Research Article Int J Cur Res Rev | Vol 7 • Issue 13 • July 2015 62 PREGNANCY OUTCOME IN ISOLATED OLIGOHYDRAMNIOS AT OR BEYOND 34 WEEKS OF GESTATION Kavitha G. Assistant Professor, Velammal medical college and research institute, Madurai, Tamilnadu, India. ABSTRACT Objectives: A significant reduction in the amount of amniotic fluid co-relates with an increased rate of both perinatal morbidity and mortality. The objectives of the study are to determine the neonatal outcome, and the appropriate route of delivery in isolated oligohydramnios. Methodology: This was a prospective case-control study conducted over a period of 22 months (November 2006 to August 2008) at department of obstetrics and gynecology, Basaveshwar Teaching and General Hospital and Sangameshwar Hospital, attached to Mahadeveppa Rampure Medical College, Gulbarga. The study consists of analysis of pregnancy outcome in 50 an- tenatal patients with the ultrasound diagnosis of oligohydramnios (AFI ≤ 5) at or beyond 34 weeks of gestation. Oligohydramnios was defined as ultrasound diagnosis of amniotic fluid index ≤5cm. Inclusion Criteria included singleton pregnancy of any order of parity with gestational age ≥ 34 weeks and AFI ≤ 5cm. Multiple gestation, gestational age <34 weeks and >40 weeks, AFI > 5cm and <5cm, ruptured membrane, pregnancy induced hypertension and congenital anomalies were excluded from the study. The results were analyzed using parameters like standard deviation, chi square test and ‘Z’ test. Results: There was statistically significant difference in two groups in non-stress NST, rate of induced labor, cesarean section rate, IUGR, low birth weight, admission to NICU and no difference in meconium stained liquor and Apgar score <7 at 5 minutes. Conclusion: Pregnancies with isolated oligohydramnios (AFI ≤ 5) at or beyond 34 weeks is associated with increased rates of non reactive NST, FHR deceleration during labor, development of fetal distress, caesarean delivery and low birth weight. Key Words: Isolated oligohydramnios, Non stress test, FHR deceleration. Corresponding Author: Dr. kavitha G., Assistant Professor, Velammal medical college and research institute, Madurai, Tamilnadu, India. Mob: 09994719818; E-mail: [email protected] Received: 02.05.2015 Revised: 29.05.2015 Accepted: 25.06.2015 INTRODUCTION Importance of amniotic fluid volume as an indicator of fetal status was appreciated relatively recently. 1 Amniotic fluid has a number of important roles in fetal develop- ment. It cushions the fetus against trauma, has antibacte- rial property and promotes growth and development of gastrointestinal and musculoskeletal system. 2 It helps to maintain the fetal body temperature and plays a part in the homeostasis of fluid, and permits fetal movements. 2, 3 Amniotic fluid volume maintains amniotic fluid pres- sure there by reducing the loss of lung fluid - an essen- tial component to pulmonary development. It prevents compression of the umbilical cord. 4 Decreased amniotic fluid volume is frequently one of the first clues to an un- derlying fetal abnormality or maternal disease state. 5 Most common quantitative measure for fluid volume used in clinical practice is AFI. It is calculated by di- viding the uterus externally into 4 quadrants and using ultrasound to measure vertical diameter of the largest pocket in each quadrant in millimeter, which is then summed to calculate AFI. 6. AFI ≤ 5cm is the accepted cut off for the diagnosis of oligohydramnios. Ante partum diagnosis of oligohydramnios by means of AFI accounted for 2.3% of pregnancies undergoing so- nography after 34weeks. 7 Sonogram – assisted diagnosis of oligohydramnios is associated with increased preg- nancy intervention, still birth, fetal heart rate decelera- tion during labor and increased neonatal morbidity and mortality rates. 7 Oligohydramnios can be an idiopathic finding in women who have low risk pregnancies and no medical or fetal complication. 8 The present study was designed to study the outcome of pregnancies with AFI ≤ 5cm at or beyond 34weeks of gestation. IJCRR Section: Healthcare Sci. Journal Impact Factor 4.016
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