scholarly journals Perinatal outcome associated with oligohydramnios in third trimester

Author(s):  
Kamlesh R. Chaudhari ◽  
Kushagra R. Chaudhari ◽  
Omkar M. Desai

Background: We aimed to evaluate the effect of Oligohydramnios on fetal outcome in terms of fetal distress, Meconium staining of amniotic fluid, birth weight, Apgar score of newborn babies, NICU admission, early neonatal morbidity and mortality.Methods: This was a prospective study of 156 antenatal patients booked at K. J. Somaiya medical college and research centre during the year January 2012 to December 2013 with gestational age between 30-40wks with AFI<5cms with intact membranes were analyzed for perinatal outcome.Results: The Caesarian section rate for fetal distress was 41% in patients with Oligohydramnios. Meconium staining of amniotic fluid was found in 30.7% patients. APGAR score at 5 minutes <7 was found in 6 patients (3.8%).Conclusions: Oligohydramnios has significant correlation with Caesarean section for fetal distress and low birth weight babies. Oligohydramnios is associated with high rate of pregnancy complication and increased perinatal morbidity and mortality. Oligohydramnios is a frequent occurrence demand careful evaluation, intensive parental counseling, fetal surveillance and proper antepartum and intrapartum care.

Author(s):  
P. Kalpana ◽  
A. Kavitha

Background: Meconium staining of the amniotic fluid is a common problem occurring in 10-22% of all deliveries. Meconium aspiration syndrome complicates approximately 1.5% of these deliveries with a reported mortality rate as high as 40%. Objectives of the study were to determine whether meconium stained liquor during labour is associated with fetal distress and to check if there is any correlation in between the degree of meconium staining liquor and fetal outcome.Methods: A clinical study of 200 cases of meconium stained amniotic fluid in cephalic presentation was undertaken among patients who were admitted in labour room were examined in detail and investigations were done. Fetal heart rate and its pattern were noted every fifteen min. Total APGAR score at one minute and five minute was noted down. Odds ratio with 95% confidence interval was calculated. Proportions were analyzed using chi square value.Results: Majority of the study subjects belonged to the age group of 21-30 years. Majority i.e. 54.5% were multigravida. Majority had toxemia in 24% of the cases. Fetal distress and the incidence of forceps delivery or LSCS was significantly more in those with thick meconium compared to those with thin meconium (p<0.05). But fetal asphyxia was not associated with type of stained meconium. It is seen that as the duration of the meconium staining increased, the proportion of babies with low APGAR score, perinatal mortality and morbidity increased.Conclusions: Thick meconium stained amniotic fluid was associated with increased rate of interventions, neonatal morbidity and mortality compared to thin meconium stained meconium fluid.


2015 ◽  
Vol 10 (1) ◽  
pp. 48-51
Author(s):  
S Pradhan ◽  
A Adhikary ◽  
P Pradhan ◽  
S Pradhan

Aims:  This study was done to evaluate the predictive value of low amniotic fluid index (AFI) of < 5 cm for adverse perinatal outcome in term of caesarean section for fetal distress, birth weight, meconium stained liquor and APGAR scores. Methods: This was a prospective study of 200 antenatal women booked at Nepal Medical College Teaching Hospital during the year 2013-2014 with gestational age between 34 and 41 weeks. Patients history and clinical examination were recorded and AFI was measured and the perinatal outcome was compared between two groups i.e AFI <5 cm and >5 cm. Results: The caesarean section (C/S) rate for fetal distress and low birth weight babies (<2.5 kg) was higher in patients with low AFI (p=0.048, 0.001 respectively). There was no significant difference in meconium staining, APGAR score at 5 minutes between the two groups (p=0.881, 0.884 respectively). Conclusions: Caesarean section for fetal distress and low birth weight babies was significantly associated with low amniotic fluid index. There was no significant difference in meconium staining liquor, APGAR score at 5 minutes between the two groups.  


