Maternal and fetal outcome in oligohydramnios after 34 weeks of gestation

Background: Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. It is a clinical condition characterized by Amniotic Fluid Index (AFI) ≤5 cm by sonographic assessment. The aim of present study is to know the maternal and fetal outcome in oligohydramnios after 34 weeks of gestation compared with women who had normal volume of amniotic fluid.Methods: Study was done for the period of 21 months from November 2014-July 2016 at Adichunchanagiri Institute of Medical Sciences, Hospital and Research Centre Bellur. 50 antenatal cases with > 34 weeks of gestation with AFI ≤5 cm by ultrasonographic estimation were included as study group and 50 women with normal AFI were included as control group. Maternal and fetal outcome of the women with oligohydramnios were analyzed and compared with control group.Results: Results were analyzed statistically using parameters like mean, SD, Chi Sq test, P value. Amniotic fluid was clear in 32% in study and 78% in control group, thin meconium stained in 30% in study group and 14%in control group and was thick meconium stained in 38% in study group and 8% in control group (Chi square =22.31, p<0.0001). Induction of labour was done in 54% in study group and 20% in control group. Cesarean delivery was done in 58% in study group women and 28% in control group women. Regarding the birth weight of babies 62% were < 2.5 kg in study group and 18% in control group with p<0.001. 10% of babies in study group required NICU admission and perinatal mortality was 2%.Conclusions: Due to increased perinatal morbidity and mortality and increased rate of LSCS, timely decision during labour is important to reduce perinatal morbidity and mortality.

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Perinatal outcome of term pregnancies with borderline amniotic fluid index: a prospective case control study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201803 ◽

2020 ◽

Vol 9 (5) ◽

pp. 2047

Author(s):

Devika V. Desai ◽

Nigamananda Mishra ◽

Gayatri V. Savani

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Amniotic Fluid ◽

Perinatal Outcome ◽

Research Centre ◽

P Value ◽

Amniotic Fluid Index ◽

Chi Square ◽

Test Analysis ◽

Chi Square Test

Background: It has been since antiquity that the importance of amniotic fluid and fetal growth with perinatal outcome is being documented. But the lacunae lies in studying the relationship between borderline amniotic fluid and perinatal outcome. The following study was undertaken to provide recent data that would help predict perinatal outcome in borderline AFI pregnancies.Methods: About 144 patients were considered in the study OPD/IPD patients in obstetrics and gynecology department in Bhabha Atomic Research Centre and Hospital, with about 72 cases with borderline amniotic fluid index (5-8 cm) and controls with amniotic fluid index ≥9-25 cm. Patients were selected and subjected to history taking, examination, ultrasound test with doppler studies and perinatal outcome documented over a period of one year.Results: The incidence of borderline AFI in my study was 16%. 58% were primigravidas. Meconium stained liquor was found in 18% cases compared to 7% controls. Low birth weight was found in 12.5% cases and 2.7% in controls. On applying statistical test analysis chi square test, it was found that borderline amniotic fluid index in relation to presence of meconium stained amniotic fluid and low birth weight, p value was found to be statistically significant (<0.05).Conclusions: Borderline amniotic fluid and perinatal outcome had significant relationship in terms of meconium stained liquor and birth weight while rest had no significance. Thus, borderline amniotic fluid patients require vigilant fetal surveillance.

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Maternal and Perinatal Outcomes Among Pregnancies Complicated by Isolated Oligohydramnios Compared with Normal Amniotic Fluid Index

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v11i2.17458 ◽

2017 ◽

Vol 11 (2) ◽

pp. 32-36

Author(s):

Ramesh Shrestha ◽

DK Uprety ◽

A Thakur

Keyword(s):

