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

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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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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Perinatal outcome associated with oligohydramnios in term pregnancies

Nepal Medical Journal ◽

10.37080/nmj.10 ◽

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.

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Study of perinatal outcomes in normal and borderline oligamnios

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20196034 ◽

2019 ◽

Vol 9 (1) ◽

pp. 279

Author(s):

Divya R. Prasad ◽

Neelima V. Nair

Keyword(s):

Heart Rate ◽

Caesarean Section ◽

Amniotic Fluid ◽

Fetal Heart Rate ◽

Perinatal Outcome ◽

Fetal Heart ◽

Mode Of Delivery ◽

Perinatal Outcomes ◽

Amniotic Fluid Index ◽

Meconium Staining

Background: Oligamnios is a common cause of perinatal mortality and morbidity, but the outcome of borderline oligamnios, defined as Amniotic Fluid Index (AFI) between 5 and 8, is less clear. This study aims to find out the effect of borderline oligamnios on perinatal outcomes in pregnancies beyond 37 weeks.Methods: An observational prospective study of 131 antenatal mothers with AFI between 5 and 8, after 37 weeks of gestation was conducted in Sree Gokulam Medical College and Research Foundation from October 2017 to September 2019. These observations were compared with that of 131 antenatal mothers with normal AFI beyond 37 weeks of gestation. The observations according to fetal heart rate abnormalities, meconium staining of amniotic fluid, mode of delivery, low birth weight babies, APGAR score, the need of neonatal intensive care unit (NICU) admissions due to neonatal complications were statistically analysed.Results: Both groups were comparable with respect to age, parity and gestational age. In those with borderline oligamnios, fetal heart rate abnormality was seen in 21% (28), meconium stained amniotic fluid in 18% (23), 70% (91) delivered vaginally and 30% (40) underwent caesarean section, 31% (41) babies weighed below 2.5 kg and 21% (27) neonates needed NICU admissions. In those with normal AFI, none showed fetal heart rate abnormality, 2% (3) showed meconium staining, 93% (122) delivered vaginally and 7% (9) underwent caesarean section, 11% (14) babies weighed below 2.5 kg and 3% (4) neonates needed NICU admissions.Conclusions: Borderline oligamnios is associated with poor perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. It helps to identify those infants at risk of poor perinatal outcome.

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Maternal and neonatal outcome in pregnancy bbeyond 41 Weeks of Gestation: Observational study

VIMS Health Science Journal ◽

10.46858/vimshsj.8201 ◽

2021 ◽

Vol 8 (2) ◽

pp. 53-57

Author(s):

Dr. Asmita Misal ◽

Dr. Urmila Gavali ◽

Dr. Gautam S. Aher

Keyword(s):

Amniotic Fluid ◽

Perinatal Outcome ◽

Maternal Morbidity ◽

Tertiary Care ◽

Mode Of Delivery ◽

Labour Induction ◽

Care Hospital ◽

Perinatal Complications ◽

Perineal Tear ◽

Meconium Stained Amniotic Fluid

Background: Pregnancy beyond term is associated with adverse maternal and perinatal outcome. The aim of the study the maternal and perinatal outcome in pregnancies at and beyond 41 week of gestation. Methods: This is a prospective study of 140 patients with pregnancy beyond 41 weeks fulfilling the eligibility criteria and admitted and delivered in department of obstetrics and gynaecology at a tertiary care hospital. We examined its association with following outcomes: age, parity, genetic factors, bishop’s score at admission, mode of delivery, induction rate, meconium stained amniotic fluid, oligohydramnios, Perinatal and neonatal morbidity, Perineal tear, postpartum haemorrhage, maternal morbidity and mortality etc. Results: Out of 140 patients, majority in the age group of 21-25 years, 68 (48.6%) patients were primigravida while 72 (51.4%) patients were multigravida. Maximum patients 65% were not in labour whereas 35% were in labour. In 51 (36.4%) patients mode of delivery was caesarean section, in which most common indication being foetal distress in 25.5% followed by meconium stained amniotic fluid in 17.6%. In present study perinatal morbidity like stillbirth, RDS were 2.86% & 25.8% respectively. Maternal morbidity like PPH, tear and wound infection were 4.31%, 6.4%, 0.7%respectively. Conclusions: With Regular antenatal check-up, incidence of post term pregnancy can be decreased and Labour induction should be considered at 41weeks to prevent lot of maternal and perinatal complications.

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Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205443 ◽

2020 ◽

Vol 10 (1) ◽

pp. 107

Author(s):

Vandana Mohapatra ◽

Sujata Misra ◽

Tapas Ranjan Behera

Keyword(s):

Caesarean Section ◽

Amniotic Fluid ◽

Pregnant Women ◽

Perinatal Outcome ◽

Mode Of Delivery ◽

Birth Asphyxia ◽

Control Group ◽

Study Group ◽

The Mean ◽

Meconium Stained Amniotic Fluid

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction. Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.

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Comparison of Amniotic Fluid Index and Single Deepest Vertical Pocket

Current Women s Health Reviews ◽

10.2174/1573404817666210223162752 ◽

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.

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Perinatal outcome in uncomplicated pregnancies with oligohydramnios

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185426 ◽

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.

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Comparison of adverse perinatal outcomes after single-needle and double-needle CVS techniques

Journal of Perinatal Medicine ◽

10.1515/jpm-2015-0360 ◽

2017 ◽

Vol 45 (2) ◽

Author(s):

Cenk Gezer ◽

Atalay Ekin ◽

Gokhan Goynumer ◽

Kaan Pakay ◽

Hicran Acar ◽

...

Keyword(s):

Significant Risk ◽

Perinatal Outcomes ◽

Invasive Procedure ◽

Significant Risk Factor ◽

Adverse Outcomes ◽

Control Group ◽

Needle Technique ◽

Adverse Perinatal Outcomes ◽

Chorion Villus ◽

The Impact

AbstractObjective:To determine the impact of the chorion villus sampling (CVS) technique on adverse perinatal outcomes.Methods:In this case-control study, 412 women who underwent CVS at 11–14 weeks of gestation and 231 women who did not undergo any invasive procedure were retrospectively evaluated. The women in the CVS group were further divided into two groups according to the use of single-needle technique (n=148) vs. double-needle technique (n=264). The adverse outcomes were compared between controls and the two CVS groups, and regression analysis was used to determine the significance of independent contribution.Results:The rate of preeclampsia for the control group was 2.2%, for the double-needle group was 3% and for the single-needle group was 8.1%. CVS with single-needle technique was found to be an independent and statistically significant risk factor for preeclampsia [odds ratio (OR)=2.1, 95% confidence interval (CI); 1.4–2.7, P=0.008].Conclusion:The risk of preeclampsia after CVS appears to be increased with single-needle technique compared with double-needle technique.

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