A Retrospective Study to Evaluate the Maternal and Fetal Outcome in 100 Cases of Altered Amniotic Fluid Index
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Abstract
Introduction: Successful pregnancy requires the accumulation of adequate amounts of amniotic fluid both to support fetal growth and to allow for maternal physiologic changes. Disruption of the fetomaternal equilibrium regulating the amniotic fluid balance may result in overproduction (polyhydramnios) or underproduction (oligohydramnios) of fluid and may affect the maternal and fetal outcome.
Aims and Objectives:
To determine the prevalence of Altered AFI at the study centre,
To study the co-morbid maternal and fetal factors associated with Abnormal AFI,
To evaluate the impact of altered AFI on the Maternal & fetal outcome.
Material and Methods: A Retrospective observational study was conducted over 2 years. 100 Pregnant women with gestational age between 20 to 42 weeks attending the OPD and admitted at the study centre with abnormal liquor volumes as detected by USG were enrolled in the study and their maternal and fetal outcomes were documented.
Results: In the present study the prevalence of oligohydramnios was found to be 3.39% and that of polyhydramnios was found to be 1.14%.
Conclusion: Abnormal liquor volumes affect the maternal and fetal outcome adversely especially if they develop in the late second or early third trimester and if associated with other antenatal complications (PIH, GDM) hence close surveillance and follow-up are required when altered amniotic fluid volumes are diagnosed early in pregnancy.
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References
Volante E, Gramellini D, Moretti S, Kaihura C, Bevilacqua G. Alteration of the amniotic fluid and neonatal outcome. Acta Biomed. 2004;75 Suppl 1:71-5.
Boyd RL, Carter BS. (2002). Polyhydramnios and Oligohydramnios. eMedicine. Retrieved from http://www.emedicine.com
Chhabra, S, Dargan, R, Bawaskar R. “Oligohydramnios: A potential marker for serious obstetric complications.” Journal of Obstetrics & Gynaecology2007; 27(7): 680-683(4).
Varma TR, Bateman S. Ultrasound evaluation of amniotic fluid -outcome of pregnancies with severe oligohydramnios. Int J Gynaecol Obstet Oct 1988; 27(2):185-92.
Elliot H. Phillipson, Robert J. Sokol: Oligohydramnios – Clinical association and predictive value for intrauterine growth retardation. Am J Obstet Gynecol 1983; 146:271.
Vaid S; Khandelwal S; Mishra A: polyhydramnios – A clinical, radiological and ultrasonic study of 100 cases in relation to fetal outcome. J Obstet Gynecol India; 37(6):807-11
Biggio JR Jr, Wenstrom KD, Dubard MB, Cliver SP. Hydramnios prediction of adverse perinatal outcome. Obstet Gynecol1999; 94: 773–777.
Hill LM, Breckle Robert, Marion Thomas, Joanne fries. Polyhydramnios: Ultrasonically detected prevalence and neonatal outcome. Obstet Gynecol 1987; 69(1): 21-25.
Guin G, Punekar S, Lele A, Khare S. A prospective clinical study of fetomaternal outcome in pregnancies with abnormal liquor volume. J Obstet Gynaecol India. 2011;61:652-5.
Nazlima N, Fatima B. Oligohydramnios at third trimester and perinatal outcome. Bangladesh journal of medical science vol11.no.01 January 2012.
Bangal VB, Giri PA, Sai BM. Incidence of oligohydramnios during pregnancy and its effects on maternal and perinatal outcome. Journal of Pharmaceutical and Biomedical Sciences (JPBMS), 2011 Nov;12(5).
Everett FM, Thomas EN: Measurement of amniotic fluid volume-Accuracy of ultrasonography technique. Am J Obstet Gynecol 1992; 167:1533-7.
Zhang J, Troendle J, Meikle S, Klebanoff MA, Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG2004; 111:220–225.
Fawad A, Shamshad, Danish N. frequency, causes and outcome of Polyhydramnios; Gomal Journal of Medical Sciences July-December 2008, Vol. 6, No. 2
Shabnam MM, Syed S, Rizvi G. Polyhydramnios: Risk factors and outcome. Saudi Med J. 2008; 29:256–60.
Pri-Paz S ; Khalek N ; Fuchs KM ; Simpson LL. Maximal amniotic fluid index as a prognostic factor in pregnancies complicated by polyhydramnios. Ultrasound Obstet Gynecol. 2012; 39(6):648-53
Tashfeen K, Hamdi IM. Polyhydramnios as a predictor of adverse pregnancy outcomes. Sultan Qaboos Univ Med J. 2013 Feb;13(1):57-62. doi: 10.12816/0003196.
Garmel SH, Chelmow D Sha et al. Oligohydramnios and appropriately grown fetus. Am J Perinatology 1997;14:359-63.
Casey BM, McIntire DD, Bloom SL, et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks’ gestation. Am J Obstet Gynecol 2000; 182:909–912.
Chauhan SP, Sanderson M, Hendrix NW et al. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: Ameta-analysis. Am J Obstet Gynecol 1999; 181: 1473-78.
Magann EF Kinsella JM, Chauhan SP McNamanra MF, Gehring BW and Morison JC. Does an amniotic fluid index of <5 necessitate delivery in high risk pregnancies? A case control study. Am J Obstet Gynecol 1999; 181: 1473-8.
