scholarly journals A technology for prediction of preterm discharge of amniotic fluid

2021 ◽  
pp. 66-72
Author(s):  
V.A. Mudrov ◽  
◽  
A.V. Yakimova ◽  
A.M. Ziganshin ◽  
◽  
...  
Keyword(s):  
Neural Network ◽  
Amniotic Fluid ◽  
Perinatal Outcomes ◽  
Statistical Processing ◽  
Total Bilirubin Level ◽  
Amniotic Fluid Index ◽  
Female Patients ◽  
Group 2 ◽  
Perceptron Learning ◽  
Distinguished Group

Aim of study. To create a technology for prediction of preterm discharge of amniotic fl uid based on universally accessible methods of laboratory and instrumental evaluation. Material and methods. A retrospective analysis of 200 birth cases dated 2018-2021 at the premises of obstetric facilities in Chita and Ufa cities featuring patients admitted to the inpatient unit shortly before term labour (1-2 days). In the course of the study, 2 groups were distinguished: Group 1 included 128 female patients with term discharge of amniotic fluid and Group 2 was constituted by 72 female patients with preterm discharge of amniotic fluid. The groups were comparable in age, anthropomorphic parameters and extragenital pathology. On admission, all women underwent general medical examination and ultrasonography. Statistical processing of the results was performed via the IBM SPSS Statistics Version 25.0 soft ware. Results. The technology for prediction of preterm discharge of amniotic fluid was based on multilayer perceptron learning. The structure of the learning neural network included 5 input neurons: body mass index, fundal height, the total bilirubin level, activated partial thromboplastin time and the amniotic fluid index. Th e percentage of incorrect predictions of the neural network totalled 28.5 %. Conclusion. A complex approach based on integration of universally accessible methods for laboratory and instrumental tests shortly before the labour based on a neural network makes it possible to predict possible preterm discharge of amniotic fl uid with an accuracy of up to 75 %. Application of this technology in clinical practice will make it possible not only to perform timely preparation of the parturient canal but also to reduce the frequency of adverse obstetric and perinatal outcomes

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 Perinatal outcome in uncomplicated pregnancies with oligohydramnios

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.

scholarly journals Maternal and Perinatal outcomes of oligohydramnios in a tertiary care hospital in Salem, Tamil Nadu, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1939
Author(s):  
Jeyamani B. ◽  
Anurekha J. P. ◽  
Arun Daniel J.
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Tamil Nadu ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Fluid Volume ◽  
Care Hospital ◽  
Amniotic Fluid Index ◽  
Amniotic Fluid Volume

Background: Oligohydramnios is the term coined for a condition where the amount of liquor amnii is less than 200 ml at term. Using an ultrasonogram, oligohydramnios can be deliberated when the vertical pocket of liquor is less than 2 cm or when amniotic fluid index (AFI) is less than 5 cm. Oligohydramnios is reported to occur in 1 to 5% of total pregnancies. It has been associated with adverse maternal and foetal outcomes.Methods: This hospital-based follow-up study was conducted among 540 pregnant women at 37 weeks attending to the Department of Obstetrics and Gynaecology for a period of 1 year from January to December 2018. All included pregnant women were subjected to routine ultrasound examination and assessment of amniotic fluid volume using Amniotic fluid index.Results: The incidence of oligohydramnios was 17.04% (n=92) among the included women and 62% (n=57) among them were primigravida. Among those women diagnosed with Oligohydramnios, the caesarean section rate was 56.5% (n=52), the common indications for LSCS being fetal distress 44. 2% (n=23) and IUGR 34.6% (n=18). The oligohydramnios pregnancies had more associated post-dated deliveries (28.3%), pregnancy induced hypertension (10.9%) and gestational diabetes (8.7%). It was also associated with higher incidence of low birth weight (27.2%), NICU admissions (32.6%), congenital anomalies (3.3%) and fetal deaths (5.4%).Conclusions: The study showed that an amniotic fluid index of less than 5 at term was associated with adverse maternal and perinatal pregnancy outcomes emphasizing the importance of amniotic fluid volume surveillance during the antenatal period.

scholarly journals Adverse perinatal outcomes in borderline amniotic fluid index

2016 ◽  
Vol 14 (11) ◽  
pp. 705-708 ◽  
Author(s):  
Ashraf Jamal ◽  
Maryam Kazemi ◽  
Vajiheh Marsoosi ◽  
Laleh Eslamian ◽  
◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcomes ◽  
Amniotic Fluid Index ◽  
Adverse Perinatal Outcomes

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

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.

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 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.

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