Optimising management of oligohydramnios
Meetanpreet, Ripan Bala, Preet Kamal, Madhu Nagpal
Objectives: This study is carried out to observe the feto-maternal outcome with optimal management of oligohydramnios after 28 weeks of gestation. Methodology: The present study was conducted on 50 pregnant women with oligohydramnios at admission confirmed on ultrasound by amniotic fluid index (AFI) after 28 weeks of gestation. Bed rest, daily foetal movement count, regular nonstress test (NST), weekly or as indicated doppler, high protein infusions, hydration and appropriate diet was given. Outcome in the form of mode of delivery, APGAR score of neonate and NICU stay was studied. Results: In the presence of oligohydramnios without any opportunity to do therapeutic intervention, 90.9% subjects underwent caesarean section. In the presence of anhydramnios, 75% underwent caesarean section. Out of these, half of the babies were still born or died during NICU stay in spite of rigorous management. Intervention and optimization could be done in 46 women with resultant improved AFI in 35 cases. Out of the improved AFI cases with optimization 31.5% underwent caesarean section and 68.6% delivered normally. Only 8.6% needed short NICU stay. In the presence of persistent oligohydramnios, calcific changes and degenerations were seen in 63.6% of placentae on histopathology examination. In cases where liquor became adequate, placental changes were seen in 8.6% only. Conclusion: Outcome of oligohydramnios pregnancy can be altered by vigorous management and antenatal supervision leading to decreased NICU admissions with better perinatal outcome.