Perinatal outcome of oligohydramnios in academic hospitals in a low resource setting

Hale Teka, Hagos Gidey, Tesfay G. Gebrehiwot, Awol Yemane, Hiluf Ebuy Abraha, Mohamedawel M. Ebrahim, Ermias Abate, Abida Hasan, Mebrihit Gebremeskel, Ephrem Berhe, Sumeya Ahmed, Yibrah B. Zelelow

Abstract

Oligohydramnios has been a topical issue in obstetrics. The prevalence of oligohydramnios ranges from 1 to 5%. Conflicting data exists concerning its effects on adverse perinatal outcome. This study aims to assess perinatal outcomes of oligohydramnios at the Mekelle Public Hospitals from April 1, 2018 – March 31, 2019. This was a cross-sectional study and a total population purposive sampling method was employed to collect data prospectively. During the study period, there were a total of 10,451 deliveries in both hospitals. Oligohydramnios complicated 332 pregnancies (3.2%, 95%CI: 2.9%, 3.5%) across all gestations and 273 pregnancies (2.6%, 95% CI: 2.3%, 2.9%) at term. The composite adverse perinatal outcome rate was 29.7% (95% CI, 24.5, 35.4). Primigravidity and presenting at post-term gestation were associated with adverse perinatal outcome. Nearly 70% of mothers gave birth via Cesarean delivery. Oligohydramnios was found to be associated with a significant increase in adverse newborn and maternal outcomes in the study setting. Although a significant proportion of mothers underwent Cesarean delivery for a perceived increased complications associated with vaginal delivery in this population of patients, Cesarean delivery was found to not improve perinatal outcome. Primigravids and postdated pregnancies must receive increased surveillance to detect oligohydramnios early and to institute appropriate and timely interventions. Indications for Cesarean delivery in patients complicated by oligohydramnios must be carefully examined to balance the benefit on the perinatal outcome on the one hand and to avoid unnecessary major surgery with potential fatal maternal complications on the other. (Afr J Reprod Health 2023; 27 [4]: 54-64)

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References

Rizvi SA. Study of Oligohydramnios At Term on Maternal

and Fetal Outcome. Int J Adv Res 2017; 5[10]:652–

https://aimc.edu.pk/wpcontent/uploads/2019/11/Vol-15-Issue-04.pdf

Jagatia K, Singh N and Patel S. Maternal and fetal outcome

in oligohydramnios- Study of 100 cases. Int J Med

Sci Public Heal 2013; 2[3]:724.

ttp://dx.doi.org/10.18203/2320-

ijrcog20180864

Shylla MHH. Pregnancy outcome in oligohydramnios. Int J

Curr Res 2015; 7[6]:16906–8.

http://dx.doi.org/10.18203/2320-

ijrcog20184515

Rosati PA comparison between amniotic fluid index and the

single deepest vertical pocket technique in predicting

adverse outcome in prolonged pregnancy. J Prenat

Med, 9 April 2013; 12–5.

11138/jpm/2015.9.1.012

Chate P, Khatri M and Hariharan C. Pregnancy outcome

after diagnosis of oligohydramnios at term. Int J

Reprod Contraception, Obstet Gynecol 2013;

[1]:23–6. 10.5455/2320-1770.ijrcog20130204

Lim KI, Butt K, Naud K and Smithies M. Amniotic Fluid:

Technical Update on Physiology and Measurement.

J Obstet Gynaecol Canada 2017; 39[1]:52–8.

1016/j.jogc.2016.09.012

Agwu EJ, Ugwu AC, Shem SL and Abba M. Relationship of

amniotic fluid index [AFI] in third trimester with

fetal weight and gender in a southeast Nigerian

population. Acta Radiol Open 2016;

[8]:205846011665265.

https://doi.org/10.1177/2058460116652651

Goldstein RB and Filly RA. Sonographic Estimation of

Amniotic Fluid. 1988; 363–9.

