Perinatal outcomes with isolated oligohydramnios at term pregnancy

2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Mariña Naveiro-Fuentes ◽  
Alberto Puertas Prieto ◽  
Rocío Sánchez Ruíz ◽  
María Paz Carrillo Badillo ◽  
Francisco Montoya Ventoso ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Umbilical Artery ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Induction Of Labor ◽  
Obstetric Outcomes ◽  
Term Pregnancy ◽  
Neonatal Birth Weight ◽  
Blood Ph ◽  
Discharge Status

AbstractAims:To compare the outcomes of term gestations with oligohydramnios in the absence of other underlying disorders and term gestations with normal amniotic fluid.Methods:A retrospective analysis of obstetric outcomes in 27,708 term pregnancies. We compared three groups: labor induced because of oligohydramnios, spontaneous onset of labor with normal amniotic fluid, and labor induced because of late term pregnancy with normal amniotic fluid. We excluded pregnancies with maternal or fetal diseases or disorders potentially related with amniotic fluid alterations. The main outcome measures were mode of delivery, neonatal birth weight, umbilical artery blood pH, Apgar scores and neonatal discharge status.Results:Compared to spontaneous labor, induction of labor because of oligohydramnios was associated with a higher risk of cesarean delivery and small size of the fetus for gestational age (SGA). Compared to induction because of late term pregnancy there were no significant differences in neonatal, although neonates had a higher risk of being SGA.Conclusion:The only perinatal outcome for which the risk was higher in term pregnancies with isolated oligohydramnios was SGA. The systematic induction of labor in these pregnancies should be questioned.

Oligohydramnion in the First Half of Pregnancy in the Fetuses with Congenital Abnormalities: Ultrasound Diagnostics and Obstetric Outcomes

2021 ◽  
Vol 76 (4) ◽  
pp. 341-350
Author(s):  
Sergey M. Voevodin ◽  
Tatiana V. Shemanaeva ◽  
Alyona V. Serova
Keyword(s):  
Amniotic Fluid ◽  
Congenital Malformations ◽  
Fetal Death ◽  
Congenital Abnormalities ◽  
Neonatal Period ◽  
Perinatal Outcomes ◽  
Main Group ◽  
Obstetric Outcomes ◽  
Fetal Abnormalities ◽  
4D Ultrasound

Background.Oligohydramnion in the first half of pregnancy, combined with congenital abnormalities in the fetus has objective difficulties in diagnosis. The morphology features and type of defects associated with oligohydramnion, which manifests in the first half of pregnancy, are not sufficiently studied at the present stage. Aims to evaluate the clinical significance of diagnosing oligohydramnion in the first half of pregnancy in women with congenital fetal malformations. Materials and methods.The analysis of the course of pregnancy and perinatal outcomes in 77 women with low water content in combination with congenital malformations of the fetus and 72 patients with a normal amount of amniotic fluid and no congenital malformations of the fetus was performed. The patients of the main group were divided into two subgroups depending on the severity of oligohydramnion: the 1st subgroup (n = 54) patients with severe oligohydramnion and the 2nd subgroup (n = 23) patients with moderate oligohydramnion. The amount of amniotic fluid was determined by 3D/4D ultrasound (1321 weeks of gestation) and the structure of fetal abnormalities associated with oligohydramnion was analyzed. We evaluated perinatal outcomes in women with congenital malformations of the fetus in combination with oligohydramnion and the effect of its severity on the outcome of pregnancy. Results.In the main group (n = 77), fetal abnormalities were detected in patients: urinary system 39 (50.6%), respiratory system 4 (5.2%), heart 1 (1.3%), chromosomal and genetic abnormalities 14 (18.2%), central nervous system 3 (3.9%), osseous system 3 (3.9%), multiple 13 (16.9%). In the main group (n = 77), pregnancy was terminated for medical indications in 47 (61%) cases, in 6 (7.8%) spontaneous miscarriage occurred, in 5 (6.5%) antenatal fetal death. 19 (24.7%) children were born alive, and surgical treatment in the neonatal period was required in 8 (10.4%) cases. In the 1st subgroup (n = 54) in 53 (98.1%) cases, there was a loss of the fetus, in 1 (1.9%) the newborn died on the 9th day. In the 2nd subgroup (n = 23), fetal death occurred in 5 (21.7%) cases, 18 (78.3%) children were born alive, and 8 (44.4%) newborns were operated on in the neonatal period. In the control group, all pregnancies ended with the birth of healthy children. A decrease in ultrasound imaging of internal organs in the fetus was observed when a pregnant woman was obese (BMI more than 35). Conclusions.Oligohydramnion in the first half of pregnancy in combination with fetal malformation should be considered an extremely unfavorable clinical sign for the prognosis of pregnancy and the health of the fetus and newborn. 3D/4D ultrasound scanning allows you to reliably determine oligohydramnion in the first half of pregnancy, and the degree of its severity to assume the nature of complications.

