Isolated Oligohydramnios at Term as an Indication for Labor Induction: A Systematic Review and Meta-Analysis

Shrem, Guy; Nagawkar, Sima S.; Hallak, Mordechai; Walfisch, Asnat

doi:10.1159/000445948

Cited by 63 publications

(57 citation statements)

References 40 publications

(54 reference statements)

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“…Subsequent significant factors, still more strongly associated with PCS than PPCS in this study were eclampsia/pre-eclampsia, oligohydramnios, birthweight < 2,000 g and pre-term gestations (33-36 weeks). Whilst eclampsia/pre-eclampsia and very low birthweight (VLBW) are critical conditions often requiring emergency obstetric care 14 , isolated oligohydramnios at term was found to be a risk factor for labour induction, CS and short-term neonatal morbidity in a recent systematic review on 35,999 women, with 2,414 (6.7%) of them being affected by oligohydramnios 62 . However, the health risks associated with isolated oligohydramnios diminish with increasing gestational age, being relatively lower in the last trimester 62 .…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Whilst eclampsia/pre-eclampsia and very low birthweight (VLBW) are critical conditions often requiring emergency obstetric care 14 , isolated oligohydramnios at term was found to be a risk factor for labour induction, CS and short-term neonatal morbidity in a recent systematic review on 35,999 women, with 2,414 (6.7%) of them being affected by oligohydramnios 62 . However, the health risks associated with isolated oligohydramnios diminish with increasing gestational age, being relatively lower in the last trimester 62 . In the present investigation, the clear majority of PCS (53.3% = 478/893) among women with oligohydramnios were performed for term pregnancies (37-40 weeks), and 91.2% (=815/893) in gestations ≥ 33 weeks.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015

Cegolon

Mastrangelo

Maso

et al. 2020

Sci Rep

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Although there is no evidence that elevated rates of cesarean sections (cS) translate into reduced maternal/child perinatal morbidity or mortality, cS have been increasingly overused almost everywhere, both in high and low-income countries. the primary cesarean section (pcS) has become a major driver of the overall cS (ocS) rate, since it carries intrinsic risk of repeat cS (RcS) in future pregnancies. in our study we examined patterns of pcS, pl compared with planned toLAc anned PCS (PPCS), vaginal birth after 1 previous CS (VBAC-1) and associated factors in Friuli Venezia Giulia (FVG), a region of NorthEastern Italy, collecting data from its 11 maternity centres (coded from A to K) during 2005-2015. By fitting three multiple logistic regression models (one for each delivery mode), we calculated the adjusted rates of pcS and ppcS among women without history of cS, whilst the calculation of the VBAC rate was restricted to women with just one previous CS (VBAC-1). Results, expressed as odds ratio (OR) with 95% confidence interval (95%CI), were controlled for the effect of hospital, calendar year as well as several factors related to the clinical and obstetric conditions of the mothers and the newborn, the obstetric history and socio-demographic background. in fVG during 2005-2015 there were 24,467 OCS (rate of 24.2%), 19,565 PCS (19.6%), 7,736 PPCS (7.7%) and 2,303 VBAC-1 (28.4%). We found high variability of delivery mode (DM) at hospital level, especially for pcS and ppcS. Breech presentation was the strongest determinant for pcS as well as ppcS. Leaving aside placenta previa/abuptio placenta/ante-partum hemorrhage, further significant factors, more importantly associated with pcS than ppcS were non-reassuring fetal status and obstructed labour, followed by (in order of statistical significance): multiple birth; eclampsia/pre-eclampsia; maternal age 40-44 years; placental weight 600-99 g; oligohydramios; pre-delivery LoS 3-5 days; maternal age 35-39 years; placenta weight 1,000-1,500 g; birthweight < 2,000 g; maternal age ≥ 45 years; pre-delivery LoS ≥ 6 days; mother's age 30-34 years; low birthweight (2,000-2,500 g); polyhydramnions; cord prolaspe; ≥6 US scas performed during pregnancy and pre-term gestations (33-36 weeks). Significant factors for PPCS were (in order of statistical significance): breech presentation; placenta previa/abruptio placenta/ante-partum haemorrhage; multiple birth; pre-delivery LoS ≥ 3 days; placental weight ≥ 600 g; maternal age 40-44 years; ≥6 US scans performed in pregnancy; maternal age ≥ 45 and 35-39 years; oligohydramnios; eclampsia/pre-eclampsia; mother's age 30-34 years; birthweight

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Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015

Cegolon

Mastrangelo

Maso

et al. 2020

Sci Rep

View full text Add to dashboard Cite

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“…However, recent (2016) systematic review and metaanalysis done by Shrem et al included 2,414 patients with isolated oligohydramnios found that they are higher risk of labour induction (OR 7.56, CI 4.58-12.48) and Cesarean sections (OR 2.07, CI 1.77-2.41) 8 . Also, there were higher rates of an Apgar score <7 at 1 and 5 min (OR 1.53, CI 1.03-2.26, and OR 2.01, CI 1.3-3.09, respectively) and admission to the neonatal intensive care unit (OR 1.47, CI 1.17-1.84).…”

Section: Literature Reviewmentioning

confidence: 99%

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

Musthaq

Kodithuwakku

Shireen

et al. 2019

Sri Lanka J Obstet & Gynae

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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.

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“…Shrem et al, reported that total caesarean rates were significantly higher in the isolated oligohydramnios group when compared with the normal amniotic fluid group (13.77% vs 6.31%). 8 If authors compare the C.S. rates of their study with present study , authors find that C.S.…”

Section: Discussionmentioning

confidence: 52%

“…Regarding perinatal outcomes, Apgar score < 7 at 1 min and 5 min was observed in 15.7% and 5.7% respectively in the study group as compared to 6.8% and 2.3% in the control group. 3,4,8,12 However, none of the babies had birth asphyxia. (Table 3) The main reason for NICU admissions for >24hours was meconium aspiration in both the groups.…”

Section: Resultsmentioning

confidence: 99%

Neonatal and maternal outcome in term primigravida with isolated oligohydramnios

Agarwal¹,

Gupta²

2018

Int J Reprod Contracept Obstet Gynecol

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Background: The aim of this study is to evaluate the maternal and perinatal outcome in term primigravida with isolated oligohydramnios.Methods: A retrospective, case–control study was carried out in the department of OBG, School of Medical Sciences and Research, Sharda Hospital, Greater Noida from November 2014 to October 2017. The study population comprised of low-risk primigravida with singleton, term pregnancy, with vertex presentation and intact membranes. After meeting the inclusion and exclusion criterion, the study population was divided into cases (n = 51) and control group (176) and the results were analyzed in reference to rate of induction of labour, C. Section rate and the perinatal outcome.Results: Isolated oligohydramnios is associated with increased rate of induction of labour and increased operative interference, but perinatal outcome in terms of mean birth weight, Apgar score at 5 min and NICU admissions for over 24 hours, are not statistically significant in comparison with control group.Conclusions: Isolated oligohydramnios is not an indicator of adverse perinatal outcome.

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Isolated Oligohydramnios at Term as an Indication for Labor Induction: A Systematic Review and Meta-Analysis

Cited by 63 publications

References 40 publications

Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015

Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015

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

Neonatal and maternal outcome in term primigravida with isolated oligohydramnios

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