2017 ◽  
Vol 24 (03) ◽  
pp. 462-465
Author(s):  
Afsheen Memon ◽  
Aisha Abdullah Sheikh ◽  
Anisa Kamal

Objectives: To compare the effect of nuchal cord versus without cord aroundthe neck on mode of delivery and fetal outcome. Study design: Case control comparativestudy. Period: 1st August 2013 to 31st March 2014. Setting: Gyn /Obs Department at Sir SyedHospital Karachi. Material and Methods: A comparative study was carried out on 2 groupsof parturient ladies. The study group comprised of those ladies who at the time of delivery(vaginal delivery/caesarean-section) had clinically cord around the neck while the other group(control) did not have nuchal cord. Duration of labour, mode of delivery were noted. Perinataloutcome was measured in terms of Apgar score and NICU admission. High risk pregnancieswere excluded from the study. Result: Incidence of nuchal cord at the time of delivery was22.7%. A high rate of caesarean delivery observed in study group as compared to controlgroup (70 % vs 40%) (P value 0.00006). Fetal heart rate irregularities & meconium stainedliquor finding was not significantly different in two groups (p< 0.161) & (p<0.169) respectively.Similarly fetal outcome measured in terms of Apgar score at 1 & 5 min & NICU admissionwas also not significantly different between the two groups. Conclusion: A significant highrate of caesareans section rate was observed in the study group mainly due to fetal distress(FHR irregularities). This means cord around the neck is a risk factor & needs extra monitoringspecially through intermittent CTG monitoring during labour so that fetal distress can be pickedup early & emergency caesarean section can be performed to avoid fetal compromise.


Author(s):  
Richa Dwivedi ◽  
Anju Depan ◽  
Kanti Yadav ◽  
Meenakshi Samariya

Background: In pregnancy amniotic fluid surrounds the foetus and plays an important role in the development of fetus. From the very beginning of the formation of the extracoelomic cavity amniotic fluid can be detected. To evaluate the predictive value of amniotic fluid index (AFI) (<5) for adverse perinatal outcome in terms of cesarean section for fetal distress, birth weight, meconium staining, Apgar scores, and NICU admission at birth.Methods: This was a prospective study of 100 antenatal women visited RMC, Ajmer, Rajasthan, India during the year 2018 with gestational age >34 weeks. The women’s history, clinical examination recorded, and AFI were measured and the perinatal outcome was compared between two groups, i.e., AFI <5 and >5.Results: The cesarean section rate for fetal distress, low birth weight babies, <2.5 kg and meconium staining was higher in patients with oligohydramnios (p=0.012, 0.001, 0.00015 respectively). There was no significant difference in Apgar score at 5 min <7 (p=0.087) and NICU at birth between the two groups.Conclusions: Oligohydramnios has a significant correlation with cesarean section for fetal distress, low birth weight babies and NICU admission.


2021 ◽  
pp. 1-3
Author(s):  
Kajal Kunwar ◽  
Shanti HK Singh

Aims and objectives: Meconium stained amniotic fluid was considered a sign of fetal distress and associated with poor fetal outcome, but others considered physiological phenomena to be meconium passage through the fetus and create environmental threats to the fetus before birth. Such magnitude of different opinions was the object behind taking up this study and the aim was to find out the incidence and effect of meconium in terms of morbidity and mortality. Material and Methods: The present study was undertaken to evaluate the significance of MSAF and its fetal outcome in parturients admitted to a tertiary care hospital between June 2012 to June 2014. Detection of MSAF during delivery and follow-up of mother and baby during hospital stay was done. A total number of 100 cases were studied in each group as a prospective study. Results: The total numbers of deliveries during the study period were 850 of which 100 cases had meconium staining of AF (11.6%). Thin meconium staining was seen in 37 cases (4.35%) and Thick meconium was seen in 63 cases (7.41%). The major neonatal complication was birth asphyxia in MSG (19%) which was more in thick MSG (14%). Neonatal morbidity was more in the newborn with the thick meconium group (36.5%) compared to the thin meconium-stained group (29.7%). Early neonatal mortality was 100% associated with thick MSG. Early neonatal death was 2 in thick MSG and it was due to MAS. Stillbirth was 100% associated with thick MSG and it was 4. Whereas stillbirth in the control group was 1. Perinatal mortality was 6% in MSG that was associated with thick MSG. In the control group, it was 1%. Consistency of meconium has a direct bearing on the fetal outcome. In the thick meconium-stained group, Neonatal morbidity was (in our study group) 23 out of 63 cases. Stillbirth was 4; early neonatal death was 2 out of 63 cases. Whereas in thin MSG neonatal morbidity was 11 out of 37 cases. No stillbirth or neonatal death occurred in thin MSG. Conclusion: Immediate airway management, need for suction, and intubation should be guided by the state of the newborn rather than the presence of meconium. Timely diagnosis and management of amniotic fluid stained with meconium can enhance the fetal outcome. The authors of the current study conclude that MSAF adversely affects the fetal outcome mainly by thick meconium.


