scholarly journals Perinatal outcome in pregnant females at term having low amniotic fluid index.

2021 ◽  
Vol 28 (09) ◽  
pp. 1358-1364
Author(s):  
Nadia Sharif ◽  
Ayesha Qasim

Objectives: To determine the frequency of perinatal outcome in pregnant females at term having low amniotic fluid index. Study Design: Descriptive, Case Series study. Setting: Department of Obstetrics & Gynecology, Independent University Hospital, Faisalabad. Period: 1st October 2019 to 31st March 2020. Materials & Methods: A total of 90 women having singleton pregnancy with cephalic presentation having 37-40 weeks of gestation with AFI <8cm, 20 to 35 years of age were included. Patients with multiple pregnancy, ruptured membrane, fetal anomaly, gestational diabetes and Rh Incompatibility were excluded. Cesarean delivery, meconium stained liquor, low birth weight, NICU admission and APGAR score <7 at 5 min were assessed by consultant gynecologist. Results: Age range in this study was from 20 to 35 years with mean age of 28.92 + 4.45 years. Majority of the patients 43 (47.77%) were between 31 to 35 years of age. Mean gestational age was 38.31 + 1.20 weeks. Mean parity was 2.72 + 1.02. In this study, frequency of perinatal outcome in pregnant females at term having low amniotic fluid index was as follows; cesarean section was performed in 60 (66.67%), low birth weight was observed in 58 (64.44%) patients, APGAR score <7 at 5 minutes in 56 (62.22%), meconium stained liquor in 24 (26.67%) and NICU admission in 17 (18.89%) patients. Conclusion: This study concluded that proper antenatal monitoring and management should be done in these high risk patients in order to reduce the morbidity and mortality of the fetus.

Author(s):  
Devika V. Desai ◽  
Nigamananda Mishra ◽  
Gayatri V. Savani

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.


2015 ◽  
Vol 10 (1) ◽  
pp. 48-51
Author(s):  
S Pradhan ◽  
A Adhikary ◽  
P Pradhan ◽  
S Pradhan

Aims:  This study was done to evaluate the predictive value of low amniotic fluid index (AFI) of < 5 cm for adverse perinatal outcome in term of caesarean section for fetal distress, birth weight, meconium stained liquor and APGAR scores. Methods: This was a prospective study of 200 antenatal women booked at Nepal Medical College Teaching Hospital during the year 2013-2014 with gestational age between 34 and 41 weeks. Patients history and clinical examination were recorded and AFI was measured and the perinatal outcome was compared between two groups i.e AFI <5 cm and >5 cm. Results: The caesarean section (C/S) rate for fetal distress and low birth weight babies (<2.5 kg) was higher in patients with low AFI (p=0.048, 0.001 respectively). There was no significant difference in meconium staining, APGAR score at 5 minutes between the two groups (p=0.881, 0.884 respectively). Conclusions: Caesarean section for fetal distress and low birth weight babies was significantly associated with low amniotic fluid index. There was no significant difference in meconium staining liquor, APGAR score at 5 minutes between the two groups.  


2021 ◽  
Vol 71 (3) ◽  
pp. 952-56
Author(s):  
Bushra Iftikhar ◽  
Aysha Shahid ◽  
Nuzhat Aisha Akram ◽  
Afeera Afsheen ◽  
Rabia Mushtaq ◽  
...  

Objective: To find out low molecular weight heparin (LMWH) efficacy inlate second trimester oligohydramnios cases. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Malir, from Jan to Jun 2017. Methodology: A total of 30 patients having amniotic fluid index (AFI) <8 on ultrasound scan during their late second trimester phase were enrolled in the study after informed consent. Exclusion criteria included congenital anomalies on U/S, PPROM, and drug-induced oligohydramnios. Personal, medical and obstetric history was obtained for age, parity and co-morbids like hypertension, antiphospholipid syndrome, and previous oligohydramnios. Low molecular weight heparin was started at dose of 0.5mg/kg of body weight subcutaneously for 8-12 weeks and stopped 24 hours prior to delivery. Rescan for amniotic fluid index and fetal bio-metry assessment done every 2 weeks till date of delivery. Fetal outcome in terms of maturity, mode of delivery, birth weight, APGAR score and need for NICU admission were measured. Results: There were 28 live births and two intrauterine deaths. Twelve patients were delivered normally and 18 had elective LSCS. Of twenty eight cases, eight were premature low birth weight (LBW) babies. Twenty six patients showed significant improvement in amniotic fluid index. Average birth weight was 2.5kg. Neonates showed an average APGAR score of 7. Eight neonates admitted in NICU (for prematurity and/or low birth weight) and discharged within a week. Conclusion: Low molecular weight heparin plays significant role in treating oligohydramnios in cases with or without risk factors. However further studies with large sample............


