A Clinical Study of Effects of Poly and Oligohy Dromnios on Obstetric Outcome With a Sp E C I Al Ref Erence to Perinatal Mortality and Morbi D Ity

Abstract

OBJECTIVES:To study the obstetric outcome in pregnancies with oligohydramnios and polyhydramnios. To determine the perinatal outcome in pregnancies complicated with oligohydramnios and polyhydramnios. METHODS: This study is conducted on pregnant woman with abnormal liquor volume who attended the antenatal clinic at Institute of obstetrics and gynecology, Bowring and Lady curzon Hospital attached to BMCRI Bengaluru January 2013 to January 2014, 150 cases of oligohydramnios and 50 cases of polyhydramnios were selected for the study. A detailed history was taken. Detailed examination was done. Routine investigation was done. USG was done. Patient was followed up for timely and post-natal period. The values obtained so far was tabulated, analyzed, compared with other studies and concluded. RESULTS: Majority of the oligohydramnios cases were primigavida and polyhydramnios cases were multigravida. Mild polyhydramnios was the most common type. Isolated oligohydramnios (37.33%) was the most common cause followed by postdated pregnancy (28.67%) and third being the hypertensive diseases of pregnancy (17.34%) in oligohydramnios group. Incidence of congenital anomalies was high in polyhydramnios (22%) than in oligohydramnios (4%). Induction of labour was high in oligohydramnios group (65.33%) than in polyhydramios (20%) group. 59.33% were underwent cesarean section in oligohydramnios group compared to 18% in polyhydramnios group. Fetal distress (76.4%) was the leading cause of cesarean in oligohydramnios, CPD (33.33%) was the common cause in polyhydramnios group. In oligohydramnios group, the alive babies' rate was 92.7% and perinatal death was 7.3%. In polyhydramnios group, the alive and perinatal death rate was 72%, and 28% respectively. In the oligohydramnios group, congenital anomaly was not the cause of any perinatal death but in polyhydramnios group majority of the death was due to lethal congenital anomalies. Birth weight <2.5kg were high in oligohydramnios group (54%). IUGR cases were common in oligohydramnios group. NICU admission was highest in oligohydramnios group (50.66%) than polyhydramnios (28%) group. CONCLUSION: Development of abnormal liquor volume during pregnancy signals danger to the foetus. It is associated with an increased incidence of caesarean section, labour complications and adverse perinatal outcome. Etiological factors are important in all cases of abnormal liquor volume, to get better foetal outcome as well as to avoid the maternal complications.