Title: Study of Maternal and Foetal Outcome in Normal term Pregnancy with Isolated Oligohydramnios
Authors: Dr Chaitra Ramachandra, Dr Roopa, Dr Rekha, Dr Shankaregowda, Dr Nirupama.Y.S
DOI: http://dx.doi.org/10.18535/jmscr/v4i6.09
Objectives: To study the maternal and foetal outcome in normal term pregnancy with isolated oligohydramnios. Methods: This was a prospective study conducted in the department of obstetrics and gynaecology at BGS Global Medical college, Bangalore over a period of one year from January 2015 to December 2015. A total of 100 patients of gestational age >37 weeks matched for age and parity were studied, of which the study group had 50 women with an AFI less than 5 and the control group had 50 women with an AFI more than 5 .The mode of delivery and the perinatal outcome was compared between the two groups. Chi square test was used for statistical analysis. Results: Non stress test (NST) was reassuring in 39 patients (78%) in the study group and 46 patients (92%) in the control group (p value <0.05) and was found to be statistically significant. In the study group, 16 of the 50 patients (32%) had normal vaginal delivery, 9 patients (18%) had instrumental delivery and 25 patients (50%) underwent caesarean section, whereas 34 of the 50 patients (68%) had normal vaginal delivery, 2 patients (4%) had instrumental delivery and 14 patients (28%) delivered by caesarean section in the control group (p value <0.05). This difference was statistically significant. Apgar score <7 was seen in 9 patients (18%) win the study group and in 6 patients (12%) in the control group (p value >0.05). The difference was not statistically significant. 22 babies (44%) in the study group had birth weight <2.5 kg, whereas 10 babies (20%) in the control group had birth weight <2.5 kg (p value <0.05). This difference was statistically significant. 6 babies in the study group (12%) were admitted to the neonatal intensive care unit (NICU), whereas 4 babies (8%) in the control group had NICU admission (p value >0.05). The difference was not statistically significant. All the babies were stable at the time of discharge. There were no babies needing ventilatory support and no perinatal deaths in either the study or control groups. Conclusion: Isolated oligohydramnios without any complicating factor is not associated with adverse perinatal outcome, though the babies may have a lower birth weight. Keywords: isolated oligohydramnios, amniotic fluid index, intrauterine growth restriction. 1. Phelan JP, Ahn MO, Smith CV, Rutherford SE, Anderson E. Amniotic fluid measurements during pregnancy. J Reprod Med 1987; 32: 601-604. 2. Chamberlain PF, Manning FA, Morrison I, Harman CR, Lange IR. Ultrasound evaluation of amniotic fluid volume: The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gynecol 1984; 150: 245-249. 3. Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment with four quadrant technique at 36 to 42 weeks’ gestation. J Reprod Med 1987; 32: 540-542. 4. Phelan JP, Platt LD, Yeh S, Broussard P, Paul RH. The role of ultrasound assessment of amniotic fluid volume in the management of the post date pregnancy. Am J Obstet Gynecol 1985; 151: 304-308. 5. Michael Y, Divon MD, Ariel D, Marks MS, Cassandra S, Henderson et al. Longitudinal measurement of amniotic fluid index in post term pregnancies and its association with fetal outcome. Am J Obstet Gynecol 1995; 172: 142-146. 6. Peipert, Jeffrey F, Donnenfeld, Alan E. Oligohydramnios: A review. Obstetrical and gynecological survey.1991; 46(6): 325-339. 7. Sarno AP, Ahn MO, Phelan JP. Intrapartum AFV at term. Association of ruptured membranes, oligohydramnios and increased fetal risk. J Reprod Med 1990; 35(7):719-723. 8. Brian M, Casey, Donald D, McIntire, Steven L, Bloom et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol 2000;182(4): 909-912. 9. Zhang J,Troendle J, Meikle S, Klebanoff MA, Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. Br J Obstet Gynaecol 2004 March; 111(3):220-5. 10. Baron C, Morgan MA, Garite TJ. The impact of amniotic fluid volume assessed during intrapartum on perinatal outcome. Am J Obstet Gynecol 1995; 173(1): 167-174. 11. Garmel SH, Chelmow D ,Sha SJ, Roan JT, D’Alton ME. Oligohydramnios and the appropriately grown fetus. Am J Perinatol 1997; 14:359-363. 12. Chauhan SP, Hendrix NW: Intrapartum oligohydramnios does not predict adverse peripartum outcome among high risk parturient. Am J Obstet Gynecol, 1997; 176(6):1130-1136. 13. Jun Zhang, James Troendle: Isolated oligohydramnios is not associated with adverse perinatal outcome. Int J Gynaecol Obstet Mar 2004;3:220-225. 14. Everett FM, Thomas EN: Measurement of amniotic fluid volume-Accuracy of ultrasonography technique. Am J Obstet Gynecol 1992; 167:1533-7. 15. Casey Brian M, Donald D McIntire: Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol, April 2000; 182(4): 909-912. 16. Hoskins IA, Friden FJ: Variable deceleration in reactive non stress test with decreased amniotic fluid index predicts fetal compromises. Am J Obstet Gynecol 1991; 165(4):1094-1098. 17. Divon MY, Marks, Henderson CE: Longitudinal measurement of amniotic fluid index in post term pregnancies and its association with fetal outcome. Am J Obstet Gynecol 1995; 172:142. 18. Elliot H. Phillipson, Robert J. Sokol: Oligohydramnios – Clinical association and predictive value for intrauterine growth retardation. Am J Obstet Gynecol 1983; 146:271. 19. Varma TR, Bateman S: Ultrasound evaluation of amniotic fluid -outcome of pregnancies with severe oligohydramnios. Int J Gynaecol Obstet Oct 1988; 27(2):185-92Abstract
References