A case-control investigation of foetal outcome in a case of oligohydramnios after 34 weeks of pregnancy.
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 9, Pages 3822-3828
AbstractAim: To evaluate the fetal outcome in a case of oligohydramnios after 34 weeks of pregnancy.
Materials and methods: A prospective case control study was conducted in the Department of obstetrics and gynaecology, VIMS, Pawapuri, Nalanda, Bihar, India, for 18 months. 100 antenatal cases with >34 weeks of gestation with AFI ≤5 cm by sonographic estimation were included as study group and 100 women with normal AFI (8-24 cm) were included as control group. Induction of labour was done for women with high risk factors like PIH, by PGE 2 gel and accelerated with oxytocin. Labour outcome of the women were recorded includes, spontaneous /induced, nature of A F, FHR tracings, mode of delivery, indication for cesarean section or instrumental delivery. Perinatal findings such as APGAR score <7 at 1 mt and 5 mt, birth weight, admission to NICU, perinatal morbidity and mortality were noted.
Results: Study group consists of 48 % Gr 1, 52 % Gr 2 and above and control group 52% Gr 1, 48% Gr 2 and above (Chi square=21.59, p<0.0001). Antenatal complications were not seen in 70% in the study group and 58% in control group. The AFI in study and control groups. In the study group 70% of women had AFI below 4. The nature of the amniotic fluid was clear in 30% in study and 80% in control group. Amniotic fluid was thin meconium stained in 31% in study, 15% in control group and was thick meconium stained in 40% in study and 10% in control group (Chi square=21.57, p<0.0001). Incidence of LSCS in the study group was 55% and 19% in control group. Percentage of birth weight of babies in study and control group is shown in Table 5. Birth weight <2.5 kg was found in 60% in study group and 18% in control group with mean of 2.3 and 2.9 in study and control group respectively (p <0.001) statistically significant.
Conclusion: To conclude in presence of oligohydramnios a thorough evaluation for hypertension, PIH, diabetes PROM etc. should be done. An AFI ≤5 cm detected after 28 weeks was associated with adverse pregnancy outcome and poor perinatal outcome. Determination of AFI should be used as an adjunct to other fetal surveillance methods and is a valuable test for predicting fetal distress in labour requiring cesarean delivery.
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