Assessment Of Amniotic Fluid Volume Research Articles

Assessment of Amniotic Fluid Volume in Pregnancy

Amniotic fluid (AF) is an integral part of the fetal environment and is essential for fetal growth and development. Pathways of AF recirculation include the fetal lungs, swallowing, absorption through the fetal gastrointestinal tract, excretion through fetal urine production, and movement. In addition to being a marker for fetal health, adequate AF is necessary for fetal lung development, growth, and movement. The role of diagnostic imaging is to provide a detailed fetal survey, placental evaluation, and clinical correlation with maternal conditions to help identify causes of AF abnormalities and thereby enable specific therapy. Oligohydramnios prompts evaluation for fetal growth restriction as well as genitourinary issues, including renal agenesis, multicystic dysplastic kidneys, ureteropelvic junction obstruction, and bladder outlet obstruction. Premature preterm rupture of membranes should also be clinically excluded as a cause of oligohydramnios. Clinical trials evaluating amnioinfusion are underway as a potential intervention for renal causes of oligohydramnios. Most cases of polyhydramnios are idiopathic, with maternal diabetes being a common cause. Polyhydramnios prompts evaluation for fetal gastrointestinal obstruction and oropharyngeal or thoracic masses, as well as neurologic or musculoskeletal anomalies. Amnioreduction is performed only for maternal indications such as symptomatic polyhydramnios causing maternal respiratory distress. Polyhydramnios with fetal growth restriction is paradoxical and can occur with maternal diabetes and hypertension. When these maternal conditions are absent, this raises concern for aneuploidy. The authors describe the pathways of AF production and circulation, US and MRI assessment of AF, disease-specific disruption of AF pathways, and an algorithmic approach to AF abnormalities. ©RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.

Amniotic Fluid Disorders: From Prenatal Management to Neonatal Outcomes

Amniotic fluid volume assessment has become standard in the surveillance of fetal well-being, especially in high-risk pregnancies. Amniotic fluid disorders are a frequent and important topic in fetal and perinatal medicine. However, although important advances have been achieved, many important and challenging questions remain unanswered to date. An abnormally low amniotic fluid volume, referred to as oligohydramnios, has been traditionally considered a possible indicator of placental insufficiency or fetal compromise and is associated with an increased rate of obstetric interventions. An excess of amniotic fluid, referred to as polyhydramnios, may be secondary to fetal or maternal conditions and has been associated with a variety of adverse pregnancy outcomes, especially when it is severe. The ultrasonographic detection of an amniotic fluid disorder should prompt a proper workup to identify the underlying etiology. Data on the association of isolated oligohydramnios or idiopathic polyhydramnios with adverse obstetric and perinatal outcomes are conflicting. While the management of secondary oligohydramnios is usually guided by the underlying condition, the management of isolated oligohydramnios is poorly defined. Similarly, the management of idiopathic and secondary polyhydramnios is not yet standardized. There is an urgent need for randomized clinical trials to provide stronger recommendations on the management of these two common conditions.

On the term “single deepest dial” technique for assessment of amniotic fluid volume

On the term “single deepest dial” technique for assessment of amniotic fluid volume

Idiopathic polyhydramnios and pregnancy outcome: systematic review and meta-analysis.

To analyze outcomes of singleton pregnancies with idiopathic polyhydramnios through a systematic review and meta-analysis. Electronic databases, including MEDLINE, OVID, EBSCO, Cochrane collection and Science Citation Index, were searched from 1946 to 2019. Gray literature and tables of contents of relevant journals were also screened. Prospective and retrospective studies with a control group were included. Two authors independently reviewed the abstracts retrieved from the literature search. Inclusion criteria were: studies documented in English, singleton pregnancy and idiopathic polyhydramnios determined by amniotic fluid volume assessment on ultrasound. Exclusion criteria were: maternal diabetes, fetal structural or chromosomal anomaly, alloimmunization and intrauterine fetal infection. Twelve studies met the inclusion criteria, giving a total of 2392 patients with idiopathic polyhydramnios and 160 135 patients with normal amniotic fluid volume. Pregnancies complicated by idiopathic polyhydramnios were at a higher risk of neonatal death (odds ratio (OR), 8.68 (95% CI, 2.91-25.87)), intrauterine fetal demise (OR, 7.64 (95% CI, 2.50-23.38)), neonatal intensive care unit admission (OR, 1.94 (95% CI, 1.45-2.59)), 5-min Apgar score < 7 (OR, 2.21 (95% CI, 1.34-3.62)), macrosomia (OR, 2.93 (95% CI, 2.39-3.59)), malpresentation (OR, 2.73 (95% CI, 2.06-3.61)) and Cesarean delivery (OR, 2.31 (95% CI, 1.79-2.99)). This study suggests that pregnancies complicated by idiopathic polyhydramnios are at increased risk of adverse outcome. Future investigations should aim to determine an amniotic fluid volume threshold above which antenatal fetal surveillance is appropriate in the management of these pregnancies. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Measurement of amniotic fluid volume