Author(s):  
Manimekalai, Neranjana

Background: Alcohol amniotic, a protecting fluid that surround the embryo. It protects from concussion, pressure, desiccation, reminiscent of the aquatic origin of life. Adequate amount of amniotic fluid is essential requirement for the normal development and it acts like a cushion against trauma, agitation and accidental impulsions. It has also bacteriostatic properties and prevents the infection of many bacterial infections. Aim: To assess the maternal and fetal outcome in cases with normal and abnormal Amniotic Fluid Index levels. Results: The mode of delivery was spontaneous vaginal delivery followed by Assisted VD, Elective CS, Emergency CS respectively. It was affected by amount of liquor since, low AFI group 35 (75%) patients ended up in cesarean section for fetal distress. While in control group 63(18.3%) patients had caesarean section. Conclusion: Early neonatal death was seen in 0.2%, 4.5% and 70.5% newborns were born to pregnant women with normal AFI, oligohydramnios respectively. 70.5% neonates born to pregnant women with oligohydramnios had NICU admission. All cases were admitted in NICU because of respiratory distress.


2011 ◽  
Vol 3 (1) ◽  
pp. 6-9
Author(s):  
Zakia Arshad ◽  
Imam Bano ◽  
Nasreen Noor ◽  
Lata Motwani

ABSTRACT Objectives To compare and evaluate the role of nonstress test and acoustic stimulation test on the perinatal outcome. Materials and methods Around 100 patients above 34 weeks of gestation were selected and subjected to nonstress test (NST) and acoustic stimulation test (AST) on weekly basis to find whether fetus is reactive or nonreactive, and followed till delivery to find out the perinatal outcome. Results When comparison of reactive NST and reactive AST was done, the incidence of meconium staining was 8 (9%) and 9 (9.6%), clinical fetal distress 16 (18.8%) and 18 (19.3%), operative interference for fetal distress 17 (19.3%) and 20 (21.5%), low Apgar score at 5 minutes 1 (1.1%) and 1 (1%), neonatal deaths 3 (3.3%) and 3 (3.2%), low birth weight 27 (30.6%) and 29 (31.1%), and NICU admission 13 (14.7%) and 13 (13.9%) respectively. While the incidence of meconium staining was 4 (33.3%) and 3 (42.8%), clincal fetal distress 8 (66.6%) and 6 (85.7%), operative interference 6 (50%) and 3 (42.8%), low Apgar score at 5 minutes 3 (25%) and 3 (42.8%), neonatal death 4 (33.3%) and 4 (57.1%), low birth weight 7 (58.3%) and 5 (71.4%) respectively in nonreactive NST and nonreactive AST groups.


