Background: Oligohydramnios causes many intrapartum maternal and fetal complications. Intrapartum amnioinfusion effectively increases amniotic fluid volume and thereby decreases FH decelerations. The objective of this study was to compare the frequency of fetal heart decelerations and its perinatal outcome with and without amnioinfusion in patients with oligohydramnios and the cesarean rates for fetal distress between them.Methods: In study group, 100 patients in labour with AFI < 5 cm, oligohydramnios and IUGR with normal doppler, postdated pregnancies with AFI ≤ 5 cm with normal doppler were selected and prophylactic amnioinfusion with 300 ml lukewarm saline is given aseptically for 15 minutes after amniotomy. Continuous CTG monitoring done till delivery. If FH decelerations occur, the bolus was repeated up to 3 times. 100 age matched controls managed with conventional methods without amnioinfusion were selected retrospectively from labour room case records.Results: Incidence of FH decelerations was lower in study group (59% versus 84%). Cesarean section for fetal distress was reduced (20.9% versus 79.1%) Perinatal outcome was better. Babies with normal 1-minute Apgar was 86% compared to 75% in controls. Frequency of FH decelerations was reduced (20% versus 73%). Occurrence of 2 FH decelerations were 13% versus 33%, 3 FH decelerations were 7% versus 27% and > 3 times was 0% versus 13%.Conclusions: Prophylactic amnioinfusion can easily and effectively reduce the FH decelerations and caesarean section rate for fetal distress in oligohydramnios improving both maternal and fetal outcomes with negligible risks.

Background: Oligamnios is defined as an AFI <5cm, SDP <2cms or an AFI below the 5th centile for the gestational age and is associated with many maternal and perinatal complications. An effective, non-invasive method of increasing AFV is the hydration therapy. The objective of present study was to determine the impact of hydration therapy in patients complicated by oligamnios and to measure the maternal and perinatal outcome in oligamnios corrected by Intravenous hydration therapy.Methods: It is a randomised control trial done at Government Medical College, Kottayam, Kerala, India from Jan 2012 to May 2013. 136 singleton pregnant females with gestation age >34 weeks with AFI <5 cms were randomised into an Intervention group who receive 1 litre of ringer lactate i.v given daily for 5 days and nonintervention group who were kept under observation by serial ultrasound and antepartum fetal surveillance. All were followed-up till delivery to obtain maternal and perinatal outcomes.Results: Among the 68 who were given intervention, 61 responded and 7 were non responders. With hydration therapy, mean increase in AFI was 4 cm and minimum duration needed for improvement was one week. Hydration therapy showed significant improvement in the maternal and fetal outcomes. Intravenous route of maternal hydration has the advantage that a fixed amount of fluid can be infused at a relatively constant rate with ensured compliance.Conclusions: From the study, it was concluded that Hydration therapy is an excellent method to improve AFI in Oligohydramnios and maternal and perinatal outcome.

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INTRODUCTIONMaternal cardiac diseases complicate 1% of all pregnancies and are responsible for about 15% of all maternal deaths. The incidence of cardiac disease during pregnancy has remained stable for many years since the significant decrease in the occurrence of rheumatic heart disease in the last few decades has been compensated by a significant increase of pregnancy in women with congenital heart disease. In developed countries, survival of newborns affected by congenital heart disease is about 85% in many cases as a result of complex surgical procedures performed in the first few years of life.1 As a result the cardiologists and obstetricians are today facing an increasingly large group of pregnant women with surgically corrected congenital abnormalities. As these women contemplate pregnancy, they seek counseling regarding maternal and fetal outcome. The obstetrician should have adequate information about cardiac diseases during pregnancy so that he/she can function effectively as a member of the team that will be taking care of the patient. Hemodynamics are altered during pregnancy in different stages: antenatal during labor and delivery, during caesarean section and during postpartum period. Hemodynamic adaptation to pregnancy persists postpartum and gradually returns to prepregnancy values ABSTRACT Background: Although the disease is limited to only 0.5 to 1.0 percent of pregnant women, it remains an important cause of maternal morbidity and even mortality and has a significant effect on fetal outcome. Pregnancy and the peripartum period are associated with important cardiocirculatory changes that can lead to marked clinical deterioration in the woman with heart disease. Objectives of present study were to comprehend the impact of heart disease during pregnancy, to study the maternal and neonatal outcomes of pregnancies in women with heart disease, to identify predictors of pregnancy related complications in women with heart disease and to refine the risk stratification and to assess the individual risk of each pregnant woman with heart disease. Methods: It is a perspective study carried out at College Department of Obstetrics and Gynaecology, Govt. Medical, Kottayam from January 2012 to March 2014. Results:The outcomes of the pregnancies in 100 women who presented with heart disease and received their obstetrical care were evaluated. A maternal cardiac event, neonatal event, or both occurred in 37 completed pregnancies. A cardiac event complicated 8 completed pregnancies. It includes 2 maternal deaths, one on 9th postnatal day in women with hypertrophic obstructive cardiomyopathy and another in women with rheumatoid mitral stenosis who died of congestive cardiac failure. Most cardiac events (75%) occurred in the antepartum period and were either heart failure or cardiac arrhythmia. Conclusions: Strict prenatal care and early risk stratification during gestation are fundamental measures to improve the prognosis of pregnancy in women with heart disease.