitted in MYH beyond 28 weeks of pregnancy.
Results: Most of the perinatal cases nearly 64% of babies were handover, 26% were IUDs (intra uterine devices) and rest 10% requiring neonatal care in nursery. The color Doppler changes showed normal flow in 54% in cases with 26% showing early fetal hypoxia and 14% showing uteroplacental insufficiency. Rest of the 6% cases were IUD. Incidence of IUGR was 50% in babies most commonly being constitutionally small. About 8% cases were found to be associated with abruption and 24% cases were found to be associated with pregnancy induced hypertension. Most common mode of delivery was vaginal delivery in 68% cases. However, 32% cases underwent LSCS.
Conclusions: There has been reported cases of sudden IUD in severe oligohydramnios presenting with loss of fetal movements.
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