scholarly journals Low amniotic uid index and the materno-fetal out come in 3rd trimester of pregnancy

2016 ◽  
Vol 44 (1) ◽  
pp. 16-20
Author(s):  
Fahmida Monir ◽  
Rumana Nazneen ◽  
Rumana Akhter ◽  
Tahmina Begum ◽  
AKM Abdul Kayum ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Well Being ◽  
Fetal Outcome ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Medical Disorders ◽  
Indirect Indicator

Amniotic fluid volume is an indirect indicator of fetal well being. About 8% of pregnant women can have low amniotic fluid, with about 4% being diagnosed with oligohydramnios. Oligohydramnios can cause complications in about 12% of pregnancies that go past 41 wks of gestation. This cross-sectional observational study was carried out in the Department of Obstetrics and Gynaecology, BSMMU, Dhaka from July 2010 to December 2010 on 55 admitted pregnant mother of 28-40 weeks gestational age with low amniotic fluid index (<8cm) with or without medical disorders specially during and after delivery along with its impact on mode of termination of pregnancy & complications of the fetus. Most of the mother (64%) had mild oligohydramnios. Most of them were < 37weeks of gestation and 69.1% of them had to undergo caesarean section as there mode of delivery. The indications were mostly (66%) due to less fetal movement, IUGR, previous C/S, malpresentation etc. The current study showed significantly higher rate (65.5%) of low birth weight resulting from the low AFI. The APGAR score less than 7 in 5 minute was significantly higher in severe oligohydramnios group and majority of the neonate experienced complications like RDS (13%), meconeum aspiration (21%) with admission in neonatal ward (54%). Low AFI has poorer prognosis to some extent with maternal as well as fetal outcome. It is responsible for a significantly higher rate of caesarean section & also associated with low birth rate along with low APGAR score and increase in neonatal complications.Bangladesh Med J. 2015 Jan; 44 (1): 16-20

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.

Echogenic liquor at term pregnancy on ultrasonography is not always meconium

2017 ◽  
Vol 4 (1) ◽  
pp. 7-11
Author(s):  
Shreejana Shrestha ◽  
Shital Bhandary ◽  
Yogita Dwa ◽  
Pooja Jaiswal ◽  
Binod Parmar ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Term Pregnancy ◽  
Amniotic Fluid Index ◽  
Vernix Caseosa ◽  
Normal Score ◽  
Gestation Age ◽  
Fetal Wellbeing

Introductions: The presence of echogenic amniotic fluid at term pregnancy on sonography is uncommon. Finding of meconium in the amniotic fluid by ultrasound is used to predict mode of delivery of fetus, fetal wellbeing and risk of intrauterine fetal demise. We aim to observe the clinical significance of echogenic liquor at term pregnancy. Methods: This was a retrospective study of 102 cases of echogenic liquor at gestation age between 36 and 41 weeks (term pregnancy) during five years 2010 to 2015A.D. Amniotic fluid index (AFI) was calculated. Fluid was observed for presence of vernix caseosa or meconium stain during spontaneous and artificial rupture of membrane. The APGAR score of baby was taken twice at 5 and 10 minutes. Results: Among the 102 patients with echogenic amniotic fluid at term, 83 (81.4%) were vernix and 19 (18.6%) had meconium stain. Low APGAR scores were found in 5 (0.9%) and normal score in 97 (95.1%) indicating good fetal outcome. Among these cases, 89 (87.3%) had normal AFI and 13 (12.7%) had decreased liquor. Conclusions: There were no association between echogenic liquor and meconium stain, AFI or APGAR score of the baby in term pregnancy.

scholarly journals Frequency of Caesarean Section in Pregnancies with Borderline Amniotic Fluid Index at Term

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Natasha Bushra ◽  
Khaula Zeeshan ◽  
Sara Ejaz ◽  
Javeria Mushtaq ◽  
Khadija Waheed ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Increased Risk ◽  
Failed Induction ◽  
One Year

AbstractThe increased risk of caesarean section after induced labour is well documented. Rate of induction of labour has doubled in the past decade from 10 to 20%. Low Amniotic Fluid Index (AFI) as an isolated finding leads to increased obstetrical interventions but without any improvement in outcome.Objectives:  To determine the frequency of caesarean section due to failed induction in pregnancies at term with borderline AFI.Patients and Methods:  This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Unit-III, SIMS/Services Hospital, Lahore. The duration of study was one year from January, 2015 to December, 2015. A total of 150 patients were included in this study. AFI was measured by recent obstetric ultrasound. All patients with borderline AFI (5 – 8 cm) were included in the study. They were induced by glandin E2 gel. If induction of patients failed with two doses of glandin E2 gel, given vaginally 6 hours apart, patients were considered for cesarean section. The outcome measure was rate of caesarean section due to failed induction. All data were analyzed by SPSS version 20.Results:  Mean age of the patients was 30.34 ± 6.68 years. Mean gestational age was noted 38.34 ± 1.05 weeks. Out of 150 patients, 103 (68.7%) were para 1 – 3 and 47 patients (31.3%) were para 4 – 6. Caesarean section due to failed induction with borderline AFI was performed in 27 patients (18.0%). Stratification with regard to age, gestational age and parity was carried out and was found significant only for gestational age being > 39 weeks.Conclusion:  It is concluded that failed induction of labour at term in women with borderline AFI is not associated with increased risk of caesarean delivery.