7863/jum.1988.7.7.363

Giri A. Perinatal outcome of term pregnancies with

borderline amniotic fl uid index at Nepal Medical

College and Teaching Hospital. Orig Artic Nepal

Med Coll J 2015; 17[12]:63–6.

https://pdfs.semanticscholar.org/020c/a9f72ebf1c97

c1951804091450a0867f85f.pdf

Magann EF, Chauhan SP, Doherty DA, Magann MI and

Morrison JC. The evidence for abandoning the

amniotic fluid index in favor of the single deepest

pocket. Am J Perinatol 2007; 24[9]:549–55.

1055/s-2007-986689

Teka et al. Perinatal outcome of oligohydramnios in academic hospitals

African Journal of Reproductive Health April 2023; 27 (4): 63

Biradar K and Shamanewadi A. Maternal and perinatal

outcome in oligohydramnios: study from a tertiary

care hospital, Bangalore, Karnataka, India. Int J

Reprod Contraception, Obstet Gynecol 2016;

[7]:2291–4. http://dx.doi.org/10.18203/2320-

ijrcog20162113

Pradesh M, Pradesh M and Pradesh M. Maternal and fetal

factors in pregnancy with oligohydramnios and

maternal and perinatal outcome, Med Sci J 2017;

[4]:13–6.

http://www.medicalsciencejournal.com/download/3

/3-3-23-378.pdf

Hamed A and Mohamed G. Pregnancy Outcome among

Patients with Oligohydramnios and Suggested Plan

of Action. IOSR J Nurs Heal Sci 2015; 4[5]:2320–

10.9790/1959-04536575

Uche E, Chijioke O, Chukwuemeka O, Robinson O and

Anderson U. Incidence of Oligohydramnios –

Amniotic Fluid Index [AFI] Versus Single Deepest

Pocket [SDP]. Asian J Med Heal 2018; 10[3]:1–8.

https://doi.org/10.9734/AJMAH/2018/28069

Elsandabesee D, Majumdar S and Sinha S. Obstetricians’

attitudes towards “isolated” oligohydramnios at

term. J Obstet Gynaecol [Lahore] 2007; 27[6]:574

https://doi.org/10.7439/ijbar.v9i5.4787

Minwuye T, Mengistu Z and Handebo S. Oligohydramnios

at term pregnancy and associated factors among

pregnant women admitted from June 1 , 2015 to June

, 2017 at Gondar University Specialized Hospital

, Northwest Ethiopia. Acta Sci Women’s Heal 2019;

1[2]:2–7.

https://actascientific.com/ASWH/pdf/ASWH-01-

pdf

Nazlima N and Fatima B. Oligohydramnios at third

trimester and perinatal outcome. Bangladesh J Med

Sci. 2012;11[1]:33–6.

https://doi.org/10.3329/bjms.v11i1.9820

Elliott JP, Gilpin B, Strong Jr TH and Finberg HJ. Chronic

abruption-oligohydramnios sequence. J Reprod Med

; 43[5]:418–22.

https://pubmed.ncbi.nlm.nih.gov/9610464/

Binello N, Brunetti E, Cattaneo F, Lissandrin R and

Malfitano A. Oligohydramnios in a pregnant

Pakistani woman with Plasmodium vivax malaria.

Malar J. 2014; 13[1]:2–5.

https://doi.org/10.1186/1475-2875-13-156

Vidyadhar B. Bangal and Purushottam A Giri BMS.

Incidence of oligohydramnios during pregnancy and

its effects on maternal and perinatal outcome. Pharm

J O F Sci Biomed 2011; 12[12]:12–5.