Caesarean Section ◽

Amniotic Fluid ◽

Gestational Age ◽

Caesarean Section Rate ◽

Perinatal Outcomes ◽

Fluid Volume ◽

Labour Induction ◽

Control Group ◽

P Value ◽

Amniotic Fluid Index

Aims: The study was aimed to compare the maternal and perinatal outcomes among pregnancies with isolated oligohydramnios compared to normal amniotic fluid volume between 37-42 weeks.Methods: It was a prospective cohort study done among the singleton pregnancies between 37-42 weeks with isolated oligohydramnios taken as cases (n=100) and pregnancies with normal levels of amniotic fluid matched to cases by gestational age and parity in 2:1 ratio fulfilling the inclusion criteria were taken as controls (n=200). Both the mother and baby were followed up till discharge for outcomes.Results: Majority of the patients (n=300) were of age group 20-30 years (79.0%). Most of them (n=300) were primigravida (74.0%). The overall caesarean section rate was 24.66% (n=300). In the oligohydramnios group, 43.0% had undergone induction of labour (p value<0.05), 63.0% had undergone caesarean section (p value=0.001) and the most common indication for caesarean section was non-reassuring NST (44.44%) (p value<0.05). 26.0% babies had low birth weight, 12% had birth defects, 10.0% were small for gestational age (p value<0.05). There were significantly more ICU admission (13.0% vs 3.5%), early neonatal death (6.0% vs 1.5%), fetal distress (6.0% vs 1.5%) in the oligohydramnios compared to control group ( p value<0.05).Conclusions: Patients with oligohydramnios have increased labour induction, increased operative interferences and increased neonatal mortality and morbidity compared to patients with normal fluid volume.

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Effect of oral L- arginine versus intravenous hydration on maternal and fetal outcome in idiopathic oligohydramnios

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211516 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1943

Author(s):

Suhail Iqbal ◽

Mehak Ayub Malik ◽

Heena Kaurani ◽

Divya Chauhan

Keyword(s):

Risk Factors ◽

Amniotic Fluid ◽

Gestational Age ◽

Perinatal Outcome ◽

Normal Growth ◽

Fetal Outcome ◽

Perinatal Morbidity ◽

Inclusion Criteria ◽

Amniotic Fluid Index ◽

Intravenous Hydration

Background: Adequate amount of amniotic fluid was required for normal growth of fetus. Oligohydramnios or reduced amount of amniotic fluid is associated with adverse maternal and perinatal outcome due to increase in induced labour and operative deliveries. Idiopathic oligohydramnios is a condition in which no other risk factors are associated with pregnancy. This study was done to compare the effect of L-arginine and IV hydration on improvement of amniotic fluid index and fetal growth.Methods: Total 50 patients were included in the study according to inclusion criteria and divided equally into two groups randomly. IV hydration was given to one group and other group received L- arginine sachet orally. The effect on AFI and fetal outcome was compared.Result: The result was compared with respect to age, gravidity, gestational age and AFI at the time of study and after giving treatment. Maternal and fetal outcome was compared which shows that L-arginine was more effective in increasing the AFI and thereby leading to favorable results in the form of increase in gestational age at time of delivery and fetal weight.Conclusion: This study shows that both IV hydration and L-arginine are useful in treatment of oligohydramnios. But L-arginine appears more advantageous over IV hydration in improving pregnancy outcome and reducing perinatal morbidity and mortality.

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Oligohydramnios and fetal outcome in term pregnancy

Zanco Journal of Medical Sciences ◽

10.15218/zjms.2020.041 ◽

2020 ◽

Vol 24 (3) ◽

pp. 347-353

Author(s):

Hazha Ibrahim ◽

Zainab Zween

Keyword(s):

Birth Weight ◽

Cesarean Section ◽

Amniotic Fluid ◽

Growth Retardation ◽

Intrauterine Growth Retardation ◽

Comparison Group ◽

Fetal Outcome ◽

Perinatal Morbidity ◽

Amniotic Fluid Index ◽

Intrauterine Growth

Background and objective: Oligohydramnios is defined as an amniotic fluid index less than 5th centile for gestation. It presents a threat to the fetus and has been correlated with increased risk of intrauterine growth retardation, meconium aspiration syndrome, severe birth asphyxia, low APGAR scores, and congenital abnormalities. It is associated with perinatal morbidity and mortality and maternal morbidity in a significant number of cases. Therefore, early detection of oligohydramnios and its management is important. This study aimed to determine the perinatal and maternal outcomes in oligohydramnios. Methods: This retrospective cohort study was carried out at the Maternity Teaching Hospital in Erbil from March 2018 to March 2019. A total of 300 patients were recruited, including 150 pregnant women with oligohydramnios and 150 with normal amniotic fluid index. Results: There was a significant difference between the oligohydramnios group and the comparison group in relation to parity and gestational age. Oligohydramnios was more among primigravids. The rate of cesarean section was higher in oligohydramnios group compared to the comparison group. Intrauterine growth retardation among oligohydramnios group was 13%. Oligohydramnios was associated with birth weight <2500 gm (21.3%). Conclusion: Antepartum diagnosis of severe oligohydramnios at term was associated with an increased cesarean section rate, a higher rate of admission of neonatal care unit, and low birth weight. Therefore, antepartum oligohydramnios is associated with increased perinatal morbidity and mortality. Keywords: Amniotic fluid index; Maternal outcome; Fetal outcome; Oligohydramnios.

