Outcome of Pregnancies with Severe Oligohydramnios in the 3rd Trimesters

Abstract

Background: Amniotic fluid volume (AFV) of less than 200 ml is considered as insufficient, and is referred as significant oligohydramnios. Approximately 8% of pregnant women may experience low amniotic fluid levels ( less than normal / AFI < 8 cm ) But among them about 4% of pregnant women are diagnosed with severe or significant oligohydramnios. A range of unfavorable perinatal outcomes, including fatal growth restriction meconium aspiration of fetus, fetal distress and surgical intervention for foetal distress in labour and even perinatal death, are linked to oligohydramnios which are found during the antepartum period of pregnancy. The purpose of the study was to determine the outcome of pregnancies with severe oligohydramnios in the 3rd trimester. Material & Methods: This prospective observational study was carried out on the admitted patients in the Department of Gynecology & Obstetrics at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from February to July 2013 (6 months). A total of fifty women (N=50) having Oligohydramnios in pregnancy were included in the study. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for Social Sciences (SPSS) Version 25.0. The ethical clearance of this study was obtained from the Institutional Review Board (IRB) of BSMMU, Dhaka, Bangladesh. Results: Mean age of the mothers was 25.8 years and two-fifths of the mothers (20, 40.0%) belonged to 21-25 years old. Twenty-three mothers (23, 46.0%) were nulliparous. Of fifty mothers (N=50), eighteen (18, 36.0%) had borderline oligohydramnios & thirty-two (32, 64.0%) had severe oligohydramnios. Normal CTG tracing was found in eighteen patients (18, 36.0%) and abnormal CTG was found in thirty-two patients (32, 64%). Based on fetal outcome (N=50), 23 babies (23, 46.0%) were admitted to the NICU, of whom 7 (7, 14.0%) had birth asphyxia, 8 (8, 16.0%) had neonatal sepsis, 4 (4, 8.0%) had neonatal jaundice, 2 (2, 4.0%) had meconium aspiration syndrome, 4 had stillbirths, and 5 had died as neonates. Conclusion: Nowadays, routine obstetric USG is more routinely used to detect oligohydramnios. In the third trimester of pregnancy, PIH and postdated pregnancies are the most common causes of decreasing amniotic fluid. Unfavourable perinatal outcomes can be avoided with careful fetal heart rate monitoring during antenatal period and at labour. Every case of oligohydramnios necessitates a comprehensive prenatal assessment, parental counselling, and a personalized delivery time and technique. This study found no connection between meconium-stained liquor and oligohydramnios and found that caesarean section deliveries were considerably more common in these women.