The Relationship of Isolated Oligohydramnios at Term with Labor Mode
Abstract
OBJECTIVE:Toassesstherelationshipofbetweenisolatedoligohydramniosatthelastfewweeksofpregnancywithmodeofdeliveryandevaluateitsroleinfailureofinductionoflaboranditsroleinincreaserateofcaesariansection.
STUDYDESIGN:Thisisacase-controlstudywascarriedoutincluding70pregnantwomen,35ofthemwithnormalamountofliquor(controlgroup),andtheother35pregnantwomenwithisolatedoligohydramniosdiagnosedaccordingtoultrasoundcriteria(amnioticfluidindexof5cm,singledeepestpocketof2cm)(studygroup),allpregnantwomenat(37-40weeks)ofgestation,attendedtheANCunitinNu’manTeachingHospitalandtheoutpatientprivateclinicsinHayAljameaa/Al-HarthyainBaghdadfromDecember2020tillApril2021.
RESULT:Studygroupincludes35pregnantwomenwithisolatedoligohydram-niosandthecontrolgroupincludes35pregnantwomenwithnormalAFIaftermatchingofotherinclusioncriteria(maternalage,parityandgestationalage)forbothgroups,thereisasignificantdifferencebetweenthestudyandcontrolgroupinmodeofdeliveryasthehighestpercentofwomenwithIOdeliveredbycesareansection(68.57%)whilethehighestpercentofwomenwithnormalAFIdeliveredvaginally(74.29%).Thereisastatisticaldifferenceintherateofcesareansectionduetoabnormaldopplerstudybeforeinductionoflabor(pvalue=0.0500),thereissignificantdifferenceinmeanbirthweighbetweenbothstudygroups(P-value=0.0380),withthestatisticallysignificantdifferencesinApgarscoreat1minuteand5minutes7/10(P-value=0.0047,0.0253)respectively.With high level of significancy about neonatal intensive care unit admission (NICU)Admission > 24hrs (P-value= 0.0110).
CONCLUSION:Pregnancies with isolated oligohydramnios are associated with increased rate of development of fetal distress, meconium-stained liquor, rate of caesarean delivery, NICU admission and low birth weight. Rate of cesarean for fetal distress is increased because of increased rate of induction of labor in the women with oligohydramnios. The study does not suggest any root for delivery of pregnancies with IO, It is better to give the patient chance of spontaneous labor (if there is no fetal distress) with close monitoring for the fetal heart rate during labor. Cesarean section is indicated for IO with fetal distress at any stage of labor to decrease perinatal morbidity and mortality.Further studies may be required to evaluate the long-term consequences of isolated oligohydramnios.