The qualitative or semi-quantitative assessment of amniotic fluid volume (AFV) is a standard component of every ultrasound in the second and third trimesters of pregnancy. AFV abnormalities are associated with various pregnancy complications. In clinical practice, ultrasound (US) assessment of AFV is used in conjunction with other clinical and sonographic parameters (biophysical profile, non-stress test, estimated fetal weight on ultrasound, clinical examination) to make effective medical decisions to maintain fetal well-being in the management of pregnancies with obstetric complications. US is the most common AFV assessment technique, in which AFV is determined on a basis of the opinion of a physician (qualitatively) or on a basis of the value of the maximum vertical pocket (MVP) and amniotic fluid index. These techniques are well suited for detecting fetuses with normal AFV; however, they have insufficient accuracy for diagnosing oligohydramnios and polyhydramnios. Furthermore, ultrasound AFV assessment in twins poorly corresponds with the reference values for oligohydramnios and polyhydramnios. Despite this, it is advisable to use qualitative and semi-quantitative (MVP) methods for AFV assessment. Results for each twin are interpreted using the same MVP criteria as those for single fetuses.

A Comparison of Amniotic Fluid Index versus Single Deepest Pocket Method in Terms of Maternal and Perinatal Outcome in Late Term Pregnancies

Background: Over diagnosis of isolated oligohydramnios is associated with increased obstetrical intervention without improving maternal and perinatal outcome. Objective of this study is to evaluate two methods of amniotic fluid volume assessment regarding obstetrical intervention frequency and its effect on maternal and perinatal outcome. Materials and Methods: This prospective study was conducted at a Private Hospital of Dera Ismail Khan and Khyber Teaching Hospital, Peshawar from 1st January 2017 till 31st December 2019. All pregnant patients with singleton, un-complicated pregnancy with period of gestation from 41 weeks to 41 weeks 6 days, live fetus were included in the study. Women who met the eligibility criteria were assigned to two different techniques of amniotic fluid assessment, first amniotic fluid index( AFI) method and second single deepest vertical pocket(SDVP) method. Data was recorded on a specially designed proforma. The socio-demographic variables were age in years, parity. Continuous variable was measured on numerical scale and expressed as mean and SD. Research variables were maternal outcome and perinatal outcome in terms of oligohydramnios frequency, induction of labour, caeserean section, fetal distress, NICU admission, A/S &lt; than 7 at 5 minutes. Chi-sq test of significance was applied. Results: A total of 160 patients met the inclusion criteria. In first group 30 (37.5%) and in second group18 (22.5%) had oligohydramnios. In AFI group 10 (33.3%) and in SDVP group 3(16.66%) had caesereans section. Induction of labour was 30(37.5%) in AFI group and 18(22.5%) in SDVP group. These results were statistically significant with a p value less than .05 at 5% significance level. Fetal distress, A/S &lt; than 7 at 5 minutes, NICU admission results were not statistically significant for two groups. Conclusion: SDVP technique gave less abnormal results, less intervention with no significant difference in maternal and perinatal outcome. Keywords: Amniotic fluid, Oligohydramnios, Caesarean section.

Sonography Assessment of Amniotic Fluid Volume as a Predictor of Fetal Outcome in Low-Risk Pregnancy

Sonography Assessment of Amniotic Fluid Volume as a Predictor of Fetal Outcome in Low-Risk Pregnancy

Amniotic Fluid Classification and Artificial Intelligence: Challenges and Opportunities.