scholarly journals Comparison of Amniotic Fluid Index and Single Deepest Vertical Pool method for predicting fetal outcome

2017 ◽  
Vol 13 (4) ◽  
pp. 401-405
Author(s):  
Rajiv Shah ◽  
Paban Sharma
Keyword(s):  
High Risk ◽  
Data Collection ◽  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Well Being ◽  
Fluid Volume ◽  
Study Group ◽  
Amniotic Fluid Index ◽  
Amniotic Fluid Volume ◽  
Significant Difference

Background & Objectives: The measurement of amniotic fluid volume (AFV) has been an important component of antenatal evaluation of fetal well being. The most commonly used methods are by amniotic fluid index technique (AFI) and single deepest pool method (SDVP). Both the methods employ ultrasound for AFV measurement. The objective of this study is to compare the usefulness of AFI and SDVP method in assessing amniotic fluid volume for predicting adverse perinatal outcome.Materials & Methods: This is a hospital based prospective comparative study. The patient whose amniotic fluid was measured by SDVP technique was study group and that by AFI was comparison group. Any case with high risk factor was excluded from the study. First case was decided by lottery and then alternately one case was kept in study group and the other in comparative group. If the women did not deliver within 1 week the measurements was retaken and the final values was used for analysis.AFI was estimated as described by Phelan and colleagues and SDVP as described by Manning. Data collection was started after the approval of Institution review board. This study was conducted at Patan Academy of Health Sciences. Duration of data collection was 3 months, Asadh –Bhadra, 2071.Results: A total of one hundred and fifty four cases which met the inclusion criteria were taken. Incidence of oligohydramnios by SDVP method was 10.4 % by SDVP technique and by AFI method it was 18.2 %. There was no statistical significant difference between the two groups in terms of rate of induction, mode of delivery, meconium staining of liquor, fetal heart rate tracings, APGAR score at 5 mins and admission to special care baby unit.Conclusion: In non-high risk pregnancy AFI technique detects slightly more number of oligohydramnios as compared to SDVP technique without apparently any difference in perinatal outcome.

scholarly journals Study of amniotic fluid index and its pregnancy outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4727
Author(s):  
Manisha M. Parmar ◽  
Sandeep M. Parmar
Keyword(s):  
Amniotic Fluid ◽  
Maternal Morbidity ◽  
Mode Of Delivery ◽  
Well Being ◽  
Perinatal Morbidity ◽  
Amniotic Fluid Index ◽  
Neonatal Deaths ◽  
Still Births ◽  
Tertiary Teaching ◽  
Nicu Admission

Background: Amniotic fluid is vital to the well-being of the fetus. Severe oligohydramnios and polyhydramnios are associated with increased maternal morbidity and perinatal morbidity and mortality.Methods: This was prospective observational study conducted at tertiary teaching institute from July 2012 to July 2013. Total 200 patients were included in the study. On the basis of amniotic fluid index (AFI), patients were categorized in 3 groups, Normal AFI (8-24 cm), oligohydramnios (AFI <5cm) and polyhydramnios (AFI > = 25 cm). Results were analysed in the form of incidence, mode of delivery and perinatal outcome which includes preterm, low birth weight, still births, NICU admissions and neonatal deaths in all the 3 groups.Results: Out of 200 patients, there was 150 cases of normal AFI, 39 cases of oligohydramnios and 11 cases of polyhydramnios. Incidence of oligohydramnios was 4.1% and polyhydramnios was 1.1%. PIH was the most common etiological factor found in oligohydramnios (30.7%) and in polyhydramnios congenital anomalies (36.3%) followed by idiopathic cause (27.2%) was most common. Incidence of caesarean section was 58.9% in oligohydarmnios and 17.3% in normal AFI group. Incidence of NICU admission was 25.6% in oligohydramnios and 50% in polyhydramnios group in comparison to 9.3% in normal AFI group.Conclusions: Amniotic fluid index is an important part of antepartum fetal surveillance. Abnormalities of AFI are associated with high perinatal morbidity and mortality and maternal morbidity.

scholarly journals CARDIOTOCOGRAPHY

2018 ◽  
Vol 25 (10) ◽  
pp. 1537-1545
Author(s):  
Muhammad Ikram ◽  
Amna Javed ◽  
Shafqat Mukhtar
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Vaginal Birth ◽  
Cross Sectional ◽  
Group A ◽  
Group B ◽  
Labour Room