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Study of effects of oligohydramnios on perinatal outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202342 ◽

2020 ◽

Vol 9 (6) ◽

pp. 2525

Author(s):

Aashka M. Mashkaria ◽

Babulal S. Patel ◽

Akshay C. Shah ◽

Shashwat K. Jani ◽

Vismay B. Patel ◽

...

Keyword(s):

Caesarean Section ◽

Amniotic Fluid ◽

Perinatal Outcome ◽

Stress Test ◽

Fetal Distress ◽

Control Group ◽

Study Group ◽

Amniotic Fluid Index ◽

Lower Segment Caesarean Section ◽

And Control

Background: Oligohydramnios has got a noteworthy influence on perinatal outcome. Hence, early detection and its timely management will aid in curtailing of perinatal morbidity and mortality and leading to decreased operative interventions. Therefore, the present study is conducted to look for the effects of oligohydramnios.Methods: This comparative study was a prospective observational study conducted at study institution. The women were divided into study and control groups based on AFI (amniotic fluid index), 100 cases were selected in each group.Results: Out of the 200 women, included in the present study, 35% of the patients in the study group had non-reactive non-stress test (NST) while in the control group 7% had it. Caesarean section was performed in 58% of cases in the study group as compared to 30% in the control group. Amongst these, Fetal distress was the most common indication for LSCS (lower segment caesarean section). There were no perinatal deaths in this study.Conclusions: Based on this study it has been observed that, amniotic fluid index of ≤5 cm was commonly associated with increased LSCS rates, intrauterine growth restriction, non-reactive NST, and abnormal Doppler velocimetry studies. Therefore, every case of oligohydramnios requires to be assessed meticulously. Prompt detection; timely management and treating the underlying condition improve outcome.

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STUDY OF THE INCIDENCE AND EFFECT OF MECONIUM STAINED AMNIOTIC FLUID ON FETAL MORBIDITY AND MORTALITY OF NEONATES BORN

10.36106/ijsr/4201919 ◽

2021 ◽

pp. 1-3

Author(s):

Kajal Kunwar ◽

Shanti HK Singh

Keyword(s):

Amniotic Fluid ◽

Neonatal Death ◽

Neonatal Morbidity ◽

Fetal Outcome ◽

Morbidity And Mortality ◽

Control Group ◽

Care Hospital ◽

Early Neonatal Death ◽

Meconium Staining ◽

Meconium Stained Amniotic Fluid

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.

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Relationship of Amniotic Fluid Index (AFI) Between Maternal and Perinatal in Patients

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i44a32638 ◽

2021 ◽

pp. 460-465

Author(s):

Manimekalai, Neranjana

Keyword(s):

Amniotic Fluid ◽

Pregnant Women ◽

Bacterial Infections ◽

Mode Of Delivery ◽

Fetal Distress ◽

Fetal Outcome ◽

Control Group ◽

Amniotic Fluid Index ◽

Nicu Admission ◽

Relationship Of

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.

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Impact of a Head Covering on Photo-Therapy Induced Hypo-calcaemia in Full-term Neonates with Hyper-bilirubinemia

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i58b34177 ◽

2021 ◽

pp. 102-107

Author(s):

Sachin Mulye ◽

Revatdhama J. Meshram ◽

Krishnakumar Thakrani

Keyword(s):

Full Term ◽

Control Group ◽

P Value ◽

Average Weight ◽

Study Group ◽

Chi Square ◽

Substantial Impact ◽

Term Neonates ◽

Symptomatic Hypocalcemia ◽

Head Covering

Background: Hyper-bilirubinemia causes yellowish discoloration of the sclera and skin in newborns and is one of the most common disorders that neonatologists face daily. In the first week of life, 60 percent of term and 80 percent of preterm babies have jaundice. In neonates with unconjugated hyper-bilirubinemia, phototherapy is the most common treatment. Objective: To compare the occurrence of hypocalcemia in full-term icteric neonates with and without head covering during phototherapy. Materials and Methodology: Two hundred and eight full-term neonates were split into two groups for photo-therapy for hyper-bilirubinemia. The heads of the participants in the study group were covered with a hat. Before beginning photo-therapy, serum bilirubin and serum calcium levels were assessed, as well as after 48 hours of photo-therapy. SPSS software was used to tabulate and analyze the data. Results: Ninety-four (45%) of the 208 neonates in the sample were males, while 114 (55%) were females. The average age was 5.56 +2.78 days, and the average weight was 3.04 +0.58 kilograms. Out of 208 neonates, 44 (21%) had hypocalcemia. Hypocalcemia occurred in 28 neonates in the control group and 16 neonates in the study group. There was no symptomatic hypocalcemia in any of the newborns. The p-value for the Chi square test was 0.2. Since this value is greater than 0.05, it is not statistically important. Conclusion: In comparison to neonates whose heads were not covered, fewer neonates with covered heads experienced hypocalcemia in our research. However, these findings were not statistically important. However, Research in other countries found that neonatal head cover at phototherapy had a substantial impact. As a result, we propose that a major multicenter study be performed in our country to determine the exact significance.

