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.

scholarly journals Comparison of Perinatal Outcomes between Borderline and Normal Amniotic Fluid Index in Term Singleton Pregnancies

2021 ◽  
Vol 18 (4) ◽  
pp. 709-713
Author(s):  
Nishma Bajracharya ◽  
Ganesh Dangal ◽  
Rekha Poudel ◽  
Kenusha Devi Tiwari ◽  
Sonu Bharati ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Normal Group ◽  
Amniotic Fluid Index ◽  
Safe Delivery ◽  
Meconium Stained Amniotic Fluid ◽  
Singleton Pregnancies

Background: Amniotic fluid provides necessary fluid and growth factors for normal development of fetal lungs, cushions the umbilical cord from compression and protects the fetus. This study aims to compare the perinatal outcome between pregnancy with borderline and normal Amniotic Fluid Index that provide greatest chance for appropriate safe delivery with least maternal fetal and neonatal risk.Methods: A total of 94 singleton full term pregnant women were included in the study-at Kathmandu Model Hospital from February to August 2020. Forty Seven women each with Amniotic Fluid Index 5-8 cm was taken as borderline oligohydramnios group and Amniotic Fluid Index 8.1-24 cm was taken as normal group. Ultrasonography was taken as the medium for measuring Amniotic Fluid Index.Results: The rate of intra-partum fetal distress, meconium-stained amniotic fluid, low birth weight and neonatal intensive care unit admission were not statistically significant between the two groups while rate of cesarean section was noted to be 76.6% in exposed groups as compared to 44.7% among women with non-exposed normal group [RR=1.71; 95%CI: 1.2-2.44 p=0.006]. Conclusions: We concluded that in cases of borderline oligohydramnios there was higher risk of operative delivery.Keywords: Adverse perinatal outcome; amniotic fluid; borderline oligohydramnios; meconium-stained amniotic fluid

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 Study of Oligohydramnios and its perinatal outcome

2019 ◽  
Vol 8 (7) ◽  
pp. 2705
Author(s):  
Sudha V. Patil ◽  
Fatima Zahra Shaikmohammed
Keyword(s):  
Amniotic Fluid ◽  
Vaginal Delivery ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
Control Group ◽  
Amniotic Fluid Index ◽  
Gestational Age At Delivery ◽  
Late Deceleration ◽  
Group 2

Background: Importance of amniotic fluid volume as an indicator of fetal status is being appreciated relatively recently. Around 3% to 8% of pregnant women are presenting with low amniotic fluid at any point of pregnancy. The present study was undertaken to study the outcome of pregnancies with Oligohydramnios [(amniotic fluid index) AFI≤5cm] at or beyond 34 weeks.Methods: This study consists of 50 cases of antenatal patients with oligohydramnios (AFI≤5) at or beyond 34 weeks of gestation compared with age and gestation matched 50 normal liquor (AFI≥5 and ≤25). The outcome measures recorded were labor, gestational age at delivery, amniotic fluid index (AFI), mode of delivery, indication for cesarean section or instrumental delivery, APGAR score and birth weight.Results: In the present study, AFI was significantly decreased in cases (3.74±1.2) compared (12.54±2.5) with controls. Variable deceleration was noted in 14 (28%) and late deceleration in 5 (10%) cases. In control group, 2 (4%) had late deceleration. In cases induced labor is in 14 (28%), spontaneous labor 36 (72%). In cases, term normal vaginal delivery was in 15 (30%), PVD in 6 (12%), LSCS in 28 (56%) and instrumental vaginal delivery in 1 (2%). In controls, full term normal vaginal delivery was in 41 (82%), PVD in 5 (10%), LSCS in 4 (8%). APGAR score <7 at 1 minute was in 19 (38%) and at 5 minutes was in 5 (10%) in cases. Birth weight is reduced in cases. IUGR was reported in 9 (18%) in cases.Conclusions: Pregnancies with Oligohydramnios (AFI≤5) is associated with increased rate of non-reactive NST. Routine induction of labor for Oligohydramnios is not recommended. It is preferable to allow patients to go into spontaneous labor with continuous FHR monitoring. Antepartum diagnosis of Oligohydramnios warrants close fetal surveillance.

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 Role of admission cardiotocography and amniotic fluid index on perinatal outcome in low risk pregnancy at term

2021 ◽  
Vol 10 (4) ◽  
pp. 1591
Author(s):  
Manasi Patnaik ◽  
Tejaswini M ◽  
Sudhanshu Kumar Rath ◽  
Shaik Afrah Naaz
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Well Being ◽  
Low Risk ◽  
Amniotic Fluid Index ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy

Background: Fetal surveillance even in normal or low risk pregnancy is essential to ensure safe parturition with minimum intervention. Cardiotocography (CTG) and clinical estimation of amniotic fluid volume (AFV) measured as amniotic fluid index (AFI) are two tests that are easily available in the labor room and can be used to identify fetal well-being. Our study aimed to evaluate role of admission cardiotocography (CTG) and amniotic fluid index (AFI) on perinatal outcome in low risk pregnancy at term.Methods: The study was conducted as a prospective observational study. All low risk pregnant women at term admitted to the labor ward in early or established labour between September 2018 and August 2020 were included in the study. They underwent admission CTG and AFI assessment using ultrasonography. All parameters including CTG changes, mode of delivery, AFI, presence of meconium, APGAR score at 1 and 5 mins, need for admission in neonatal ICU and perinatal mortality were recorded. Quantitative data was compared using chi square test.Results: A total of 180 patients were included in the study. Majority of the women belonged to the age group of 30-35 years. Abnormal CTG showing fetal distress was seen in 105 (58.33%) cases. Non-reactive CTG was significantly associated with meconium stained liqour, requirement for LSCS, still birth, fetal distress, APGAR <7 at 1 and 5min and NICU admission (p<0.001). The association of low AFI with non-reactive CTG had statistically significant impact on perinatal outcomes like low birth weight, requirement for LSCS, fetal distress, APGAR <7 at 1 and 5 mins and NICU admissions.Conclusions: Admission CTG is a simple non-invasive test that can serve as a screening tool in low risk obstetric population to detect fetal distress already present or likely to develop and prevent unnecessary delay in intervention. Thus, it may help in preventing fetal morbidity and mortality.

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.

scholarly journals Fetomaternal outcome in pregnancy with oligohydramnios: a prospective study

2021 ◽  
Vol 10 (2) ◽  
pp. 571
Author(s):  
Heena Talesara ◽  
Vidhi C. C. Shah ◽  
Dipti A. Modi ◽  
Rahi S. Modi
Keyword(s):  
Risk Factor ◽  
Prospective Study ◽  
Amniotic Fluid ◽  
Congenital Anomalies ◽  
Mode Of Delivery ◽  
Favourable Outcome ◽  
Hypertensive Disorder ◽  
Amniotic Fluid Index ◽  
Health Care Centre ◽  
A Prospective Study

Background: Oligohydramnios is defined as amniotic fluid index <5th percentile or 2 standard deviation below the normal amniotic fluid volume. It affects 4% of all the pregnancy. The aim of this study is to evaluate the etiological risk factor of oligohydramnios and to assess their clinical significance and mode of delivery and maternal and perinatal outcome.Methods: This study was conducted at a tertiary health care centre, SSG Hospital, Baroda, from 1st September 2019 to 30th August 2020. It is a prospective study of 200 cases of oligohydramnios with gestational age > 30 weeks.Results: The most common risk factor associated with oligohydramnios was hypertensive disorder of pregnancy (35%) followed by intra uterine growth restriction (31%), preterm rupture of membranes (17%), post-datism (5%) and about 12% were due to idiopathic causes. Among cases majority were primigravida (43%). Lower segment caesarean section was done in 86 cases (43%), and main indication was fetal distress. There was no maternal mortality in the study. NICU admission for low birth weight (26%), pre-maturity (20%), meconium aspiration syndrome (8%), congenital anomalies (8%). Among congenital anomalies, posterior urethral valve had highest incidence (50%) followed by renal agenesis (25%). The neonatal mortality was 5%.Conclusions: Oligohydramnios adversely affects the perinatal outcome. Therefore, it requires meticulous assessment, prompt detection, timely management and treating underlying condition. However, a favourable outcome can be expected by good antenatal and intrapartum surveillance and neonatal care.

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

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.

scholarly journals Borderline oligohydramnios in term pregnancy and it's relation with pregnancy outcome

2021 ◽  
Vol 10 (2) ◽  
pp. 505
Author(s):  
M. Vennila ◽  
S. Deepika
Keyword(s):  
Amniotic Fluid ◽  
Fetal Growth ◽  
Clinical Symptoms ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Term Pregnancy ◽  
Amniotic Fluid Index ◽  
College Hospital ◽  
Apgar Scores ◽  
Adverse Pregnancy

Background: Oligohydramnios can lead to contamination of amniotic fluid, fetal distress, neonatal asphyxia, aspiration pneumonia, increased perinatal mortality and adverse pregnancy outcomes. Because of atypical clinical symptoms, the critical point is to treat patients with oligohydramnios in late pregnancy. The objectives of the research were to study the mode of delivery/rate of operative interference/incidence of cesarean section due to fetal distress/non-reassuring fetal heart rate status in cases of term pregnancy with borderline amniotic fluid index (AFI), and to study the perinatal outcome in cases of term pregnancy with borderline AFI.Methods: The study is a prospective comparative study to be conducted in patients attending antenatal clinic at department of obstetrics and gynaecology, Tirunelveli government medical college hospital from from January 2018 till January 2019 (12 months). Data collected with regards to age, demographic characteristics, and socioeconomic status, detailed history including patient’s complaints, duration of complaints, menstrual and obstetric history, significant past, family and personal history. 265 cases of borderline oligohydramnios were detected of which 150 cases were selected for the study after applying exclusion criteria.Results: APGAR scores between the two groups. The mean APGAR scores of the normal group were 8.3±0.7 and the same of the borderline AFI group was 8.0±0.9. The difference between the means was statistically highly significant (p<0.01).Conclusions: Cumulative analysis of various studies, it will be reasonable to conclude that antepartum surveillance for borderline oligohydramnios is indicated in cases associated with fetal growth restriction or suboptimal fetal growth.

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