A fetal ultrasound (US) is a technique to examine a baby’s maturity and development. US examinations have varying purposes throughout pregnancy. Consequently, in the second and third trimester, US tests are performed for the assessment of Amniotic Fluid Volume (AFV), a key indicator of fetal health. Disorders resulting from abnormal AFV levels, commonly referred to as oligohydramnios or polyhydramnios, may pose a serious threat to a mother’s or child’s health. This paper attempts to accumulate and compare the most recent advancements in Artificial Intelligence (AI)-based techniques for the diagnosis and classification of AFV levels. Additionally, we provide a thorough and highly inclusive breakdown of other relevant factors that may cause abnormal AFV levels, including, but not limited to, abnormalities in the placenta, kidneys, or central nervous system, as well as other contributors, such as preterm birth or twin-to-twin transfusion syndrome. Furthermore, we bring forth a concise overview of all the Machine Learning (ML) and Deep Learning (DL) techniques, along with the datasets supplied by various researchers. This study also provides a brief rundown of the challenges and opportunities encountered in this field, along with prospective research directions and promising angles to further explore.

Validated, Consensus-Based Second- and Third-Trimester Sonographic Learning Objectives for the Obstetrics Clerkship.

Currently, there are no established guidelines for obstetric ultrasound training at the core medical student clerkship level. Our objective was to develop practical, consensus-based learning objectives in second- and third-trimester ultrasound and assess the feasibility of implementing these objectives into a clinical curriculum. Using the modified Delphi approach, a panel of expert stakeholders (n = 23) was assembled to reach consensus on the proposed learning objectives. A model curriculum was created consisting of a video tutorial, in-person training, and an optional tracker and piloted at two academic medical centers. Participant perception of acquired ultrasound skills and the program were assessed using a modified, previously validated survey. Pre- and postprogram survey responses were compared using the Chi-squared test of association. A p-value of <0.05 was considered statistically significant. The expert panel reached consensus on five learning objectives to include determination of fetal number and presentation, assessment of fetal heart rate, determination of placental location, assessment of amniotic fluid volume, and a general understanding of the biophysical profile and its indications. A total of 26 students participated in the piloted curriculum. On completion, a majority of participants reported improved confidence in understanding and performing prenatal ultrasound in the second and third trimesters (p < 0.05). The majority of participants valued a hands-on ultrasound curriculum. We propose practical, consensus-based learning objectives for second- and third-trimester sonography during the core clerkship with demonstrated feasibility in a two-center pilot program. · Ultrasound is a valuable skill for medical students.. · Specific learning objectives in obstetric ultrasound are currently lacking.. · We propose consensus-based objectives and a model curriculum.. · A two-center pilot study demonstrated efficacy..

Measurement of Amniotic Fluid Volume in 2nd and 3rd Trimesters of Normal Pregnancies

The important implication of obstetric care is the assessment of amniotic fluid volume. This assessment can prevent anomalies that are associated with oligohydramnios and polyhydramnios. Objective: To evaluate normal amniotic fluid volume in the 2nd and 3rd trimesters with the correlation of gestational age. Methods: It was a cross-sectional study and data were collected from a private health care setup in Gujrat, Pakistan. After informed consent data were collected in four months. A sample size of 75 patients was calculated conveniently using a mean from previous related studies. The women with singleton gestation from 20 to 40 years of age group were included in this research. The data were entered and analyzed on SPSS version 20. Results: This study showed that 47(62.7%) of women were multigravida and 28(37.3%) were primigravida. The most frequent maternal age group was 26-30(38.7%) years and the gestational age group was 31 to 35(42.7%) weeks. At the gestational age of 21-25 weeks, the mean of AFI was 14.38 and the mean of SDP was 5.69, while at the age of 26-30 weeks the estimated mean of AFI was 12.12 and the mean of SDP was 5.11. The mean of AFI and SDP at the age of 31-35 weeks were calculated at 11.48 and 4.26 respectively. At the age of 36-40 weeks, the estimated mean of AFI and SDP were calculated 10.22 and 3.73 correspondingly. Conclusions: This study concluded that amniotic fluid volume measured by amniotic fluid index and the single deep pool was increased in the 2nd trimester from 21-25 weeks of gestation and then progressively reduced in the third trimester as the pregnancy advances.

