DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20211510

Pregnancy outcome in isolated oligohydramnios diagnosed in third trimester

Pratibha Singh, Vibha Rani Pipal, Dharmendra Kumar Pipal, Navdeep Kaur Ghuman, Garima Yadav, Meenakshi Gothwal

Abstract


Background: The aim of this study was to compare the outcomes of pregnancies complicated by isolated oligohydramnios with the low risk pregnancies with normal amniotic fluid volume.

Methods: The present study is a retrospective cohort study of singleton pregnancies diagnosed with Isolated oligohydramnios (AFI≤5) in their third trimester (N=35). Pregnancy outcome was compared with a matched control group of low risk pregnancies with amniotic fluid volume >5 (N=30).

Results: The overall incidence of Isolated oligohydramnios was 0.7-0.8%. In oligohydramnios group, significant association were found in null-parity (60% vs 23.33%, p-value<0.005), Fetal growth retardation (25.71% vs 0% p-value<0.02), preterm delivery (22.85% vs 3.33%, p-value 0.025), rate of Induction of labor (40% vs 10%) and cesarean rate for non-reassuring fetal heart rate (20% vs 3.33%, p-value<0.001). Likewise, the incidence of low birth weight was (54.28% vs 13.33%, p-value<0.001) and NICU admissions was (20% vs 0%, p-value<0.01), but there was no difference in Apgar score finding. NICU stay was of short duration and all babies discharged in stable condition, there were no stillbirth or early neonatal death in both groups.

Conclusions: Isolated oligohydramnios has an adverse influence on pregnancy and neonatal outcome in the form of FGR, preterm delivery, increased rate of Induction and cesarean section. Despite the high incidence of low birth weight and NICU admissions, the overall early neonatal outcome was similar to the other low risk pregnancies.


Keywords


Amniotic fluid index, Fetal growth retardation, Iatrogenic prematurity, Isolated oligohydramnios, Non-reassuring fetal heart rate

Full Text:

PDF

References


Spong CY, Cunningham F, Leveno K, Bloom S. Williams Obstetrics. 25th ed. McGraw-Hill, 2018.

Moore TR. Amniotic fluid dynamics reflect fetal and maternal health and disease. Obstet Gynecol. 2010;116(3):759-65.

Moore TR, Cayle JE. The amniotic fluid index in normal human pregnancy. Am J Obstet Gynecol. 1990;162(5):1168-73.

Machado MR, Cecatti JG, Krupa F, Faundes A. Curve of amniotic fluid index measurements in low-risk pregnancy. Acta Obstet Gynecol Scand. 2007;86(1):37-41.

Phelan JP, Ahn MO, Smith CV, Rutherford SE, Anderson E. Amniotic fluid index measurements during pregnancy. J Reprod Med. 1987;32(8):601-4.

Committee on Practice Bulletins. Obstetrics and the American Institute of Ultrasound in Medicine. Practice Bulletin No. 175: Ultrasound in Pregnancy. Obstet Gynecol. 2016;128(6):241-56.

Casey BM, Intire DD, Bloom SL, Twikler DM, Ramus RM, Leveno KJ, et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol. 2000;182(4):909-12.

Zhang J, Troendle J, Meikle S, Klebanoff MA, Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG. 2004;111(3):220-5.

Kehl S, Schelkle A, Thomas A, Puhl A, Meqdad K, Tuschy B, et al. Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): a multicenter, open-label, randomized controlled trial. Ultrasound Obstet Gynecol. 2016;47(6):674-9.

Petrozella LN, Dashe JS, McIntire DD, Leveno KJ. Clinical significance of borderline amniotic fluid index and oligohydramnios in preterm pregnancy. Obstet Gynecol. 2011;117(1):338-42.

Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis. Am J Obstet Gynecol. 1999 Dec;181(6):1473-8.

Melamed N, Pardo J, Milstein R, Chen R, Hod M, Yogev Y. Perinatal outcome in pregnancies complicated by isolated oligohydramnios diagnosed before 37 weeks of gestation. Am J Obstet Gynecol. 2011;205(3):241.

Fuentes NM, Prieto PA, Ruíz RS, Carrillo Badillo MP, Ventoso FM, Vallejo GJL. Perinatal outcomes with isolated oligohydramnios at term pregnancy. J Perinat Med. 2016;44(7):793-8.

Bhagat M, Chawla I. Correlation of amniotic fluid index with perinatal outcome. J Obstet Gynaecol India. 2014;64(1):32-5.

Spong CY, Cunningham F, Leveno K, Bloom S. Williams Obstetrics. 25th ed. McGraw-Hill, 2018.

Moore TR. Amniotic fluid dynamics reflect fetal and maternal health and disease. Obstet Gynecol. 2010;116(3):759-65.

Moore TR, Cayle JE. The amniotic fluid index in normal human pregnancy. Am J Obstet Gynecol. 1990;162(5):1168-73.

Machado MR, Cecatti JG, Krupa F, Faundes A. Curve of amniotic fluid index measurements in low-risk pregnancy. Acta Obstet Gynecol Scand. 2007;86(1):37-41.

Phelan JP, Ahn MO, Smith CV, Rutherford SE, Anderson E. Amniotic fluid index measurements during pregnancy. J Reprod Med. 1987;32(8):601-4.

Committee on Practice Bulletins. Obstetrics and the American Institute of Ultrasound in Medicine. Practice Bulletin No. 175: Ultrasound in Pregnancy. Obstet Gynecol. 2016;128(6):241-56.

Casey BM, Intire DD, Bloom SL, Twikler DM, Ramus RM, Leveno KJ, et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol. 2000;182(4):909-12.

Zhang J, Troendle J, Meikle S, Klebanoff MA, Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG. 2004;111(3):220-5.

Kehl S, Schelkle A, Thomas A, Puhl A, Meqdad K, Tuschy B, et al. Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): a multicenter, open-label, randomized controlled trial. Ultrasound Obstet Gynecol. 2016;47(6):674-9.

Petrozella LN, Dashe JS, McIntire DD, Leveno KJ. Clinical significance of borderline amniotic fluid index and oligohydramnios in preterm pregnancy. Obstet Gynecol. 2011;117(1):338-42.

Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis. Am J Obstet Gynecol. 1999 Dec;181(6):1473-8.

Melamed N, Pardo J, Milstein R, Chen R, Hod M, Yogev Y. Perinatal outcome in pregnancies complicated by isolated oligohydramnios diagnosed before 37 weeks of gestation. Am J Obstet Gynecol. 2011;205(3):241.

Fuentes NM, Prieto PA, Ruíz RS, Carrillo Badillo MP, Ventoso FM, Vallejo GJL. Perinatal outcomes with isolated oligohydramnios at term pregnancy. J Perinat Med. 2016;44(7):793-8.

Bhagat M, Chawla I. Correlation of amniotic fluid index with perinatal outcome. J Obstet Gynaecol India. 2014;64(1):32-5.