scholarly journals Study of mode of delivery and fetal outcome in pregnancies with oligohydramnios

Author(s):  
Lavanya B. ◽  
A. Prajwala

Background: The significance of amniotic fluid volume as a marker of fetal status is an ongoing turn of events. Oligohydramnios causes adverse fetal outcomes like meconium-stained liquor, meconium aspiration syndrome, fetal heart rate abnormalities, poor APGAR scores, fetal growth restriction and fetal prematurity. It is associated with maternal hypertension, infections, and placental insufficiency. It causes maternal complication because of increased incidence of induction of labour and operative intervention.Methods: Hundred cases of oligohydramnios were included in our study conducted at the Navodaya medical research, hospital and research centre, during a period of two years after obtaining the informed consent of patients and institutional ethical clearance. All gravidas were included with a gestational age greater than 28 weeks with singleton pregnancies with oligohydramnios. Associated fetal and maternal risk factors were observed. The amniotic fluid index (AFI) was measured by ultrasound. The nonstress test, the fetal biophysical profile and the Doppler study were carried out to evaluate the fetal condition. Then we have observed for delivery and fetal outcome.Results: Incidence of oligohydramnios was 2.85% in our study. The 53% of cases had LSCS while 47% had normal delivery. Fetal distress was the commonest indication for LSCS. Poor neonatal APGAR score was 16.9% in LSCS while 36% in vaginal delivery.Conclusions: From the above study, the caesarean delivery seems to be a safer mode of delivery than vaginal delivery because it is associated with a good perinatal outcome.

2012 ◽  
Vol 10 (3) ◽  
pp. 198-202
Author(s):  
S Kumar ◽  
SN Gupta ◽  
IP Mahato ◽  
R Giri ◽  
A Yadav ◽  
...  

Introduction: Passage of meconium in utero is a dangerous sign for fetal outcome which influence the decision to deliver as well as the mode of delivery. Methods: This descriptive case control study was carried out in the department of Obstetrics and Gynaecology, Koshi Zonal Hospital from March 2006 to July 2006. A total of 50 women with meconium stained amniotic fluid( MSAF) were studied to identify maternal and fetal outcome and was compared with women with clear amniotic fluid. Results: Normal delivery was significantly higher (58%) in clear liquor group as compared to MSAF group (22%). Cesarean section was more common in MSAF group (66%) where as it was (38%) in the clear liquor group (p=0.005). Low Apgar scores of < 5 at one minute was seen in 48% of MSAF and 6% of clear liquor born babies (p<0.2). But at 5 minutes low Apgar score persisted in same 48% of MSAF babies whereas it was seen in 12% of clear liquor group (p<0.000). Among the babies born with MSAF 34% were referred to higher center compared to 6% in clear liquor babies (p=0.000). Four babies with thick MSAF and one baby with clear liquor had neonatal death (p=0.005). Conclusion: Mode of delivery and fetal outcome were adversely affected by the presence of thick meconium stained liquor as compared to clear liquor. Additional monitoring facilities e.g. cardiotocography (CTG) if available would reduce fetal distress and allow timely intervention in such cases. DOI: http://dx.doi.org/10.3126/hren.v10i3.7135 Health Renaissance; September-December 2012; Vol 10 (No.3);198-202


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.


Author(s):  
Mahantappa A. Chiniwar ◽  
Joe Kaushik M. ◽  
Sharada B. Menasinkai

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.


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):  
Hema K. R. ◽  
Lalitha H. S.

Background: Perinatal morbidity and mortality are significantly increased when oligohydramnios is present. As the amniotic fluid volume decreases, the perinatal mortality rate increases. The incidence of major congenital anomalies with IUGR also increases as the amniotic fluid volume declines. There is a close association between declining placental function in the latter part of the third trimester and amniotic fluid volume1. Thus, post term patients are at a greater risk for development of oligohydramnios. Fetal anomalies that results in oligohydramnios classically involve the urinary tract. The most frequently mentioned renal anomalies include bilateral renal agenesis, multicystic dysplastic kidneys, bladder outlet obstruction and infantile polycystic kidneys.Methods: All antenatal patients seen in the Department of Obstetrics and Gynecology at Sri Siddhartha Medical College and Research Centre between January 2015 to January 2017, who were willing to participate in the trial study were enrolled. Ultrasound GE Voulson S8-PRO equipped with 3.5 MHz transducer was used to measure the amniotic fluid index. The AFI in each group was noted and the pregnancy outcome in each group was determined. At the time of delivery following data variables were collected and compiled.Results: There were 105 women, who were divided into three groups of 35 each. Those women with AFI<5 had more chances of emergency caesarian section, the causes were fetal distress with variable and late fetal heart decelerations. The incidence of meconium stained liquor and NICU admission were more.Conclusions: The women with AFI<5 had more chances of emergency caesarian section, the causes were fetal distress with variable and late fetal heart decelerations. Amniotic Fluid Index is a valuable screening test for detecting fetuses that may have poor perinatal outcome.


