A prospective study of maternal and fetal outcome in oligohydramnios in a tertiary care hospital

Abstract

Background: Amniotic fluid surrounding the fetus is an important biophysical marker of fetal wellbeing. Oligohydramnios defined as AFI<8cm can result in adverse maternal and perinatal outcomes. Aims & Objectives: The aim of study is to analyze the maternal and fetal out come in pregnant women with oligohydramnios at term. Materials & methods: A prospective study was conducted of all ANC'S admitted in labor room from the year august 2017 to July 2018. Out of 5800 patients 400 women at term with AFI of less than 8cms were included in the study. Outcome was observed in terms of AFI, type of delivery, Apgar score, birth weight, and NICU admissions. Results: The incidence of oligohydramnios was 6.89% in our hospital, in which moderate oligohydramnios was 4.58% &severe oligohydramnios 2.31%. Doppler changes were found in 3.2% on USG. The rate of LSCS was 28.5%. SGA was seen in 33% of which 11% had IUGR. NICU admissions were 28% and perinatal deaths 2%. Conclusion: Prevention, early detection and intervention of antenatal complications can probably reduce the incidence of oligohydramnios and improve maternal and fetal outcome. Keywords: oligohydramnios, amniotic fluid index, maternal and perinatal outcome Introduction Quantitative estimation of amniotic fluid volume is a part of routine obstetric scan. Semi quantitatively the amount of amniotic fluid is described using the amniotic fluid index. Oligohydramnios occurs in about 1% to 5% of pregnancies at term. Amniotic fluid surrounds the developing fetus. Its existence plays an essential role in fetal development [1]. At first, amniotic fluid is mainly water with electrolytes, but by about the 12-14th week the liquid also contains proteins, carbohydrates, lipids and phospholipids and urea, all of which aid in the growth of the fetus [2]. The amniotic fluid volume varies with the gestational age from 200ml at 16weeks, 1000ml at 28 weeks, 900ml at 36 weeks and 800ml at 40 weeks of gestation. A good clinical examination can pick up most subjects of abnormal liquor volume and can be confirmed ultrasonographically [3] As per definition of liquor assessment an AFI less than 5cm is known as oligohydramnios, AFI from 5 to 8 cm has been termed borderline AFI. 4 Oligohydramnios is associated with increased fetal malformations and in the absence of malformations, to be complicated by fetal growth restriction, maternal morbidity and adverse perinatal outcome [5]. Hence every case of oligohydramnios needs careful antenatal evaluation, parental counseling, individualized decision regarding timing and mode of delivery, continuous intrapartum fetal monitoring and good neonatal care for optimum perinatal outcome [6] .