The amniotic fluid index and oligohydramnios: a deeper dive into the shallow end

Second- and third-trimester obstetrical ultrasound examinations include an amniotic fluid volume assessment. Professional organizations' clinical guidance recommends using semiquantitative techniques, such as the single deepest vertical pocket or amniotic fluid index, for this purpose. The single deepest vertical pocket is described as the preferred method of assessing amniotic fluid volume based on fewer oligohydramnios diagnoses and labor inductions with no demonstrable difference in pregnancy outcomes compared with the amniotic fluid index. We offer an alternative interpretation of the evidence for this advice, drawn from 6 randomized clinical trials and 2 meta-analyses comparing the single deepest vertical pocket to the amniotic fluid index. Individually and collectively, these reports are underpowered to detect significant differences in maternal and perinatal outcomes by study group. Moreover, randomized clinical trials comparing maternal and perinatal outcomes resulting from a policy of labor induction at or beyond 37 weeks of gestation vs expectant care consistently favor labor induction, the very intervention paradoxically cited as favoring the single deepest vertical pocket vs the amniotic fluid index. We conclude that the amniotic fluid index should be considered a reasonable method for third-trimester amniotic fluid assessment and diagnosing oligohydramnios.

Amniotic Fluid Index Versus Single Deepest Pocket Techniques in Evaluation of Oligohydramnios: A Review of Current Literature

Amniotic fluid volume (AFV) assessment is an essential part of antenatal fetal screening programs as it reflects fetal well-being. Oligohydramnios is a decline in AFV for gestational age. It is associated with high incidence of fetal morbidity and mortality as well as poor maternal outcomes with increased rate of obstetric intervention. Therefore, accurate estimation of AFV is crucial in both low-as well as high-risk pregnancies. Ultrasound has been described as a practical and accurate method for estimation of AFV. The commonly used techniques are amniotic fluid index (AFI) and single deepest pocket (SDP). In this study, we reviewed the recent literature comparing the two techniques in pregnancies complicated with oligohydramnios. The results indicated that SDP is relatively more accurate, with AFI resulting in overdiagnosis of oligohydramnios. This was associated with more unnecessary obstetric interventions, without significant improvement in maternal and fetal outcomes.

Amniotic Fluid Volume Assessment: Eight Lessons Learned.

Actual AFV can be determined by a dye-dilution technique or be directly measured at cesarean. This allows investigators to correlate estimated and actual AFVs. Lessons learned by assessing the relationship of estimated to actual AFVs. 1) Ultrasound estimates normal actual AFVs well, but abnormal AFVs poorly. 2) Quantile regression is a better statistical methodology to create a normal AFV curve across pregnancy. 3) There is no difference in the accuracy of the subjective (visualization without measurements) compared with the objective (visualization with measurements) technique in identifying normal and abnormal AFVs. 4) Color Doppler use leads to the over-diagnosis of oligohydramnios. 5) Intravenous hydration increases actual AFVs. 6) The estimation of AFV can be done with the transducer held perpendicular to the floor or perpendicular to the uterine contour. 7) The single deepest pocket should be used for identifying low AFVs. 8) The AFI should be used for identifying high AFVs.

