DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20194855

A study on maternal and perinatal outcome of oligohydramnios in term low risk pregnancy

Sripreethika Rajavelu, Vinitra Dayalan, Surya S.

Abstract


Background: Oligohydramnios is a frequent complication of pregnancy that is associated with increased perinatal morbidity and mortality. Once diagnosed; oligohydramnios should further lead to intensive fetal surveillance including ultrasound evaluation. The aim of the study was to determine obstetric outcome in term low risk pregnancy with AFI less than or equal to 5 and to assess whether antepartum oligohydramnios is associated with adverse perinatal outcome.

Methods: 200 patients in third trimester in the hospital with evidence of oligohydramnios (AFI less than or equal to 5) were selected after satisfying inclusion and exclusion criteria and studied prospectively. Observations regarding the outcome of labour in form of maternal and perinatal parameters including AFI value, CTG features, mode of delivery, LSCS rate, meconium stained, APGAR score, birth weight and NICU admission were made.

Results: Overall perinatal outcome with respect to CTG, 128 (64%) out of 200 patients had non-reactive CTG and only 72 (36%) had reactive CTG. 128 (64%) of non-reactive CTG delivered by LSCS, 72 (36%) delivered by labour natural. Nil labour natural in the subset of AFI 1 to 2, birth weight (<2.5 kg-8% and >2.5 kg-92%), Apgar score (<7 at 1-5 mins:18%), still birth (1%), meconium (58.5%), NICU admission (6%) and perinatal mortality (2%).

Conclusions: AFI measurement of less than 5 cm detected after 37 completed weeks of gestation with a low risk pregnancy is found to be an indicator of adverse pregnancy outcome with higher fetal distress, meconium stained liquor and higher caesarean section rate. AFI assessment serves as an important tool and remains as an effective screening test in predicting fetal distress in labour that requires caesarean section.


Keywords


Amniotic fluid less than 5, Fetal distress, Maternal outcome, Meconium, Oligohydramnios, Perinatal outcome, Pregnancy

Full Text:

PDF

References


A Underwood, Mark and M Gilbert, William and Sherman, Michael. Amniotic Fluid: Not Just Fetal Urine Anymore. J Perinatol official journal of the California Perinatal Association. 2005;25:341-8.

Physiology of amniotic fluid volume regulation. Brace RA Clin Obstet Gynecol. 1997;40(2):280.

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

Van Reempts P, Kegelaers B, Van Dam K, Van Overmeire B. Neonatal outcome after very prolonged rupture of membranes. Am J Perinatol. 1993;10:288-91.

Hill LM, Breckle R, Wolfgram KR, O’Brien PC. Oligohydramnios: ultrasonically detected incidence and subsequent fetal outcome. Am J Obstet Gynecol. 1983;147(4):407-10.

Mercer LG, Brown LG. Fetal outcome with oligohydramnios in the second trimester. Obstet Gynecol. 1986;67(6):840-2.

Bastide A, Manning F, Harman G, Lange I, Marrison I. Ultrasound evaluation of amniotic fluid: outcome of pregnancy with severe oligohydramnios. Am J Obstet Gynecol. 1986;15(4):895-900.

Reddy UM, Abuhamad AZ, Levine D. Fetal imaging: executive summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound Fetal Imaging workshop. Obstet Gynecol. 2014;123:1070.

Magann EF, Chauhan SP, Hitt WC. Borderline or marginal amniotic fluid index and peripartum outcomes: a review of the literature. J Ultrasound Med. 2011;30:523.

Youssef AA, Abdulla SA, Sayed EH, Salem HT, Abdelalim AM, Devoe LD. Superiority of amniotic fluid index over amniotic fluid pocket measurement for predicting bad fetal outcome. South Med J. 1993;86(4):426-9.

Jandial C, Gupta S, Sharma S, Gupta M. Perinatal Outcome after Antepartum Diagnosis of Oligohydramnios at or Beyond 34 Weeks of Gestation. JK Sci. J Med Edu Res. 2007;9(4):213-4.