McCurdy CM Jr and Seeds JW. Oligohydramnios:

problems and treatment. Semin Perinatol 1993;

(3):183-196.

https://pubmed.ncbi.nlm.nih.gov/7690990/

Adebayo1 FO, Onafowokan O, Babalola A, Adewole N and

Nggada B. Comparison of Amniotic Fluid Index at

different gestational age in normal pregnancy. J

Women's Health Care 2017; 10.4172/2167-

1000377

Bhat S and Kulkarni V. Study of effect of oligohydramnios

on maternal and fetal outcome. Int J Med and Dent

Sci 2015; 4(1):582-588.

OA Ogunlaja, AA Fawole, AS, Adenira AS, Adeniran KT,

Adesina HJ, Akande IP, Ogunlaja OM, Bojuwoye

and A. Idowu. Ultrasound estimation of amniotic

fluid and perinatal outcome in normotensive and preeclamptics at term in a Nigerian tertiary hospital. J

Med Biomed Sci. 2015; 4[3]:1–8.

http://dx.doi.org/10.4314/jmbs.v4i3.1

Rabie N, Magann E, Steelman S and Ounpraseuth S.

Oligohydramnios in complicated and uncomplicated

pregnancy: a systematic review and meta-analysis.

Ultrasound Obstet Gynecol 2017; 49[4]:442–9.

1002/uog.15929

Nazlima N and Fatima B. Oligohydramnios at third

trimester and perinatal outcome. Bangladesh J Med

Sci 2012; 11[1]:33–6.

https://doi.org/10.3329/bjms.v11i1.9820

Bansal D and Deodhar PA Clinical Study of Maternal and

Perinatal Outcome in Oligohydramnios. J Res Med

Dent Sci 2015; 3[4]:312.

http://dx.doi.org/10.18203/2320-

ijrcog20162113

Mushtaq E, Parveen S, Shaheen F, Jan S, Abdullah A and

Lone YA. Perinatal Outcome in Patients with

Isolated Oligohydramnios at Term: A Prospective

Study. J Pregnancy Child Heal 2017; 04[03]:1–5.

4172/2376-127X.1000332

Madhavi K, Rao Pc and Professor A. Clinical Study of

Oligohydramnios, Mode of Delivery and Perinatal

Outcome. IOSR J Dent Med Sci. 2015;14[4]:2279–

10.3126/jpahs.v5i2.23995

Chamberlain PF, Manning FA, Morrison I, Harman CR and

Lange IR. Ultrasound evaluation of amniotic fluid

volume. Am J Obstet Gynecol. 150[3]:245–9.

1016/s0002-9378(84)90359-4

Crowley P, O’Herlihy C and Boylan P. The value of

ultrasound measurement of amniotic fluid volume in

the management of prolonged pregnancies. Br J

Obstet Gynaecol 1984; 91[5]:444–8.

1111/j.1471-0528.1984.tb04781.x

Rutherford SE, Phelan JP SC and Jacobs N. The fourquadrant assessment of amniotic fluid volume: an

adjunct to antepartum fetal heart rate testing. Obstet

Gynecol. 1987; 70[3]:353–6.

https://pubmed.ncbi.nlm.nih.gov/3306497/

Winn HN, Chen M, Amon E, Leet TL, Shumway JB and

Mostello D. Neonatal pulmonary hypoplasia and

perinatal mortality in patients with midtrimester

rupture of amniotic membranes--a critical analysis.

Am J Obs Gynecol, 2000; 182[6]:1638–44.

1067/mob.2000.107435

Shenker L, Reed KL, Anderson CF and Borjon NA.

Significance of oligohydramnios complicating

pregnancy. Am J Obstet Gynecol 1991; 164[6 PART

:1597–600. 10.1016/0002-9378(91)91442-y

Sherer DM. A review of amniotic fluid dynamics and the

enigma of isolated oligohydramnios. American

Journal of Perinatology 2002; Vol. 19, p. 253–66.

1055/s-2002-33084

Ashwal E, Hiersch L, Melamed N, Aviram A, Wiznitzer A

and Yogev Y. The association between isolated

Teka et al. Perinatal outcome of oligohydramnios in academic hospitals

African Journal of Reproductive Health April 2023; 27 (4): 64

oligohydramnios at term and pregnancy outcome.