1129 How useful is assessment of amniotic fluid volume in antenatal surveillance of fetal growth restriction?

Maximum vertical pocket (MVP) is commonly assessed for surveillance of fetal growth restriction (FGR) and small for gestational age (SGA). It is theorized that MVP becomes compromised when blood flow to the brain is prioritized. Our objectives are to evaluate the relationships among FGR and SGA, MVP, and perfusion parameters. This is a retrospective study of the last ultrasound prior to delivery of 105 fetuses with an estimated fetal weight <10th percentile. Data include biometry, MVP, middle cerebral artery Doppler peak systolic velocities (MCA-PI), and cardiac size, shape, and right-to-left disproportion. Fetuses were classified as FGR or SGA by International Society of Ultrasound in Obstetrics and Gynecology criteria. MCA-PI <10th percentile for gestational age was abnormal. Relationships between dichotomized and continuous variables were analyzed using Fisher’s exact tests and linear regressions respectively. Mean gestational age at time of ultrasound assessment was 36 +/- 2 weeks. A total of 61 (58%) and 44 (42%) fetuses met criteria for FGR and SGA respectively. Five fetuses (5%) had low or low-normal MVPs (≤3cm). MVP ≤3cm did not correspond to increased rate of FGR or abnormal MCA-PI (p=0.39 and 0.31 respectively). The risk ratio (RR) of FGR for MVP ≤3cm compared to MVP >3cm is 1.40 [95% confidence interval (CI) 0.88, 2.25], and the RR of MCA <10th percentile for MVP ≤3cm compared to MVP >3cm is 1.89 [CI 0.60, 5.89]. Cardiac deformation was present in all fetuses with MVP ≤3cm (table). In our series, MVP ≤3cm was found infrequently in fetuses with FGR. There were no differences in MVP between fetuses with FGR v. SGA. Low MVP was not associated with abnormal MCA-PI, contrary to the theorized competitive relationship between amniotic fluid production and fetal brain sparing. However, this pilot study suggests that MVP ≤3cm is associated with fetal cardiac deformation, indicating possible compromise of renal perfusion in the setting of cardiac remodeling; further research is needed to validate this relationship.

Can maternal characteristics on admission for preterm prelabor rupture of membranes predict pregnancy latency?

Latency duration after preterm prelabor rupture of membranes has been an area of investigation for many years. Previously described factors associated with latency include gestational age at the time of rupture, cervical dilation of >1 cm, vaginal bleeding at the time of presentation, and oligohydramnios. However, little is known about the impact of composite maternal factors and presenting symptoms on the duration or prediction of the latency period. This study aimed to determine whether maternal factors and subjective presenting symptoms can predict pregnancy latency after preterm prelabor rupture of membranes. This is a retrospective observational study of singleton pregnancies complicated by preterm prelabor rupture of membranes for over 3 years at a single institution utilizing a uniform management protocol. Maternal demographics, obstetrical data, maternal subjective symptoms and physical examination findings on admission, amniotic fluid volume assessment, presence of contractions, and maternal perception of feeling unwell were collected and analyzed. Clinical characteristics were summarized with mean and standard deviation for continuous measures and frequency and percentages for categorical variables. For skewed variables, medians with 25th and 75th percentiles were reported. Cumulative latency duration (ie, survival time) was estimated with a Kaplan-Meier model. Multivariable Cox proportional hazards regression model with backward variable selection was used to determine the effects of maternal factors on latency duration. Of the 212 patients available for analysis, there was a considerable variability in the latency duration with values ranging between 0 and 119 days. Factors related to latency duration included maternal age, parity, gestational age at rupture, cervical dilation, amniotic fluid volume, and contractions. Advancing maternal age (P=.012), increased gestational age at rupture (P<.0001), cervical dilation of ≥3 (vs 0; P<.0001), anhydramnios or oligohydramnios (vs normal amniotic fluid; P<.0001), cramping (P=.012), and painful contractions (P=.015) were associated with a shorter latency duration. Utilizing these statistically significant factors, we constructed a nomogram to predict latency for 1-day, 1-week, and overall median latency duration. Maternal factors and presenting symptoms can predict pregnancy latency after preterm prelabor rupture of membranes. We created a nomogram for clinical use that provides a visual display of the probability of pregnancy latency. This tool may be useful for counseling and providing additional information on expectations for providers and patients with pregnancies complicated by preterm prelabor rupture of membranes.

ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals.

ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals.

199: Use of fetal myocardial speckle tracking to predict category 2 tracings prior to maternal pushing

