Oligohydramnios and fetal outcome in term pregnancy
Background and objective: Oligohydramnios is defined as an amniotic fluid index less than 5th centile for gestation. It presents a threat to the fetus and has been correlated with increased risk of intrauterine growth retardation, meconium aspiration syndrome, severe birth asphyxia, low APGAR scores, and congenital abnormalities. It is associated with perinatal morbidity and mortality and maternal morbidity in a significant number of cases. Therefore, early detection of oligohydramnios and its management is important. This study aimed to determine the perinatal and maternal outcomes in oligohydramnios.
Methods: This retrospective cohort study was carried out at the Maternity Teaching Hospital in Erbil from March 2018 to March 2019. A total of 300 patients were recruited, including 150 pregnant women with oligohydramnios and 150 with normal amniotic fluid index.
Results: There was a significant difference between the oligohydramnios group and the comparison group in relation to parity and gestational age. Oligohydramnios was more among primigravids. The rate of cesarean section was higher in oligohydramnios group compared to the comparison group. Intrauterine growth retardation among oligohydramnios group was 13%. Oligohydramnios was associated with birth weight <2500 gm (21.3%).
Conclusion: Antepartum diagnosis of severe oligohydramnios at term was associated with an increased cesarean section rate, a higher rate of admission of neonatal care unit, and low birth weight. Therefore, antepartum oligohydramnios is associated with increased perinatal morbidity and mortality.
Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment using the four-quadrant technique in the pregnancy at 36-42 weeks gestation. J Reprod Med 2013; 32(7):540–2.
Brace RA. Physiology of amniotic fluid volume regulation. Clin Obstet Gynecol 2013; 40(2):280–9.
Kehl S, Schelkle A, Thomas A, Puhl A, Meqdad K, Tuschy B et al. Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): A multicenter, open-label, randomized controlled trial. Ultrasound Obstet Gynecol 2016; 47(6):674–9.
Oosterhoof H, Haak MC, Arnoudes JG. Acute Maternal Rehydration increases the urine production rate in the near-term human fetus. Am J Obstet Gynecol 2011;183(1):226–9.
Sherer DM. A review of amniotic fluid dynamics and the enigma of isolated oligohydramnios. Am J Perinatol 2002;19:253–66.
Machado MR, Cecatti JG, Krupa F, Faunds A. Curve of amniotic fluid index measurements in low-risk pregnancy. Acta Obstet Gynecol Scand 2007; 86:37–41.
Patrelli TS, Gizzo S, Cosmi E, Carpano MG, Di Gangi S, Pedrazzi G et al. Maternal hydration therapy improves the quantity of amniotic fluid and the pregnancy outcome in third-trimester isolated oligohydramnios: a controlled randomized institutional trial. J Ultrasound Med 2012; 31(2):239–66.
Elasandabesee D, Majumdhar S, Sinha S. Obstetricians’ attitudes towards isolated oligohydramnios at term. J Obstet and Gynecol 2007; 27(6):574–6.
Guin G, Punekar S, Lele A, Khare S. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume. J Obstet Gynaecol India 2011; 61:652–5.
Chate P, Khatri M, Hariharan C. Pregnancy outcome after diagnosis of oligohydramnios at term. Int J Reprod Contracept Obstet Gynecol 2013; 2:23–6.
EK S, Andersson A, Johansson A, Kublicas M. Oligohydramnios in uncomplicated pregnancies, beyond 40 completed weeks. A prospective, randomized, pilot study on maternal and neonatal outcomes. Fetal Diagn Ther 2005; 20:182–5.
Manzanares S, Carrillo MP, Gonzalez -peran E, Puertas A, Montoya F. Isolated Oligohydramnios in term pregnancy as an indication for induction of labor. J Matern Fetal Neonatal Med 2007; 20:221–4.
Melamed N, Pardo J, Milstein R, Chen R, Hod M, Yogev Y. Perinatal outcome in pregnancies complicated by isolated oligohydramnios diagnosed before 37 weeks of gestation. Am J Obstet Gynecol 2011; 205(241):1–6.
JagatiaK, Singh N, Patel S. Maternal and fetal outcome in Oligohydramnios: a study of 100 cases. Int J Med Sci Public Health 2013; 2(3):724–7.
Johnson JM, Chauhan SP, Ennen CS, Niederhauser A, Magann EF. A comparison of 3 criteria of oligohydramnios in identifying peripartum complications: a secondary analysis. Am J Obstet Gynecol 2007; 197(2):207.e1–7.
Jandial C, Gupta S, Sharma S, Gupta M. Perinatal (12) outcome after antepartum diagnosis of oligohydramnios at or beyond 34 weeks of gestation. J K Sci 2007; 9(4):2013–4.
Sriya R, Singhai S. Perinatal outcome in patients with amniotic fluid index < 5cm. J Obstet Gynaecol India 2001; 51:98–100.
Umber A. Perinatal outcome in pregnancies complicated by isolated oligohydramnios at term. Annals KEMU 2009; 15:35–7.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).