Author(s):  
Bharti Maheshwari ◽  
Preeti Sharma ◽  
Kamini Pawar ◽  
Kirti Goswami

Background: COVID-19 has spread globally at an accelerated rate with rapid increases in cases and mortality. Viral pneumonia is one of the leading causes of pregnancy deaths worldwide. Physiological changes during pregnancy, such as reduced functional residual volumes, diaphragm elevation, and oedema of respiratory tract mucosa, as well as changes in cell immunity can lead to increased susceptibility to viral infections and can have worsened outcomes.Methods: The study was conducted after clearance from Board of Studies and Ethical committee in the Department of obstetrics and gynaecology, Muzaffarnagar medical college, Muzaffarnagar. It was a retrospective study. Out of total 1500 covid positive patients admitted in 3 months, 33 pregnant women were included which were covid positive.Results: The study population consisted of 16 (48.5%) women from 20-25 years, 12 (36.4%) women from 26-30 years and 5 (15.2%) women from above 30 years. There was history of exposure among all (100.0%) pregnant women with only 2 (6.1%) having symptoms of COVID-19.Out of 33, 8 patients were severelyanemic, 4 had preeclampsia, 2 cases had previous 2 LSCS, 5 previous 1 LSCS, 1 leaking pervaginum, 3 cases had fetal distress at admission. As per gestational age, 9 (27.3%) women had pre-term delivery, 21 (63.6%) had normal term delivery and 3 (9.1%) had post-term delivery. 13 women were primigravida and 20 were multigravida. The mode of delivery was LSCS among 24 (73%) and normal delivery among 1 (3.0%) women.Conclusions: In our study, there were no maternal and fetal complications among pregnant women with COVID-19.


Author(s):  
V. G. Vanamala ◽  
Aruna Rachel ◽  
Sushil Pakyanadhan ◽  
Sudheep Abraham P.

Background: Baby’s well-being in utero is often done by using a cardiotocograph (CTG) machine, which assesses the baby’s heart beat pattern as well as the mother’s uterine contractions. However, lowered fetal movements sometimes may be fatal for the baby. Thus, the biophysical and the modified biophysical profile have been introduced.Methods: 242 patients with over 34 weeks of gestation and with one or more risk factors were included in the study. After taking the demographic details, the patients were subjected to detailed physical and clinical evaluation. Modified BPP was done on all the patients. Index of acute fetal hypoxia the NST was done along with the cardiotocograph (CTG). Amniotic fluid volume was calculated.Results: According to the fetal non-stress test, majority of the patients (70.7%) were reactive while 29.3% were non-reactive. Most of the patients had an amniotic fluid index in the normal range i.e. between 8 -<25, 18.6%) had an AFI value of <6 cm while 13.6% had between 6 - <8. Among the babies with reactive NST, non-reactive NST and AFI ≤5, the most common outcome was low birth weight.  APGAR score <7 was observed in 11.1%, 13.1%, 20% among Reactive NST, Non-reactive NST and AFI ≤5 respectively.Conclusions: Present study shows that BPP and MBPP are both comparable to each other, therefore, MBPP, being an easier test can be substituted for BPP.


Author(s):  
Nalini Sharma ◽  
Hanslata Gehlot

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.


2018 ◽  
Vol 1 (01) ◽  
pp. 25-30
Author(s):  
Deepa Chudal ◽  
Keshang Diki Bista ◽  
Neelam Pradhan

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
H. Bakhsh ◽  
H. Alenizy ◽  
S. Alenazi ◽  
S. Alnasser ◽  
N. Alanazi ◽  
...  

Abstract Background The amniotic fluid is a protective liquid present in the amniotic sac. Two types of amniotic fluid disorders have been identified. First refers to polyhydramnios, which is an immoderate volume of amniotic fluid with an Amniotic Fluid Index (AFI) greater than 24 cm. Second includes oligohydramnios, which refers to decreased AFI i.e., less than 5 cm. This study aims to; a) identify the maternal risk factors associated with amniotic fluid disorders, b) assess the effect of amniotic fluid disorders on maternal and fetal outcome c) examine the mode of delivery in pregnancy complicated with amniotic fluid disorders. Methods A comparative retrospective cohort study design is followed. Sample of 497 pregnant women who received care at King Abdullah bin Abdul-Aziz University Hospital (KAAUH) between January 2017 to October 2019 was included. Data were collected from electronic medical reports, and was analyzed using descriptive statistics. Association of qualitative variables was conducted by Chi-square test, where p-value < 0.05 was considered statistically significant. Results Among the collected data, 2.8% of the cases had polyhydramnios and 11.7% patients had oligohydramnios. One case of still born was identified. A statically significant association was found between polyhydramnios and late term deliveries (P = 0.005) and cesarean section (CS) rates (P = 0.008). The rate of term deliveries was equal in normal AFI and oligohydramnios group (P = 0.005). Oligohydramnios was mostly associated with vaginal deliveries (P = 0.008). Oligohydramnios and polyhydramnios were found to be associated with diabetes mellitus patients (P = 0.005), and polyhydramnios with gestational diabetes patients (P = 0.052). Other maternal chronic diseases showed no effect on amniotic fluid index, although it might cause other risks on the fetus. Conclusion Diabetes mellitus and gestational diabetes are the most important maternal risk factors that can cause amniotic fluid disorders. Maternal and fetal outcome data showed that oligohydramnios associated with gestational age at term and low neonatal birth weight with high rates of vaginal deliveries, while polyhydramnios associated with gestational age at late term and high birth weight with higher rates of CS.


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