Study of Oligohydramnios and Perinatal Outcome in Term Pregnancy

BACKGROUND Oligohydramnios is associated with an increased risk of adverse pregnancy outcomes. The perinatal mortality rate in oligohydramnios is high. Oligohydramnios is also associated with fetal heart conduction abnormalities, meconium staining of the amniotic fluid, umbilical cord compression, lower Apgar scores, poor tolerance of labour and fetal acidosis. We wanted to assess the perinatal outcome in term pregnancies complicated with oligohydramnios in this study. METHODS A prospective cohort study was conducted among 200 cases of pregnant women with singleton term pregnancy with intact membranes and AFI < 5cm admitted from January 2019 to June 2020 in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode. Antenatal patients with oligohydramnios confirmed by USG were induced within 24 hrs based on the Bishops score. History and examination findings were recorded in a predesigned proforma. Mode of delivery and APGAR scores were also noted. Neonatal complications and the need for ICU admission were studied up until their NICU admission or hospital stay. Statistical Analysis: Statistical tests of association using SPSS (version 20.0) were employed at the level of significance of 5 %. RESULTS The majority of patients in this study were primigravida (60.5 %) and belonged to the age group 20-29 yrs (73.5 %). There was a higher rate of induction (67.5 %) in oligohydramnios patients. Around 26 % had meconium-stained amniotic fluid. The rate of caesarean section was found to be 22.5 % and that of instrumental delivery was 3.5 %. Oligohydramnios was associated with a higher rate of NICU admission (27.5 %). The most common complications noted were jaundice (9.8 %), birth asphyxia (4.9 %), meconium aspiration syndrome (3.4 %) and respiratory distress syndrome (1 %). Only 1 case of neonatal mortality was seen in this study. CONCLUSIONS Oligohydramnios adversely affects the maternal and perinatal outcome. It is associated with higher rates of induction, caesarean section, meconium-stained amniotic fluid, low APGAR scores, fetal distress and perinatal morbidity and mortality. However, the outcome can be improved by good antepartum and intrapartum monitoring and neonatal care.