A prospective cohort study of perinatal outcomes: pregnancies with isolated oligohydramnios versus normal pregnancies

Abstract

Key words: isolated oligohydramnios, amniotic fluid index, perinatal outcome Background: Pregnancies with oligohydramnios at term in the absence of fetal and maternal compromise pose a dilemma in management. Evidence regarding the outcome of these pregnancies are controversial, and it is one of the common reason for early induction of labour in the fear of adverse perinatal outcome. Outcomes of such pregnancies are not adequately studied in Sri Lankan setting.Objective: To compare the perinatal fetal outcomes of isolated oligohydramnios with normal pregnancy at term among women who were admitted to Teaching Hospital Kandy.Methods: A prospective cohort study was carried out. All the pregnant mothers admitted to ward 7 Teaching Hospital Kandy at term were routinely scanned for fetal growth and amniotic fluid volume. Women with isolated oligohydramnios (n=70) and without any other pregnancy-related complications were selected as controls. Two controls (normal pregnancy n=140) were selected per case matching the age and parity. These pregnant mothers were followed up from the date of admission to discharge. Immediate perinatal fetal and postnatal outcomes were assessed. Data were entered and analyzed by SPSS 22.0. Results:The majority of the patients (58.5%) with isolated oligohydramnios were induced early, and a significant number of these patients have undergone emergency caesarean section (X 2 =12.98, p=0.003). Although pregnancies with isolated oligohydramnios tends to have more CTG abnormalities, it was not statistically significant (X 2 =4.29, p=0.12). But, the incidence of significant meconium-stained liquor was higher than normal pregnancies (X 2 =6.02, p=0.049). However, the fetal outcome APGAR <7 at 5 minutes (X 2 =0.33, p=0.95) short term perinatal morbidities (X 2 =0.29, p= 0.59) were shown no statistical difference between both group. Neonatal special care baby unit admissions were higher in pregnancies with isolated oligohydramnios (X 2 =23.56, p=0.0001). Conclusion and recommendation:Compared to normal pregnancies, pregnancies with isolated oligohydramnios didn't show any statistically significant difference in perinatal outcome. Oligohydramnios itself doesn't indicate the fetal compromise when other growth parameters were normal. However, as there are controversies in management further researches are needed in this field.

Prevalence of Pregnant Women With Oligohydramnios and Its Effect on Maternal and Fetal Outcome

“…The mean maternal age was (27.7 ± 6.8 years), which is in agreement with previous studies done by Musthaq et al [23] and Yenigul et al [24] found that the mean maternal age were 27.6 ± 4.2 years and 27.1 ± 5.6 years respectively.…”

Impact of Low Amniotic Fluid Index at Term Pregnancy on Perinatal Outcome

“…Shrestha et al [9] reported that 8.33% perinatal death in low AFI and 1.38% death in normal AFI patient where P value was non-significant (P value 0.053). Found that short term perinatal morbidities (p= 0.59) were shown no statistical difference between both group that align with the findings of this study [21] . However, Casey et al [16] reported that both still birth (1.4% vs 0.3%) and neonatal deaths (5% vs 0.3%) difference among normal and low AFI group were statistically significant.…”