Comparison of Amniotic Fluid Index and Single Deepest Vertical Pocket

2021 ◽  
Vol 17 ◽  
Author(s):  
Roopa Padavagodu Shivananda ◽  
Rekha Anbu ◽  
Shubha Rao ◽  
Nivedita Hegde ◽  
Anjali Suneel Mundkur ◽  
...  
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Fluid Volume ◽  
Maternal Outcomes ◽  
Amniotic Fluid Index ◽  
Amniotic Fluid Volume ◽  
Vaginal Deliveries ◽  
Nicu Admission

Background: The best method of estimation of amniotic fluid volume is a matter of ongoing debate. Objectives: To determine the perinatal & maternal outcomes in pregnant patients when the amniotic fluid volume was assessed by the amniotic fluid index (AFI) in comparison to the single deepest vertical pocket (SDVP). Methods: We studied abnormal Cardiotocograph, meconium stained amniotic fluid, birth weight <2.5kg, Apgar score at 5 min <7, cord blood pH <7.2 & necessity for NICU admission as perinatal outcomes. Rate of diagnosis of oligohydramnios, induction of labor for oligohydramnios & mode of delivery were observed in maternal outcomes. Results: Of the 697 pregnant patients recruited, 353 were in the AFI and 344 in the SDVP group. Perinatal outcomes were similar in both. In the AFI group, the number of women diagnosed with oligohydramnios was higher (p = 0.0333) & the rate of induction was also higher (p = 0.003378). Vaginal deliveries were more in the SDVP group. The Receiver Operating Characteristic curves showed statistically significant correlation with NICU stay, birth-weight, and mode of delivery. While an AFI of >5cm and SDVP of >1.9cm had good sensitivity in predicting babies with a birth weight of ≥ 2.5kg and avoiding NICU admissions, an AFI of > 5.8cm and an SDVP of > 1.9 cm had a sensitivity of around 80% in predicting successful vaginal deliveries. Conclusion: The SDVP method has a slight edge over the AFI in terms of lower inductions and higher vaginal deliveries with comparable perinatal outcomes.

scholarly journals Perinatal outcome in uncomplicated pregnancies with oligohydramnios

2018 ◽  
Vol 8 (1) ◽  
pp. 215
Author(s):  
Snehal Gaware ◽  
V. B. Bangal
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Induction Of Labor ◽  
P Value ◽  
Amniotic Fluid Index ◽  
Medical College ◽  
Time Of Admission ◽  
Singleton Pregnancies

Background: Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. We aimed to assess the perinatal outcomes in pregnancies with oligohydramnios.Methods: The prospective study was conducted in the Department of Obstetrics and Gynecology, Pravara Medical College, Loni in which 200 consecutive singleton pregnancies delivered vaginally, with intact membranes were included. Amniotic fluid index was determined using the Phelan’s technique at the time of admission and women were diagnosed with oligohydramnios if AFI was five or less, which formed the first group and the rest of mother formed the second group. Perinatal outcomes were noted in the proforma as well.Results: Of the 200 mothers included in the study, 38 had AFI ≤ 5. Baseline characteristics was similar in both the groups. Most common antenatal risk factors studies were pregnancy induced hypertension (29% vs 12%; p value <0.05), intrauterine growth restriction (34% vs 10%; p value <0.001) and severe anemia (21% vs 9%; p value <0.05). Proportion of pregnancies needing induction of labor and birth weight less than 2.5 kgs were significantly higher among mothers with oligohydramnios.Conclusions: Authors observed that induction of labor and low birth weight were significantly associated with oligohydramnios. Prospective randomized trials are needed to establish whether early induction of labor in the presence of a oligohydramnios improves perinatal outcome.

scholarly journals Study of maternal and foetal outcome in post-term pregnancies

2017 ◽  
Vol 6 (7) ◽  
pp. 3147
Author(s):  
Priya Shankar ◽  
Hemalatha KR
Keyword(s):  
Pregnancy Termination ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Term Pregnancy ◽  
Amniotic Fluid Index ◽  
Neonatal Deaths ◽  
Foetal Growth Restriction ◽  
Incidence Risk ◽  
One Year ◽  
Post Term Pregnancy