Introduction: The cardiotocography (CTG) is more commonly knows aselectronic fetal monitoring (EFM). A cardiotocography measures the fetal heart and the frequencyof uterine contractions. Using two separate disc shaped transducers. Objectives: The objectiveof this study is to co-relate the intrapartum cardiotocography monitoring with fetomaternaloutcome. Study Design: Cross sectional analytical study. Setting: Department of Obstetricsand Gynaecology, Shaikh Zayed Hospital, Lahore, Pakistan. Period: From September 2012 toMarch 2013 (Six Months). Patient & Method: Total 60 patients (pregnant females) fulfilling theinclusion criteria were selected for this study, who were admitted in labour room in early andactive labour. In group A normal CTG monitoring and in Group B women with abnormal CTGmonitoring. Maternal outcomes in terms of mode of delivery and fetal outcome (APGAR Score,neonatal seizures, admission to nursery and time of neonatal discharge were seen). Result: Themean age in group A was 26.13+3.90 years and in group B was 26.53+4.17 years. The meangestational age in group A was 38.40+1.50 weeks and in group B was 36.60+1.59 weeks. Ingroup A, 25 (83.3%) woman were delivered through spontaneous vaginal birth and 4(13.4%)women, who were delivered by caesarean section (for all indication except fetal distress), 1(3.3%) woman by assisted vaginal birth (for all other indications). In group B there were 7(23.8%)women who delivered through spontaneous vaginal birth. 3(10%) women by assisted vaginalbirth (for abnormal CTG monitoring) and 20(66.7%) women by caesarean section (for abnormalCTG). In group A, there were 7(23.3%) neonates who were admitted in nursery, while in groupB, there were 19(63.3%) neonates, who were admitted in nursery. Conclusion: Intrapartumexternal fetal cardiotocography is not a single indicator of fetal distress. An increased caesareansection rate in babies with a pathological cardiotocography stresses on the need for additionaltests to differentiate hypoxic fetuses from non-hypoxic.

scholarly journals Biophysical profile and modified biophysical profile in predicting the fetal outcome

2018 ◽  
Vol 7 (9) ◽  
pp. 3516
Author(s):  
V. G. Vanamala ◽  
Aruna Rachel ◽  
Sushil Pakyanadhan ◽  
Sudheep Abraham P.
Keyword(s):  
Amniotic Fluid ◽  
Stress Test ◽  
Well Being ◽  
Fetal Outcome ◽  
Heart Beat ◽  
Amniotic Fluid Index ◽  
Uterine Contractions ◽  
Beat Pattern ◽  
Biophysical Profile ◽  
Fetal Movements

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.

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.

scholarly journals Comparative study of maternal and fetal outcome between low and normal amniotic fluid index at term

2017 ◽  
Vol 6 (2) ◽  
pp. 640
Author(s):  
Gayatri Mathuriya ◽  
Megha Verma ◽  
Sudha Rajpoot
Keyword(s):  
Comparative Study ◽  
Amniotic Fluid ◽  
Well Being ◽  
Fetal Outcome ◽  
Low Risk ◽  
Amniotic Fluid Index ◽  
Risk Pregnancy ◽  
Ready Availability ◽  
Prospective Comparative Study ◽  
Low Risk Pregnancy

Background: Amniotic fluid index (AFI) is kind of an estimate of the amount of amniotic fluid. It is an index for the fetal well-being. The aim was to study fetal and maternal out come in cases of low AFI and normal AFI.Methods: This was a case control prospective comparative study performed on 200 randomly selected low risk pregnant patients at term (37-40 weeks of gestation) admitted in Obstetrics and Gynaecology Department. 100 patients with AFI <5 cm (cases) and 100 patients with AFI 8-20 cm (control).Results: Increased number of LSCS in cases that is 35 while only 10 in control and almost equal incidences of MSL and FD in both the groups, while in cases 17 women were planned for elective LSCS for various indications in expectation of better fetal outcome.  There was significant low APGAR score in babies of cases, but clinically we refute this. In present study almost double the no. of babies in cases was IUGR or FGR. Significant association between low AFI and congenital anomalies in babies. Most of the anomalies were of urinary tract system.Conclusions: An AFI ≤5 cm detected at term that was at or after 37 completed weeks of gestation in a low risk pregnancy was an indicator of poor perinatal outcome. Oligohydramnios was being detected more frequently now-a-days due to ready availability of ultrasonography these days.

scholarly journals Relationship between Amniotic Fluid Index and Perinatal Outcome

2015 ◽  
Vol 10 (1) ◽  
pp. 48-51
Author(s):  
S Pradhan ◽  
A Adhikary ◽  
P Pradhan ◽  
S Pradhan
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Fetal Distress ◽  
Amniotic Fluid Index ◽  
Significant Difference ◽  
Low Birth Weight Babies ◽  
Meconium Staining

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.  

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