Pregnancy outcome in cases of oligohydramnios after 28 weeks of gestation

Background: Amniotic fluid volume may reflect a problem with fluid production or circulation due to fetal, placental, and maternal pathology. Some authors have shown that amniotic fluid index (AFI) is a poor predictor of adverse pregnancy outcome, but others have not confirmed the association of adverse perinatal outcome with oligohydramnios. Objectives: To compare the mode of delivery and neonatal outcome in patients with oligohydramnios (AFI <5 cm) with no-oligohydramnios group (AFI 5–25 cm). Methods: A prospective hospital-based observational study was carried out in the Department of Gynecology and Obstetrics, Nobel Medical College, Biratnagar; a referral center in eastern Nepal. In 1 year duration, 100 patients who completed 28 weeks of gestation with AFI <5 cm were included in the oligohydramnios group and 100 patients having AFI 5–25 cm were enrolled to the no-oligohydramnios group. Results: A total of 8096 women were admitted during the study from March 1, 2015 to February 28, 2016. Among them, 100 patients meeting the inclusion criteria were taken into oligohydramnios group. AFI <5 cm was more in primipara 58 (58%) and 43 (43%) were postdated pregnancy. Increased operative delivery [85 (85%)] was found in oligohydramnios group, whereas it was 30 (30%) in the no-oligohydramnios group. The neonatal outcome which was assessed by Apgar score (P < 0.003) and Neonatal Intensive Care Unit admission (P < 0.026) were significantly different between the two groups. Conclusion: Isolated oligohydramnios in the absence of any other maternal or fetal complicating factor is associated with need for operative intervention and adversely affects the fetal outcome, when compared to no-oligohydramnios group with normal AFI.