Pregnancy Outcome in Amniotic Fluid Index 5 cm or less in Term Pregnancy at Tertiary Level Teaching Hospital, Birgunj, Nepal

Abstract

Introduction Oligohydramnios has increased incidence of fetal distress, meconium-stained liquor, prolonged labor, low Apgar score, low birth weight, admission to NICU, cord compression, birth asphyxia, and operative interference. The objective of the study was to determine the pregnancy outcome in amniotic fluid index 5 cm or less in term pregnancy. Materials and Methods This was a hospital-based cross-sectional study conducted at National Medical College & Teaching Hospital from June 2017 to May 2018. A total of 72 obstetric cases with AFI ≤ 5 cm and 72 cases with AFI > 5 cm with meeting the inclusion criteria were enrolled in the study after taking consent. Results Incidence of oligohydramnios was 2.2% out of 4318 deliveries and term oligohydramnios was 1.66%. AFI ≤ 5 cm was associated with increased induction of labor (p < 0.001), caesarean section (p = 0.01)), meconium stained liquor (p = 0.106), Apgar score <7 at 5 minutes (p = 0.001), NICU admission (p = 0.003), neonatal deaths (p = 0.053) were comparable with AFI >5 cm. Conclusion Amniotic fluid index ≤ 5 cm at term is an indicator of poor perinatal outcome. Women with AFI ≤ 5 cm can expect a good outcome if they have regular ANC visits and intrapartum monitoring than the AFI > 5 cm.

Impact of Low Amniotic Fluid Index at Term Pregnancy on Perinatal Outcome

“…Relationship regarding NICU admission and amniotic fluid volume is statistically not significant (P=0.091) for this study. However, Shrestha et al [9] found that NICU admission for low AFI group was 38.88% and 16.66% for normal AFI group with significant statistical difference (P= 0.003). Similarly, Chauhan et al [15] observed significant difference regarding need for admission to neonatal intensive care unit 8.33% for low AFI group and 1.67% for normal AFI group.…”

“…01 (one) out of 100 patients from Group-A (AFI≤5) was stillbirth resulting 04% total death from low AFI group, which is not statistically significant. Shrestha et al [9] reported that 8.33% perinatal death in low AFI and 1.38% death in normal AFI patient where P value was non-significant (P value 0.053). Found that short term perinatal morbidities (p= 0.59) were shown no statistical difference between both group that align with the findings of this study [21] .…”

“…This is comparable to the study conducted by Shrestha et ~ 113 ~ al. [9] where age were 21 to 25 years and mean was 24.36±3.98 years. Another study conducted by Jagatia et al [10] where 67% patients fell in the range of 20 to 25 years.…”