Arch Gynecol Obstet 2014; 290(5):875-

10.1007/s00404-014-3292-7

Twesigomwe G, Migisha R, Agaba DC, Owaraganise A,

Aheisibwe H, Tibaijuka L, Abesiga L, Ngonzi J and

Tornes YF. Prevalence and associated factors of

oligohydramnios in pregnancies beyond 36 weeks of

gestation at a tertiary hospital in southwestern

Uganda. BMC Pregnancy Childbirth. 2022 Aug

;22(1):610. doi: 10.1186/s12884-022-04939-x.

PMID: 35918640.

Ghimire S, Ghimire A, Chapagain S and Paudel S.

Pregnancy outcome in cases of oligohydramnios

after 28 weeks of gestation. Int J Adv Med Health

Res 2016; 3:68-72.

https://www.ijamhrjournal.org/text.asp?2016/3/2/68

/195939

Sharma P, Gandotra N, Rana D, Rasheed S and Sharma AK.

Correlation of admission labour admission test in low

risk pregnancies with pregnancy outcome. Int J

Reprod Contracept Obstet Gynecol 2019; 8(5):1880-

http://dx.doi.org/10.18203/2320-

ijrcog20191936

Anna Locatelli, Patrizia Vergani, Laura Toso, Maria

Verderio, John C. Pezzullo and Alessandro Ghidini.

Perinatal outcome associated with oligohydramnios

in uncomplicated term pregnancies. Arch Gynecol

Obstet, 2004;269[2]:130–3. DOI: 10.1007/s00404-

-0525-6

Figueroa L, McClure EM, Swanson J, Nathan R, Garces

AL, Moore JL, Krebs NF, Hambidge KM,

Bauserman M, Lokangaka A, Tshefu A, Mirza W,

Saleem S, Naqvi F, Carlo WA, Chomba E, Liechty

EA, Esamai F, Swanson D, Bose CL and Goldenberg

RL. Oligohydramnios: a prospective study of fetal,

neonatal and maternal outcomes in low-middle

income countries. Reprod Health. 2020 Jan

;17(1):19. doi: 10.1186/s12978-020-0854-y.

PMID: 32000798; PMCID: PMC6993413.

Majoko FM, Nyström L, Munjanja SP, Mason E, and

Lindmark G. Relation of parity to pregnancy

outcome in a rural community in Zimbabwe. Afr J

Reprod Health. 2004 Dec;8(3):198-206. PMID:

McLaren R Jr, London V, Stein JL and Minkoff H. Adverse

outcomes in early term versus full-term deliveries

among higher-order cesarean births. J Matern Fetal

Neonatal Med. 2021 Feb 8:1-6. doi:

1080/14767058.2021.1882985. Epub ahead of

print. PMID: 33550869.

Caughey AB. Post-Term Pregnancy. Dewhurst’s Textb

Obstet Gynaecol Eighth Ed. 2012; 4[3]:269–86.

https://doi.org/10.1002/9781119979449.ch23.

Hou L, Wang X, Hellerstein S, Zou L, Ruan Y and Zhang

W. Delivery mode and perinatal outcomes after

diagnosis of oligohydramnios at term in China. J

Matern Fetal Neonatal Med. 2020 Jul;33(14):2408-

doi: 10.1080/14767058.2018.1553944. Epub

Dec 13. PMID: 30486718.

Zilberman SN, Pekar-Zlotin M, Kugler N, Accart Z,

Nimrodi M, Melcer Y, Cuckle H and Maymon R.

Oligohydramnios: how severe is severe? J Matern

Fetal Neonatal Med. 2021 Feb 28:1-7. doi:

1080/14767058.2021.1892068. Epub ahead of

print. PMID: 33645394

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