To assess the ability of evaluation of the 4-chamber view and the right and left ventricles of the fetal heart to predict the development of a category 2 fetal heart rate tracing prior to maternal pushing in labor. This was a prospective, observational study of 91 women performed at one academic center between January 2018 and January 2019. Patients who were admitted to Labor and Delivery and in labor had an ultrasound performed to collect a 4-chamber view cine loop, fetal biometry, umbilical artery and middle cerebral artery Doppler’s and amniotic fluid volume assessment. The 4-chamber view size and shape were measured. Using speckle-tracking software, the size, shape, as well as the global, longitudinal, and transverse contractility were measured and z-scores computed from 200 normal control fetuses. The fetal heart rate tracings were analyzed during the last 30 minutes prior to full cervical dilatation just prior to maternal pushing. Logistic regression was used to compute the statistics for the receiver-operating curve (ROC) to predict the sensitivity and false-positive rate associated with late decelerations. Sixty-three percent (57/91) had a category 2 fetal heart tracing 30 minutes prior to pushing. Logistic regression analysis identified 1 Doppler variable and 20 cardiac variables for a sensitivity of 91% (52/57) and a false-positive rate of 14.7% (5/34) (Table 1). The Receiver Operator Curve had an area of 0.97(SE=0.03; 95% CI 0.89=01 to 0.995) (Figure 1). Evaluation of the size of the 4-chamber view and ventricular size and shape using speckle tracking analysis may serve as a useful test to determine which fetuses are prone to demonstrate category 2 fetal heart rate tracing during labor prior to maternal pushing. Our study did not have enough patients who required cesarean or operative vaginal delivery to determine if this technology can help to predict this complication. Further studies are warranted to determine the clinical value of speckle tracking as a supplemental tool to fetal heart rate tracings during labor.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Novel Computerized Analytic Technique for Quantification of Amniotic Fluid Volume in Fetal MRI.

OBJECTIVE. Fetal MRI is increasingly used in the evaluation of suspected congenital anomalies. Assessment of amniotic fluid volume (AFV) is crucial, but no automated quantitative technique is currently available for MRI. The purpose of this study was to develop and evaluate an analytic technique for quantifying AFV in fetal MRI. MATERIALS AND METHODS. Two MRI phantoms containing known quantities of synthetic amniotic fluid were created. A 3D steady-state free precession sequence was used for 1.5-T MRI of the phantoms and as part of a standard clinical fetal MRI protocol. Software was developed and used to retrospectively calculate AFV for the phantom and 20 clinical MRI examinations. Times to completion were recorded. AFV was also calculated by a manual hand-tracing method. To evaluate performance, paired t tests were used to compare computer-generated measurements with known phantom volumes. Intraclass correlation coefficients were calculated to assess agreement between computer-generated and manual measurements. RESULTS. There was no significant difference between computer-generated measurements of known AFV in the MRI phantoms (p > 0.11). When the software program was applied to the clinical MRI examinations, the mean time to complete AFV measurement was 110 seconds. There was excellent reliability between total AFV calculated by the two software users and by means of manual measurements (intraclass correlation coefficient, 0.995; p < 0.01). CONCLUSION. The computerized analysis evaluated in this study rapidly and accurately quantifies AFV in fetal MRI. The results are concordant with known phantom volumes and manual measurements. The technique is promising for objective MRI evaluation of AFV and has the potential to improve prenatal diagnosis and management.

Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

Pregnancy Outcome in Women Having Oligohydramnios in Gandaki Medical College Teaching Hospital, Pokhara, Nepal

Background: Amniotic fluid index is one of the most commonly used methods of amniotic fluid volume assessment and is a predictor of adverse maternal and perinatal outcome.&#x0D; Objectives: To compare the maternal and perinatal outcome in women with singleton term pregnancies having amniotic fluid index (AFI) ≤5 cm to those having AFI ≥5 to 20 cm.&#x0D; Methods: This is a prospective, case-control study which was conducted at Gandaki Medical College Teaching Hospital over a period of one year from July 2017 to July 2018. It included 60 pregnant women at term pregnancy with amniotic fluid index ≤5 cm. The control group included 60 pregnant women at term pregnancy with amniotic fluid index ≥5 cm. The two groups were compared. Statistical analysis was done using the Chi-square test to calculate the P- value.&#x0D; Results: There was a significantly higher incidence of overall cesarean rates due to fetal distress, low birth weight babies and adverse neonatal outcome like 5 minute Apgar score ≤7, neonatal intensive care unit (NICU) admission rates, and meconium aspiration syndrome in the group with oligohydramnios as compared to the group with normal liquor volume.&#x0D; Conclusion: Oligohydramnios adversely affects the perinatal outcome. However a favorable outcome can be expected by good antenatal and intrapartum surveillance and neonatal care.