Maternal and Fetal Outcome in Cases of Oligohydramnios Diagnosed By Ultrasonography after 34 Weeks of Gestation
Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 2
Abstract
The present study “obstetric outcome in cases of oligohydramnios diagnosed after 34 weeks of gestation” is a prospective study and Silchar Medical College & Hospital, Silchar during the period 1st August 2012 to 31st July 2013. A total of 200 patients were studied from the antenatal cases attending the OPD, antenatal ward and labour room of SMCH, Silchar. 100 cases and 100 controls were identified and they were confirmed ultrasonographically. All the cases were singleton pregnancies after 34 weeks of gestation in the age group of 18-32 years. Single deepest liquor pocket was < 3 cm (Crowley and O’herlihy) All the controls were singleton pregnancies after 34 weeks of gestation in the age group 18-32 years. They had single deepest liquor pocket depth between 3-8 cm. Majority of cases (60%) and controls (58%) were in the age group 23-27 years. The mean age of incidence was 24.6 years. Most of the cases (70%) and controls (72%) were primigravidas 88% cases and 86% controls were booked cases. Patients were monitored carefully for mode of onset – spontaneous or induced, course of labour, mode of delivery, caesarean section etc. To note the fetal outcome, Apgar score of 1 and 5 min, birth weight, incidence of C.S for fetal distress, NICU admissions, stillbirth, neonatal deaths etc. were monitored. Statistical analysis was done between case and control groups. Fundal heights and abdominal girths were considerably lower in cases than the control groups. This association was found to be statistically significant (p<0.05) 30% cases had associated hypertensive complications as compared to 26% controls. Anemia was seen in 22%, Rh negative in 6% and others in 4%. But most common group was uncomplicated or idiopathic with 38% cases and 43% controls. No significant relationship between oligohydramnios and any of these complications was noted. (p>0.05). 18 % cases and 14% controls had malpresentation at the time of delivery. Only 16% cases delivered spontaneously among cases whereas 83% controls delivered spontaneously. 22% cases were induced and the corresponding rate among controls was 5%. Oligohydramnios was significantly associated with increased rates of induction (p<0.05). The rates of C.S were 62% among cases compared to 12% in controls. 70.96% of these was due to fetal distress in the case group whereas only 16.67% in the control was due to fetal distress. The rates of C.S were significantly higher in cases (p<0.05) Liquor was meconium stained in 48% cases and 12% controls. 93.5% of C.S in cases was emergency compared to 83.3% in controls. The percentage of cases with birth weight <2.5 kg was 42% compared to only 12% controls. Also, 1-min apgar score <7 was seen in 70.44% of cases and only 19.08 % controls. 5-min apgar score <7 was seen in 37.46% of cases where as it was only 5.14% in controls. The association was found to be statistically significant (p<0.05) The NICU admissions were required in 33% cases ageist 5% controls. It was observed that adverse maternal and fetal outcome were associated with the cases i.e., oligohydramnios which was statistically significant.
Authors and Affiliations
Dr Shubhadeep Bhattacharjee
Keywords
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