Author(s):  
Rita Saxena ◽  
Brinda Patel ◽  
Anjana Verma

Background: Oligohydramnios is one of the major causes of perinatal morbidity and mortality. The sonographic diagnosis of oligohydramnios is usually based on an AFI≤5 cm or on a single deepest pocket of amniotic fluid≤2 cm3. Our study was aimed to study the perinatal outcome in oligohydramnios. Aim and objective were to study obstetric risk factors associated with oligohydramnios and maternal outcome in the form of mode of delivery, and to assess neonatal complications in terms of APGAR score at birth, NICU admission rates, meconium stained liquor and still birth rates.Methods: It was an Observational, Prospective, clinical study of 100 pregnant patients diagnosed with oligohydramnios by ultrasound, carried out in Geetanjali medical college and hospital, Udaipur for period of from January 2020-August 2020. The study was conducted after ethical clearance and with informed consent. Detailed history on demographic profile, medical illness, obstetric history and antenatal complication if any in the present pregnancy; general examination, obstetric examination and bimanual examination were performed meticulously.Results: In our study 53% cases of oligohydramnios were associated with some of the risk factors like PIH (29%), IUGR (22%), fetal anomaly (1%), systemic maternal disease (1%) and 47% of the cases were Idiopathic. LSCS was done in 85.71% cases with AFI<5 cm. Low birth weight was found in 51.43% cases with AFI<5 cm. NICU admission was required for 28.57% cases with AFI<5 cm.Conclusions: AFI is an important and convenient screening test for prediction of perinatal outcome. In presence of oligohydramnios, the risk of fetal distress, operative delivery, low Apgar score, low birth weight, perinatal morbidity and mortality are more. Hence early detection of oligohydramnios, associated antenatal risk factors and timely management can improve the maternal and fetal outcome.


Author(s):  
Richa Dwivedi ◽  
Anju Depan ◽  
Kanti Yadav ◽  
Meenakshi Samariya

Background: In pregnancy amniotic fluid surrounds the foetus and plays an important role in the development of fetus. From the very beginning of the formation of the extracoelomic cavity amniotic fluid can be detected. To evaluate the predictive value of amniotic fluid index (AFI) (<5) for adverse perinatal outcome in terms of cesarean section for fetal distress, birth weight, meconium staining, Apgar scores, and NICU admission at birth.Methods: This was a prospective study of 100 antenatal women visited RMC, Ajmer, Rajasthan, India during the year 2018 with gestational age >34 weeks. The women’s history, clinical examination recorded, and AFI were measured and the perinatal outcome was compared between two groups, i.e., AFI <5 and >5.Results: The cesarean section rate for fetal distress, low birth weight babies, <2.5 kg and meconium staining was higher in patients with oligohydramnios (p=0.012, 0.001, 0.00015 respectively). There was no significant difference in Apgar score at 5 min <7 (p=0.087) and NICU at birth between the two groups.Conclusions: Oligohydramnios has a significant correlation with cesarean section for fetal distress, low birth weight babies and NICU admission.


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.


2021 ◽  
Vol 15 (10) ◽  
pp. 3423-3425
Author(s):  
Amna Najam ◽  
Samreen Fakeer Muhammad ◽  
Samia Saifullah ◽  
Maryam Shoaib ◽  
Maria Anwar

Objective: The aim of this study is to compare the fetal and maternal outcomes in between asymptomatic and symptomatic COVID positive pregnant women. Study Design: Retrospective cohort study Place and Duration: The study was conducted at Gynae and Obs department of Sandeman Provincial Hospital, Quetta for duration of six months from November 2020 to April 2021. Methods: One hundred and ten pregnant women with ages 18-45 years had corona virus disease were presented. Informed written consent was taken from all patients for detailed demographics. COVID -19 was diagnosed by PCR. 55 patients had symptoms of coronavirus were included in group A and 55 patients did not show symptoms were included in group B. Frequency of pre-eclampsia, gestational diabetes mellitus and post-partum haemorrhage were calculated. Maternal adverse outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor, hypertensive disorder) were calculated among both groups. Fetal outcomes perinatal mortality, Low birth weight, Low Apgar score and NICU admission were observed. SPSS 20.0 version was used to analyze all data. Results: Mean age of the patients in group A was 28.47±3.18 years with mean BMI 24.03±5.24 Kg/m2 and in group B mean age was 27.99±4.17 years with mean BMI 24.44±6.41 Kg/m2. Maternal outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor,) in symptomatic group were significantly higher than that of asymptomatic group. Fetal outcomes, perinatal mortality in group A 9 (16.4%) and in group B was 5 (9.1%), low birth weight in group A was among 21 (38.2%) and in group B was 10 (18.2%), low apgar score in group A was 11 (20%) and in group B was 8 (14.4%), 15 (27.3%) in group A went to NICU admission and 3 (5.5%) patient in group II admitted to NICU. Conclusion: In this study we concluded that adverse outcomes among symptomatic COVID pregnant women were higher than that of asymptomatic coronavirus pregnant women in terms maternal and perinatal outcomes. Keywords: Pregnant women, Coronavirus, Symptomatic, Asymptomatic, Adverse Outcomes


2021 ◽  
Vol 17 ◽  
Author(s):  
Roopa Padavagodu Shivananda ◽  
Rekha Anbu ◽  
Shubha Rao ◽  
Nivedita Hegde ◽  
Anjali Suneel Mundkur ◽  
...  

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.


Author(s):  
Snehal Gaware ◽  
V. B. Bangal

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.


2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)


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