Case-Control Study on Fetal Outcomes in Isolated Oligohydramnios in Third Trimester
Background: Oligohydramnios is defined as a condition with low volume of amniotic fluid relative to gestational age. Long-term oligohydramnios can result in pulmonary hypoplasia, intra uterine growth retardation, Potter’s syndrome, club hand & foot and dislocation of hip. This study was conducted to assess feto-maternal outcome in isolated oligohydramnios and factors associated with poor outcome.
Methodology: This case-control study was conducted from January to December 2020 in the Gynecology & Obstetrics and Radiology departments of HBS General Hospital, Islamabad. Total 300 patients with isolated oligohydramnios fulfilling the criterion were included. For cases, patients with singleton intrauterine pregnancy with AFI <5, of any age or parity with gestational age of more than 34 weeks were included. 300 controls were also taken. Patients with increased amount of amniotic fluid, diabetics, hypertensive and cardiac patients were excluded. Patient were followed up till delivery. Mode of delivery was checked out. Fetal APGAR score at 1 minute and at 5 minutes were observed. New born weight and NICU admissions were recorded. Data was analyzed via SPSS v26.
Results: Forty six percent (n=138) patients underwent caesarean section while fifty four percent (n=162) had normal vaginal delivery. Significant association (OR=1.85, P<0.001) was found between caesarean section in mothers with oligohydramnios compared to controls. Thirty eight percent (n=114) of neonates among cases had low APGAR score. Significant association (OR=3.29, P<0.001) was found between low APGAR score and mothers with oligohydramnios compare3d to controls. Thirty percent (n=90) required NICU admission. There were 6 still births. Mother’s with oligohydramnios have double risk of still birth and NICU admission compared to women with normal fluid levels.
Conclusion: Neonate born with mothers having oligohydramnios have low birth weight, lower APGAR scores and high rate of NICU admissions. Delivery at 37-39 weeks in oligohydramnios is associated with higher rate of still births.
2. Biradar KD, Shamanewadi AN. Maternal and perinatal outcome in oligohydramnios: study from a tertiary care hospital, Bangalore, Karnataka, India. Int J Reprod Contraception, Obstet Gynecol Vol 5, No 7 July 2016DO - 1018203/2320-1770.ijrcog20162113 [Internet]. 2017 Feb 23; Available from: https://www.ijrcog.org/index.php/ijrcog/article/view/1385
3. Khatun T, Ansari A, Hamid I, Gupta R, Ahmad MP. Oligohydramnios and Fetal Outcome: A Review. Med Phoenix [Internet]. 2017;1(1):23–30. Available from: https://www.nepjol.info/index.php/medphoenix/article/view/17885
4. Figueroa L, McClure EM, Swanson J, Nathan R, Garces AL, Moore JL, et al. Oligohydramnios: a prospective study of fetal, neonatal and maternal outcomes in low-middle income countries. Reprod Health. 2020;17(1):1–7.
5. Bashir S, Siddiq A, Jahan T. Fetomaternal outcome following diagnosis of oligohydramnios at term. Pakistan J Med Heal Sci. 2015;9(3):995–6.
6. Qadir M. Polyhydramnios; Fetomaternal Outcome of Polyhydramnios; a Clinical Study in a Tertiary Care Institute. Prof Med J. 2017;24(12):1889–93.
7. Sharma M, Bhagwani DK, Chaurasia M, Jain PK. Maternal and Perinatal Outcome in Pregnancies with Oligohydramnios in Third Trimester. 2016;4(3):1–5.
8. Rabie N, Magann E, Steelman S, Ounpraseuth S. Oligohydramnios in complicated and uncomplicated pregnancy: a systematic review and meta-analysis. Ultrasound Obstet Gynecol [Internet]. 2017 Apr 1;49(4):442–9. Available from: https://doi.org/10.1002/uog.15929
9. Herstad L, Klungsøyr K, Skjærven R, Tanbo T, Forsén L, Åbyholm T, et al. Elective cesarean section or not? Maternal age and risk of adverse outcomes at term: a population-based registry study of low-risk primiparous women. BMC Pregnancy Childbirth [Internet]. 2016;16(1):230. Available from: https://doi.org/10.1186/s12884-016-1028-3
10. Chiniwar MA, M. JK, Menasinkai SB. Maternal and fetal outcome in oligohydramnios after 34 weeks of gestation. Int J Reprod Contraception, Obstet Gynecol. 2018;7(11):4604.
11. Brzezinski-Sinai NA, Stavsky M, Rafaeli-Yehudai T, Yitshak-Sade M, Brzezinski-Sinai I, Imterat M, et al. Induction of labor in cases of late preterm isolated oligohydramnios: is it justified? J Matern Neonatal Med [Internet]. 2019 Jul 18;32(14):2271–9. Available from: https://doi.org/10.1080/14767058.2018.1430134
12. Hamed A, Mohamed G. Pregnancy Outcome among Patients with Oligohydramnios and Suggested Plan of Action. IOSR J Nurs Heal Sci Ver III [Internet]. 2015;4(5):2320–1940. Available from: www.iosrjournals.org
13. U J Bakhtiar, Awan AS. Intrauterine death.an outcome of post term pregnancy at Pakistan railway hospital Rawalpindi. J Islam Int Med Coll. 2013; 8(1):29-33.
14. S. R, Babitha . A clinical study of feto-maternal outcome in pregnancies with oligohydramnios. Int J Reprod Contraception, Obstet Gynecol. 2017;6(3):868.
15. Larsson C, Saltvedt S, Wiklund I, Andolf E. Planned vaginal delivery versus planned caesarean section: short-term medical outcome analyzed according to intended mode of delivery. J Obstet Gynaecol Canada JOGC = J d’obstetrique Gynecol du Canada JOGC. 2011 Aug;33(8):796–802.
16. Abebe Eyowas F, Negasi AK, Aynalem GE, Worku AG. Adverse birth outcome: a comparative analysis between cesarean section and vaginal delivery at Felegehiwot Referral Hospital, Northwest Ethiopia: a retrospective record review. Pediatr Heal Med Ther [Internet]. 2016 Jul 1;7:65–70. Available from: https://pubmed.ncbi.nlm.nih.gov/29388592.
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