DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20173099

Ultrasound evaluation of pregnancies with oligohydramnios in third trimester and their feto-maternal outcome at tertiary care hospital

Awdhut Tiparse, Bhumika Kalathiya, Preeti Bajaj

Abstract


Background: Oligohydramnios presents a threat to the fetus due to increased risk of the umbilical cord getting compressed and resulting in impaired blood flow to the fetus. The objective of the study was to find out the significance of oligohydramnios during third trimester of pregnancy.

Methods: A hospital based prospective study was conducted in the Department of Radiodiagnosis and Obstetrics and Gynaecology, Sir T. Hospital, Bhavnagar. Amniotic fluid index (AFI) estimation was done on 60 pregnant women in third trimester, who were selected after screening for inclusion and exclusion criteria. Women with AFI < 5 cm were taken as cases while women with AFI > 5 cm as controls.

Results: Maximum number of the patients were belonging to 20-25-year age group in normal AFI, oligohydramnios and borderline oligohydramnios group. Incidence of malpresentation was significantly higher in oligohydramnios (20%), borderline oligohydramnios (17.5%). In oligohydramnios common, etiological factors were PIH (27.5%), idiopathic factor (27.5%), postdatism (12.5%) and IUGR (7.5%), while borderline oligohydramnios group is commonly associated with idiopathic factors (52.5%) followed by PIH (17.5%). Incidence of caesarean section was significantly higher in oligohydramnios group (67.5%) than normal AFI (18%). In borderline oligohydramnios group rate is significantly higher (45%) than normal AFI, but it is less as compared to oligohydramnios.

Conclusions: Identification of oligohydramnios can be done by a good clinical examination and confirmed by measuring AFI on ultrasonography. Poor fetal outcome in the form of preterm, IUD, LBW, low APGAR score at 5 minute and increased chances of still birth, NICU admission and neonatal death are seen with oligohydramnios in third trimester and more so if it is detected in early third trimester. Chances of induction of labour and risk of LSCS also increase. Thus, detection of oligohydramnios helps in proper management of the cases so that maternal and perinatal outcome can be improved.


Keywords


AFI, Oligohydramnios, Third trimester

Full Text:

PDF

References


Entezami M, Albig M, Gasiorek-Wiens A, Becker R. Placenta, cord and amniotic fluid (Chapter 14) In: Ultrasound diagnosis of fetal anomalies. Edition III US: Thieme Medical Pub; 2003:301.

Manning FA, Hill LM, Platt LD. Qualitative amniotic fluid volume determination by ultrasound: Ante partum detection of intrauterine growth retardation. Am J Obstet Gynecol. 1981;139:254-8.

Manning FA, Harman CR, Morrison I, Menticoglou SM, Lange IR, Johnson JM. Fetal assessment based on fetal biophysical profile scoring. IV. An analysis of perinatal morbidity and mortality. Am J Obstet Gynecol. 1990;162(3):703-9.

Phelan JP, Smith CV, Small M. Amniotic fluid volume assessment with the four-quadrant technique at 36 to 42 weeks gestation. J Reprod Med. 1987;32:540-2.

Sherer DM. A review of amniotic fluid dynamics and the enigma of isolated oligohydramnios. Am J Perinatol. 2002;19:253-66.

Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD. Perinatal outcomes and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis. Am J Obstet Gynecol. 1999;181:1473-8.

Chamberlain PF, Manning FA, Morrison I. Ultra-sound evaluation of amniotic fluid volume. II. The relationship of increased amniotic fluid volume to perinatal outcome. Am J Obstet Gynecol. 1984;150:250.

Bottoms SF, Welch RA, Zador IE. Limitations of using maximum vertical pocket and other sonographic evaluations of amniotic fluid volume to predict fetal growth: technical or physiologic? Am J Obstet Gynecol. 1986;155:154.

Vintzileos AM, Campbell WA, Nochimson DJ. Degree of oligohydramnios and pregnancy outcome in patients with premature rupture of the membranes. Obstet Gynecol. 1985;66:162.

Phelan JP, Smith CV, Broussard P. Amniotic fluid volume assessment with the four-quadrant technique at 36-42 weeks gestation. J Reprod Med. 1987;32:540.

Chamberlain PF, Manning FA, Morrison I. Ultra-sound evaluation of amniotic fluid volume. II. The relationship of increased amniotic fluid volume to perinatal outcome. Am J Obstet Gynecol. 1984;150:250.

Bottoms SF, Welch RA, Zador IE. Limitations of using maximum vertical pocket and other sonographic evaluations of amniotic fluid volume to predict fetal growth: technical or physiologic? Am J Obstet Gynecol. 1986;155:154.

Moore TR, Cayle JE. the amniotic fluid index in normal human pregnancy. Am J Obstet Gynecol. 1990;162:1168.

Rutherford SE, Phelan JP, Smith CV. The four-quadrant assessment of amniotic fluid volume: An adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987;70:353.

Akhter H, Guha K, Daisy KP. amniotic fluid index in high risk pregnancies and pregnancy outcome. Dinajpur Med Col. 2010;3(1):1-5.

Guin G, Punekar S, Khare S. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume. J Obstet Gynecol India. 2011;61(6):652-5.

Chen KC, Liou JD, Hung TH, Kuo DM, Hsu JJ, Hsieh CC, et al. Perinatal outcomes of polyhydramnios without associated congenital fetal anomalies after the gestational age of 20 weeks. Chang Gung Med J. 2005;28(4):222-8.

Christensen S, Michael W, Lourdes S. Cord containing amniotic fluid pocket: a useful measurement in management of oligohydramnios. Am J Obstet Gynecol 1992:80(5):775-8.