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A comparative analytical study of clinical outcome of oligohydramnios at or beyond 34 weeks of gestation

Sunita TH, Shraddha Neminath Kurkure, Rathnamala M. Desai, Vidya Kamath.

Abstract
Background: Amniotic fluid volume measurement forms an integral part of the antenatal fetal monitoring. It is widely used as an indicator of fetal wellbeing during third trimester. The four quadrant method of calculating AFI as described by Phelan et al is accepted by most of the authors. Oligohydramnios in pregnancy without a renal abnormality or genitourinary obstruction represents “chronic in utero stress”. Perinatal morbidity and mortality are significantly increased in oligohydramnios. So oligohydramnios was taken up for further study in order to devise methods and means to know the cause, diagnose and manage it in a better way. The aim of the study was to study the maternal and perinatal outcome in oligohydramnios at or beyond 34 weeks of gestation.
Methods: This comparative analytical study was done in pregnant women with AFI < 5cm diagnosed at/after 34 weeks of gestation attending antenatal clinic at department of OBG, Shri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad from November 2012 to October 2013. Clinical outcome was compared with pregnant women having normal AFI (6-24 cm) at/after 34 weeks of gestation. For all women AFI and NST were done. UAD was done in women with oligohydramnios. Patients with abnormal NST and/or Doppler studies at the time of diagnosis or any time during fetal surveillance were considered for termination of pregnancy. In pregnant women with normal AFI, NST was done once in two weeks or as necessity demanded. Various clinical outcomes were measured using appropriate statistical measurements.
Results: In presence of oligohydramnios, the occurrence of non-reactive NST, meconium stained liquor, development of fetal distress, LSCS rate; low Apgar score, low birth weight babies, NICU admissions and early neonatal deaths were high.
Conclusions: Determination of AFI is a valuable parameter, which can be used as an adjunct to other fetal surveillance methods. It helps to identify neonates at risk of poor perinatal outcome.

Key words: Amniotic fluid index, Oligohydramnios, Caesarean section, Non-stress test, Fetal distress, Perinatal mortality



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