Background: Post-term pregnancies are associated with significant foetal morbidity and increase in interventions which jeopardise the health of the fetus as well as the mother. The objective of this study was to determine the incidence, risk factors, maternal and foetal outcomes of such pregnancies.Methods: A retrospective study of 117 post-term pregnancies was studied over a period of one year, January to December 2016. Age, parity, amniotic fluid index, color of liquor, mode of delivery, maternal and foetal outcomes were studied in detail and analysed.Results: There were 10390 deliveries during our study period. 130 among them were post-term, 117 were included in the study, amounting to an incidence of 1.12%. Post-term pregnancy was noted to be higher in women of age group 21-25years (68.5%) and among primigravidae (51.2%). 66 women experienced vaginal delivery (56.4%) and 49 women underwent caesarean delivery (41.8%). Most common indications for caesarean section were foetal distress, oligohydramnios, and foetal growth restriction. NICU admissions were 16 babies and 2 early neonatal deaths were noted.Conclusions: Post-term pregnancy requires early detection, proper planning of pregnancy termination. These women should be offered induction of labour prior to 42 weeks of gestation age to avoid adverse maternal and perinatal outcomes.

scholarly journals A study of fetomaternal outcome in induction of labour in third trimester oligohydramnios

2019 ◽  
Vol 8 (11) ◽  
pp. 4196
Author(s):  
Nalini Sharma ◽  
Hanslata Gehlot
Keyword(s):  
Amniotic Fluid ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Labor Induction ◽  
Operative Delivery ◽  
Amniotic Fluid Index ◽  
Gestational Age At Delivery ◽  
A Prospective Study

Background: The Induction of labor in oligohydramnios poses a dilemma for obstetrician. Studies are limited with variable results. This study aims at finding whether isolated oligohydramnios is an indication for operative delivery or labor induction followed by vaginal delivery is possible.Methods: A prospective study carried out on females delivered in study duration in Umaid Hospital, Jodhpur, Rajasthan. Outcomes studied were gestational age at delivery, colour 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 (NICU), perinatal morbidity and perinatal mortality. Descriptive statistics were applied and data was represented on frequency tables, graphs and diagrams.Results: 40% of subjects had amniotic fluid index (AFI) <5 cm and 60% demonstrated AFI between 5-7 cm. 60% of patients induced delivered vaginally with (38.33%) having AFI <5 cm. Operative delivery was resorted to in 40% of patients. Perinatal outcomes resulted in total 97% of babies discharged in healthy condition.Conclusions: Labor induction is feasible in idiopathic oligohydramnios. Fetal distress is the most feared and predicted outcome with labor induction in oligohydramnios. This study deduced that in majority- reason for c-sections was failed labor induction due the poor Bishop's score, not fetal reasons. We hope by putting at rest apprehensions of obstetrician regarding this notion rate of c-sections could be reduced.

Perinatal outcome associated with oligohydramnios in term pregnancies

2018 ◽  
Vol 1 (01) ◽  
pp. 25-30
Author(s):  
Deepa Chudal ◽  
Keshang Diki Bista ◽  
Neelam Pradhan
Keyword(s):  
Cesarean Section ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Well Being ◽  
Fetal Outcome ◽  
University Teaching ◽  
Amniotic Fluid Index ◽  
Prelabor Rupture Of Membranes

Introduction: Amniotic fluid is a complex substance essential to fetal well-beingand dynamic milieu that changes as pregnancy progresses andsurrounds developing fetus providing an ideal environment for normal fetal growth and development. Amniotic fluid volume is fetal well being which varies with gestational age and depends on a dynamic interaction between placenta, fetus and maternal components. Methods: This was a hospital based descriptive study conducted at Tribhuvan University Teaching Hospital, from 14th April 2013 to 13th April 2014(2070) which consisted of singleton, term (37-42weeks) pregnancies admitted with ultrasonographicfinding of Amniotic Fluid Index≤ 5 with delivery within one week of ultrasonographicfinding. A prefixed questionnaire was used to fill maternal and fetal outcome parameters like age, parity, period of gestation, Amniotic Fluid Index, associated maternal conditions, mode of delivery, indication of Cesarean section, color of liquor and perinatal outcomes. Results: Total 115 cases of oligohydramnioswere noted accounting for an incidence of 2.4%. 92 women were term, giving incidence of term oligohydramnios to be 2%. Out of 92 cases, 77(83.6%) underwent emergency caesarean section and 15 (16.3%) were delivered vaginally. Low birth weight of < 2.5 kg was noted in 14 (15.2%) babies and meconium stained liquor was present in 12 (13%) of oligohydramnios cases. APGAR score of < 7 at 1 minute and 5 minute was seen in 13 (14.13%) and 3 (3.26%) cases respectively. . Among 92 cases, 44 (47.8%) were associated with Prelabor Rupture of Membranes followed by post dated pregnancies and Intrauterine Growth Retardation accounting for 12 (13.1%) cases in each group Conclusion: Prelabor Rupture of Membranes was  most common cause of term oligohydramnios resulting in high risk of caesarean delivery in oligohydramnios cases. Cesarean Section for oligohydramnios has been associated with good perinatal outcome.

