Maternal and Neonatal Outcome in Patients with Oligohydramnios

ABSTRACT

Background: Quantitative estimate of amniotic fluid capacity is asection of daily obstetric scan. Semi quantitate determination ofthe quantity of amniotic fluid is done using amniotic fluid index,that is calculated by addition of the depth in centimeters of largestvertical pocket in four quadrants each. Oligohydramnios withdisapproving maternal and fetal circumstances lead to a worstperinatal result than normal amniotic fluid volume under the sameconditions. In these situations oligohydramnios may indicate amore severe impaired function of placenta and fetal compromise.The present study was conducted to evaluate the maternal andneonatal outcome in pregnant females with Oligohydramnios.Materials and Methods: The present prospective study wasconducted in the Department of Obstetrics and Gynecology for aperiod of 1 year. Estimates of amount of amniotic fluid volume wasestimated using AFI. Color Doppler tests were performed amongstwomen with isolated oligohydramnios. All the information from thefemales was taken on a patient information sheet. Details of infantat birth were recorded. All the data this obtained was arranged ina tabulated form and analyzed using SPSS software. Probabilityvalue of less than 0.05 was considered as significant.Results: A total of 130 subjects were enrolled in the study. Theincidence of oligohydramnios was 2.8%. 37.69% patients hadsevere oligohydramnios, 43.84% patients had moderateoligohydramnios and 18.46% patients had mild oligohydramnios.55% patients were primigravidas. 42.3% patients were preterm,48.5% patients were term and 9.2% patients were post dated.26.9% patients with oligohydramnios showed intrauterine growthrestriction. 15.3% patients had pregnancy induced hypertensionand 6.9% patients had both PIH and IUGR. IUGR was maximallyseen in the group of severe oligohydramnios and foetal distresswas also observed more in this group. 33.8% patients weredelivered vaginally without any instrumentation, 2.3% patientswere delivered with help of vaccum, 63.9% underwent LSCS.There were 10% subjects less than 20 years, 51% were between21-25 years, 25% were between 26-30 years, 9% were between31-35 years. There were 85% (majority) with cephalicpresentation. 13% (n=17) had breech and 2% had transversepresentation.73.27% of babies were low birth weight. 6% babieshad congenital anomalies. 11% babies accounted for perinatalmortality with extreme prematurity as the cause of death inmajority.Conclusion: In our study the most common age group afflictedwas 21-25 years as the incidence of pregnancy is also maximumin this age group. Perinatal morbidity and mortality was maximallyseen in patients with severe oligohydramnios. Isolatedoligohydramnios at more than 36 weeks of gestation does notaffect perinatal outcome. The presence of moderate to severeoligohydramnios should alert the Obstetrician to a high risk fetalcondition and should prompt the obstetrician to initiate an activeintervention in collaboration with the neonatologist. Finally, regularANC checkup, fetal surveillance, treatment of associated maternalmedical conditions help to achieve better perinatal outcome.