Shipp TD, Bromley B, Pauker S, et al: Outcome of singleton pregnancies with severe oligohydramnios in the second and third trimesters. Ultrasound obstet gynecol 1996;7:108-113.
Parveen S, Haleemi S, Khattak ST. Correlation of increasing maternal gravidity with severity of polyhydramnios. J Postgrad Med Inst 2013; 27(2):184-7.
Many A, Hill LM, Lazebnik N, Martin JG. The association between polyhydramnios and preterm delivery. Obstet Gynecol. 1995 Sep;86(3):389-91. doi: 10.1016/0029-7844(95)00179-U.
Raj Sriya, Sunil Singhal, Monu Rajan et al, “Perinatal outcome in patients with amnioic fluid index < 5cm”. J obst Gynaecol Ind, 2001; 51(5): 98-100.
Mercer LJ, Brown LG, Petres RE, Messer RH. A survey of pregnancies complicated by decreased amniotic fluid. Am J Obstet Gynecol. 1984 Jun 1;149(3):355-61. doi: 10.1016/0002-9378(84)90237-0.
Sarno AP Jr, Ahn MO, Brar HS et al. Intrapartum Doppler velocimetry, amniotic fluid volume and fetal heart rate as prediction of subsequent fetal distress. Am J Obstet Gynecol 1989; 161: 1508-14.
Grubb DK, Paul RH,” amniotic fluid index and prolonged antepartum fetal heart rate decelerations” obstet Gynecol 92; 79: 558-60.
Baron C, Morgan M, Garite T. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome 1995;173:167-74.
K Blanas, M Theodora, N Papantoniou, MSyndos- Borderline oligohydramnios in singleton pregnancies with intact fetal membranes in the third trimester: obstetric management and perinatal outcome Arch Dis Child Fetal Neonatal Ed 2010;95:Suppl 1 Fa31.
Magann EF, Chauhan SP, Kinsella MJ, McNamara MF, Whitworth NS, Morrison JC. Antenatal testing among 1001 patients at high risk: the role of ultrasonographic estimate of amniotic fluid volume. Am J Obstet Gynecol. 1999 Jun;180(6 Pt 1):1330-6.
Crowley P, O’Herlihy C, Boylan P. The value of ultrasound measurement of amniotic fluid volume in the management of prolonged pregnancies. Br J Obstet Gynaecol. 1984;91:444–448.
Kumar P, Iyer S, Ramkumar V. “Amniotic fluid index – A new ultrasound assessment of amniotic fluid” J Obstet and Gynaecol of India 1991; 41(1): 10-12.
Rutherford SE, Phelan JP, Smith CV, Jacobs N. The four quadrant assessment of amniotic fluid volume: an adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987 Sep;70(3 Pt 1):353-6. PMID: 3306497.
Chen KC, Liou JD, Hung TH, Kuo DM, Hsu JJ, Hsieh CC, et al. Perinatal outcomes of polyhydramnios without associated congenital fetal anomalies after the gestational age of 20 weeks. Chang Gung Med J 2005; 28:222-8.
Martinez-Frias ML, Bermejo E , Rodrigues – Pinilla E, et al. Maternal and fetal factors related to abnormal amniotic fluid. J Perinatol 1999; 19:514.
Akhtar S, Mustafa N, Nazir S. Fetal Outcome In Singleton Pregnancies Complicated With Polyhydramnios From 28 To 36 Weeks. Pafmj [Internet]. 2011 Sep. 30
Mazor M, Ghezzi F, Maymon E, Shoham-Vardi I, Vardi H, Hershkowitz R, Leiberman JR. Polyhydramnios is an independent risk factor for perinatal mortality and intrapartum morbidity in preterm delivery. Eur J Obstet Gynecol Reprod Biol. 1996 Dec;70(1):41-7. doi: 10.1016/s0301-2115(96)02551-1. PMID: 9031919.
Rainford M, Adair R, Scialli AR, Ghidini A, Spongy CY. Amniotic fluid index in the uncomplicated term pregnancy. Prediction of outcome. J Reprod Med 2001;46:589-92.
Conway DL, Adkins WB, Schroeder B, Langer O. Isolated oligohydramnios in the term pregnancy. Is it a clinical entity? J Mat Foetal Med 1998; 7: 197-200.
Rossi AC, Prefumo F. Per inatal outcomes of isolated oligohydramnios at term and post-term pregnancy: a systematic review of literature with metaanalysis. Eur J Obstet Gynecol Reprod Biol. 2013 Apr 2.:301-2115(13)00139-5.
Bundgaard A, Andersen BR, Rode L, Lebech M, Tabor A. “Prevalence of polyhydramnios at a Danish hospital--a population-based study”.Acta Obstet Gynecol Scand. 2007;86(12):1427-31.
Golan A, Lin G, Evron S, Arieli S, Niv D, David MP. Oligohydramnios: maternal complications and fetal outcome in 145 cases. Gynecol Obstet Invest. 1994;37(2):91-5. doi: 10.1159/000292532. PMID: 8150377.
Stoll CG, Alembik Y, Dott B. Study of 156 cases of polyhydramnios and congenital malformations in a series of 118,265 consecutive births. Am J Obstet Gynecol. 1991 Sep;165(3):586-90. doi: 10.1016/0002-9378(91)90290-8.
Desmedt EJ, Henry OA, Beischer NA. Polyhydramnios and associated maternal and fetal complications in singleton pregnancies. Br J Obstet Gynaecol 1990; 97:1115-22.