scholarly journals Study on Meconium stained fluid-perinatal outcome

2018 ◽  
Vol 7 (2) ◽  
pp. 587
Author(s):  
Soumya Harikumar ◽  
Aparna Rajesh
Keyword(s):  
Amniotic Fluid ◽  
Fetal Heart ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Perinatal Morbidity ◽  
Neonatal Complications ◽  
Heart Monitoring ◽  
Admission Test ◽  
Meconium Stained Amniotic Fluid ◽  
Very High

Background: The objective of this study is to find a correlation between the presence of MSAF in mothers with co- morbidities like PIH and GDM and to study the fetal heart variability in cases with MSAF and the significance of an admission test. This study also throws a light on the perinatal outcomes associated with MSAF.Methods: 100 women in labor with Meconium stained amniotic fluid were taken in this study. An admission test was done for all patients, along with continuous fetal heart monitoring was done in the presence of MSAF. Effect of thin and thick meconium on fetus was studied. The cases with maternal co-morbidities were closely monitored along with the mode of delivery, Apgar score, birth weight, resuscitation of baby was studied. All the newborns born through meconium stained liquor were followed up to one week of neonatal life.Results: Out of a total of 100 cases there was 60 cases with thick meconium with a non-reactive NST seen in 65% cases with thick MSAF and 32.5% cases with thin MSAF. 79% of cases with MSAF underwent emergency LSCS. The neonatal complications were more with thick meconium stained liquor accounting to 28.3% incidence of MAS, 23.3% of sepsis, 3.3%of pneumonitis and 21.7% of birth asphyxia.Conclusions: This study ascertained the need for an admission test and continuous CTG monitoring in cases detected to have meconium stained amniotic fluid. Co-morbidities like GDM did have a small role to play though the incidence was not very high. The neonatal complications were more common among cases with thick meconium stained liquor and probably the use of procedures like amnioinfusion can bring down the incidence of perinatal morbidity along with the rate of caesarean sections.

scholarly journals The association between isolated oligohydramnios at term and pregnancy outcome and perinatal outcome in case of isolated oligohydramnosis: a retrospective analysis

2021 ◽  
Vol 11 (1) ◽  
pp. 136
Author(s):  
Vijay M. Kansara ◽  
Kunal D. Kadakar ◽  
Akash S. Chikani ◽  
Pinal A. Pateliya
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Labour Induction ◽  
Control Group ◽  
Amniotic Fluid Index ◽  
Observational Cohort ◽  
Adverse Perinatal Outcomes ◽  
The Impact

Background: Current study was carried out to assess the impact of isolated oligohydramnios on perinatal outcomes and mode of delivery.Methods: A retrospective observational cohort study was conducted at term pregnancy with sonographic finding of isolated oligohydramnios (AFI <5 cm) were recruited for the study. Uterine anomaly and high risk pregnancies were excluded from the study. The mode of delivery and perinatal outcome were compared with control group of pregnancy with normal amniotic fluid (AFI >5-25 cm).Results: When compared to the normal AFI, women with oligohydramnios had significantly lower birth weight babies and were delivered at a significantly earlier gestational age. However there was no difference in the APGAR scores at birth and NICU admissions between the two groups. Reactive NST had more chances of good APGAR score at 1 and 5 minute and that lower the AFI more the probability of nonreactive NST and abnormal Doppler. The number of inductions and caesareans done for foetal reasons were significantly higher in the exposed group.Conclusions: Obstetric and perinatal outcome remains similar in both isolated oligohydramnios with reactive NST as well as in patients with normal amniotic fluid index. Isolated oligohydramnios is not associated with adverse perinatal outcomes. However, it increases the risk for labour induction and caesarean section.

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