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FETOMATERNAL OUTCOME OF PREGNANCY BETWEEN 40 AND 42 WEEKS

The Professional Medical Journal ◽

10.29309/tpmj/2008.15.03.2846 ◽

2008 ◽

Vol 15 (03) ◽

pp. 317-322

Author(s):

NAZIA AMJAD ◽

TAYYBA IMRAN ◽

AHSEN NAZIR AHMED

Keyword(s):

Apgar Score ◽

Perinatal Death ◽

Stress Test ◽

Mode Of Delivery ◽

Fetal Outcome ◽

Control Group ◽

P Value ◽

Study Group ◽

Biophysical Profile ◽

The Difference

.Objective:To evaluatewhether serial monitoring of fetuses beyond 40 weeks with biophysical profileand non stress test improves the fetal outcome in terms of morbidity and mortality.Design: Prospective control study.Setting: Department of Obstetrics & Gynaecology at Ittefaq Hospital( Trust) Lahore,. Period: From Jan, 2007 to June2008.Patients and Methods: Two hundred women with singleton uncomplicated pregnancies at 40 weeks were dividedinto two groups; A study group with biweekly biophysical profile and non stress test and a control group with biweeklyantenatal clinical assessment with fetal kick count chart. Main outcome measures were onset of labour, mode ofdelivery, Apgar score, presence of meconium and admission to nursery. Results: The age of patients ranged between18 to 39 years with the mean of 26.33.The range of gravidity was between primigravida to gravida seven. Ninety sixpercent of total patients were delivered by 41 weeks and 6 days.18% of women were induced in study group comparedto 11% in control group ( p value=0.124 ).Cesarean section rate was 8% in study group and 11% in control group. Rateof instrumental deliveries was 6.5% in study group while 11.2% in control group. The difference in mode of delivery wasfound to be insignificant ( p=0.538 ).Weights of the babies ranged between 2.6 to 4.4 kg with a mean of 3.246 kg.Cumulative %age of APGAR score at 5 minutes was more than 6/10 in 92.5% cases ( p=0.665 ).Meconiumwas foundin 18% of cases in study group and 22% of control group( p=0.917 ).12 % of the babies were admitted to nursery instudy group compared to 16% in control group. Perinatal mortality was found to be 10/1000 in control group while therewas no perinatal death in study group. Conclusions: The difference of outcome between two groups was found to bestatistically insignificant which concluded the validity of either mode of management.

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Investigation of the Incidence of Coital Incontinence in Incontinent Women

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2019.948 ◽

2019 ◽

pp. 1

Author(s):

Omer Demir ◽

Cihan Comba

Keyword(s):

Urinary Incontinence ◽

Urine Analysis ◽

Stress Test ◽

Control Group ◽

P Value ◽

Study Group ◽

Sexually Active ◽

Chi Square ◽

Coital Incontinence ◽

Chi Square Test

Objective: Coital incontinence is the involuntary leakage of urine during sexual intercourse and is rarely reported in women with urinary incontinence. The aim of this study is to investigate the frequency of coital incontinence and its association with incontinence types.Study Design: All sexually active women with urinary incontinence (diagnosed as self-reported) attending the out-patient gynecology clinic of a regional state hospital were interviewed consecutively between September 2017 and September 2018 about their experience with regards to coital incontinence. The clinical evaluation consisted of medical history, physical examination, and urine analysis. The SPSS 20 program designed for Windows was used for statistical analysis. Results: Twenty-two of the 64 women who participated in the study were diagnosed with coital incontinence and the remaining 42 women were to be compared. 42 women were included in the control group, and 22 women were defined as the study group. The women with coital incontinence had significantly higher stress test positivity than the control group (p = 0.00). No significant differences in the frequency of coital incontinence between incontinence types were found. The chi-square test was applied, and the p-value was >0.05 (p=0.110). So there was no statistically significant relationship between the type of incontinence and the frequency of coital incontinence.Conclusion: Coital incontinence is much more prevalent than expected and therefore patients with symptomatic urinary incontinence should be investigated for the presence of coital incontinence, as this may affect patient approach and treatment.

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