Table of Contents

2017 Month : June Volume : 3 Issue : 1 Page : 1-4

MATERNAL AND PERINATAL OUTCOME IN PREGNANCIES WITH OLIGOHYDRAMNIOS AT TERM.

Uma Mohanraj1, S. Udaya Aruna2

Corresponding Author:
Dr. Uma Mohanraj,
#13, Seshapuram, Tennur,
Trichy-17.
E-mail: armohanraj87@gmail.com

ABSTRACT

BACKGROUND

The assessment of amniotic fluid volume is an integral part of antepartum surveillance. The reduction in the amniotic fluid volume carries an increased risk of intrapartum complications in high-risk pregnancy. It was found that the relationship between sonography detected oligohydramnios and 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 cm (American College of Obstetricians and Gynecologists). The diagnosis may also be based on an AFI below the 5th or 2.5th percentile,determined by a gestational age specific nomogram. Women with oligohydramnios are found to have abnormal or nonreactive FHR tracing at intrapartum, increased risk of meconium-stained amniotic fluid, increased risk of foetal distress and increased risk of operative interference. Antepartum assessment of Oligohydramnios will help to identify women who need increased intrapartum surveillance. However, some studies shows isolated oligohydramnios should not be the only parameter for predicting perinatal outcome. By this way, the present study carried out to find out the oligohydramnios can be used as a predictor of adverse perinatal outcome in pregnancies near term. The objective of this study was to find out the maternal and perinatal outcome in pregnancies with oligohydramnios at term.

MATERIALS AND METHODS

This prospective and observational study was conducted at Mahatma Gandhi Memorial Govt. Hospital, KAPV Govt. Medical College, Trichy over 6 months from November 2016 - April 2017 on the impact of oligohydramnios on maternal and perinatal outcome. In this study, 300 pregnant women with singleton pregnancy with gestational age between 34 - 40 weeks admitted for safe confinement were included. We have excluded other causes of oligohydramnios such as PROM, foetal anomaly, malpresentation, GDM and multiple gestation. A total of 300 patients were assigned into 2 groups.

Study Group I- 75 patients of AFI ≤ 5.

Control Group II - 225 patients of AFI > 5. A detailed obstetric history at the time of admission, the age, parity, height, weight, any previous history of oligohydramnios, bad obstetric history, any medical illness or any surgical illness was taken. Non-stress test at admission was made. High risk factors like evidence of anaemia, gestational hypertension if any is present or past pregnancy was noted. A detailed general examination, obstetric examination, CVS examination and RS examination was made. All cases are subjected to ultrasonic estimation of amniotic fluid volume. The patients are subjected for pelvic examination for Bishop’s scoring and pelvic assessment. The careful antepartum surveillance was made in cases of oligohydramnios, CTG recording and intrapartum monitoring, planning the mode of delivery, the careful observation for occurrence of meconium-stained amniotic fluid for patients in labour, birth weight of the baby, APGAR scoring at 1 min or 5 mins under the guidance of paediatrician, NICU admission for babies at distress and maternal monitoring of vitals, number of uterine contractions and operative interference for delivery. The following data were collected- the age, obstetric score, risk factors at delivery such as PIH, post-datism, IUGR, BOH, idiopathic, mean gestational age at delivery, non-reassuring CTG pattern, ultimate mode of delivery, meconium-stained amniotic fluid, birth weight, APGAR at 1 min and 5 mins and admission at NICU.

 

RESULTS

In this study, 300 pregnant women with singleton pregnancy with gestational age between 34 - 40 weeks admitted for safe confinement were included. We have excluded other causes of oligohydramnios such as PROM, foetal anomaly, malpresentation, GDM and multiple gestations.

A total of 300 patients were assigned into 2 groups-

Study Group I- 75 patients of AFI ≤ 5

Control Group II- 225 patients of AFI > 5. Study conducted at Mahatma Gandhi Memorial Govt. Hospital, KAPV Govt. Medical College, Trichy over 6 months from November 2016 - April 2017 on the impact of oligohydramnios on maternal and perinatal outcome.

CONCLUSION

Oligohydramnios as amniotic fluid index < 5 (3) is a threatening condition to foetal health, for which some treatment are available and some are under evaluation. AFI measurement in antepartum or intrapartum period help to target the women who need increased antepartum surveillance to improve maternal and perinatal outcome and such women were managed in an inpatient special unit to combat the complications, which can occur in the intrapartum period so that maternal and perinatal complications can be avoided. This is the ultimate aim of every obstetrician and paediatrician for ensuring healthy mother and healthy baby for our MCH services.

KEYWORDS

Oligohydramnios, Non-Reassuring CTG Pattern, Meconium-Stained Amniotic Fluid, Maternal Outcome and Perinatal Outcome.

Videos :

watch?v

Download Download [ PDF ] Download[ ABSTRACT ] Email Send to a friend