Author(s):  
Deepali S. Kapote ◽  
Apeksha M. Mohite ◽  
Anam Syed

Background: The present study was undertaken to evaluate the significance of MSAF and its fetal outcome in parturients.Methods: A total of 121 pregnant women who had completed more than 37 weeks of gestation with live singleton pregnancy, spontaneous onset of labor and at term with adequate pelvis were included in the study. All (121) low risk primigravida with MSAF were studied to identify maternal and fetal outcome and compared with equal number of cases with clear amniotic fluid. Meconium stained cases were clinically classified into two groups- thin (54 cases) and thick (67 cases). MSAF on spontaneous or artificial rupture of membranes were monitored with fetal heart rate abnormality, 1- and 5-minutes Apgar score, NICU admissions and neonatal complications as outcome variables.Results: Overall incidence of meconium staining of AF during labour was 7.71%. The common fetal heart rate abnormalities i.e. bradycardia was seen in 36% in MSG. Apgar score of less than 7 was observed in MSG at 5 minutes in 5% of cases, in thick group. Major neonatal complication was birth asphyxia in MSG (18.18%) that was more in thick MSG (14.87%). MAS were observed in 6 cases in thick and 4 cases in thin meconium stained cases. NICU care was required in 18% cases in MSG and in control group it was required in 7% cases. Neonatal morbidity was more in newborn with thick meconium group (52%) compared to thin meconium group (20%).Conclusions: The present study confirmed that meconium staining of amniotic fluid adversely influences the fetal outcome.


2021 ◽  
Vol 28 (09) ◽  
pp. 1358-1364
Author(s):  
Nadia Sharif ◽  
Ayesha Qasim

Objectives: To determine the frequency of perinatal outcome in pregnant females at term having low amniotic fluid index. Study Design: Descriptive, Case Series study. Setting: Department of Obstetrics & Gynecology, Independent University Hospital, Faisalabad. Period: 1st October 2019 to 31st March 2020. Materials & Methods: A total of 90 women having singleton pregnancy with cephalic presentation having 37-40 weeks of gestation with AFI <8cm, 20 to 35 years of age were included. Patients with multiple pregnancy, ruptured membrane, fetal anomaly, gestational diabetes and Rh Incompatibility were excluded. Cesarean delivery, meconium stained liquor, low birth weight, NICU admission and APGAR score <7 at 5 min were assessed by consultant gynecologist. Results: Age range in this study was from 20 to 35 years with mean age of 28.92 + 4.45 years. Majority of the patients 43 (47.77%) were between 31 to 35 years of age. Mean gestational age was 38.31 + 1.20 weeks. Mean parity was 2.72 + 1.02. In this study, frequency of perinatal outcome in pregnant females at term having low amniotic fluid index was as follows; cesarean section was performed in 60 (66.67%), low birth weight was observed in 58 (64.44%) patients, APGAR score <7 at 5 minutes in 56 (62.22%), meconium stained liquor in 24 (26.67%) and NICU admission in 17 (18.89%) patients. Conclusion: This study concluded that proper antenatal monitoring and management should be done in these high risk patients in order to reduce the morbidity and mortality of the fetus.


2020 ◽  
pp. 1-2
Author(s):  
Saila Khatri ◽  
Megha S. Patel ◽  
Pankti Jaiswal ◽  
Prakruti Patel

Background: Oligohydramnios is defined as amniotic fluid index <5cm sonographically.5 Various complications to fetus like meconium stained liquor, IUGR, cord around neck, fetal distress, congenital anomaly, low birth weight, low Apgar score which leads to increase NICU admissions are seen. Increase rate of caeserian section compared to vaginal birth exposes mother to further operation related complications.6,7 Methodology: A cross sectional study was carried out among 124 patients who presented with oligohydraminos and got admitted in obstetric ward. Result: Oligohydraminos seen more in gestational age from 36.1 to 42 weeks(51%) and less from 28.1 to 32 weeks(15%). 62% AFI is between 3-5cm and 38% <3cm. Complications like meconium stained liquor(19%), IUGR(18%), cord around neck(15%), fetal distress(21%) also checked in form of low Apgar score (23%),congenital anomaly(4%), NICU admission(62%), increased rate of LSCS(76%) than vaginal delivery(24%) seen.


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