BACKGROUND Oligohydramnios is defined as the amniotic fluid index < 5 cms measured through ultrasound techniques. It is becoming a major health care issue in the antenatal period. We wanted to identify and quantify the maternal and foetal outcome in patients with decreased liquor using amniotic fluid index. METHODS This study is a retrospective study done in the labour room of Sri Ramachandra Medical College, Porur, Chennai between January 2017 to March 2019. A total of 9600 deliveries were conducted during the study period of which clinically suspected cases in the second and third trimester were 106 in number. Various parameters like antenatal history, ultrasound parameters like gestational age, placental localisation, amniotic fluid volume, congenital anomalies of the foetus, APGAR score at 1 min and 5 mins and perinatal mortality were noted. RESULTS In the total of 9600 deliveries, 106 (1.1%) were having oligohydramnios. All women between 21-25 years (57.89%) of age had decreased amniotic fluid index. Anaemia and PIH were the most common factors associated with oligohydramnios. Caesarean section was 50% and vaginal delivery was 36.8% in women with low amniotic fluid index. Variable heart rate deceleration (10.52%) was seen in babies born to women with decreased amniotic fluid index. Higher incidence of low Apgar score <7 at 1 min and 5 min and meconium stained liquor was observed among cases with very low AFI [6 (15.2%) and 5 (13.15%) respectively] and low AFI (22.2%) respectively. Higher incidence of IUGR was observed in very low AFI [16 (42.10%)]. Decreased amniotic fluid index is associated with increased perinatal morbidity and mortality and still births. CONCLUSIONS Foetal distress, meconium passage and low APGAR score at 1 min and 5 mins were associated with low amniotic fluid index and these patients required careful monitoring and follow up during antenatal and intranatal period.
BACKGROUND Meconium stained Amniotic fluid is associated with higher rate of caesarean delivery, increased need for neonatal resuscitation and meconium aspiration syndrome. The risk factors for meconium stained amniotic fluid are both maternal and foetal. The maternal factors are hypertension, gestational diabetes mellitus, maternal chronic respiratory or cardiovascular diseases, post term pregnancy, preeclampsia and eclampsia. The foetal factors include oligohydramnios, intrauterine growth restriction and poor biophysical profile. We wanted to determine the maternal and foetal outcome and mode of delivery in patients with meconium stained liquor during labour. METHODS This retrospective study was conducted from January 2017 to March 2019 on patients admitted to labour ward in Sri Ramachandra Medical University. Out of 9600 deliveries over the period of 2 years, 110 patients who met the inclusion criteria were enrolled in the study. RESULTS The results of maternal and foetal outcome and mode of delivery were analyzed statistically. Increasing grade of meconium stained liquor is associated with increased adverse outcome. Association of meconium stained liquor with abnormal cardiotocography is associated with poor outcome, increased caesarean section rate and increased neonatal complications. CONCLUSIONS Meconium stained liquor alone is not associated with an adverse neonatal outcome. 90% of babies remained asymptomatic in spite of meconium stained liquor and required only routine care. Increasing grade of meconium stained liquor is associated with adverse maternal and foetal outcome. Association of meconium stained liquor with abnormal cardiotocography is associated with poor outcome, increased cesarean section rate, increased neonatal complications.
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