1Senior Resident, Dept. of Obstetrics and Gynecology, Pt B. D. Sharma,PGIMS Rohtak, Haryana 124514, India. 2Senior Resident, Dept. of Obstetrics and Gynecology, Hindu Rao Hospital And North Delhi Medical College, New Delhi, Delhi 110007, India. 3Senior Resident, Dept. of Obstetrics and Gynecology, Vardhman Mahavir Medical College & Safdarjung Hospital, Ansari Nagar, New Delhi, Delhi 110029, India. 4Senior Resident, Dept. of Obstetrics and Gynecology, Santokba Durlabhji Memorial Hospital, Jaipur,
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Background and Purpose: Over many decades, studies have been conducted in various parts of the world in an attempt to correlate the AFI with fetal and maternal outcome. Recent studies, however, have challenged the relationship between amniotic fluid volume and poor perinatal outcome, especially the relationship between oligohydramnios and poor outcome near term, but still a lot of questions remain unanswered. Through this study we plan to look in Indian scenario for maternal and fetal outcome to correlate the AFI. Method: The present study was conducted in Department of Obstetrics & Gynaecology, Batra Hospital & Medical Research Centre, and New Delhi from 1st November 2014 to 30th April 2016. A total number of 100 women were recruited in this study. The women were divided into two groups each of 50 i.e. Group I (Study group) had women with low amniotic fluid index (AFI 8) and Group II (Control group) had women with AFI (8.1cm -20cm). All subjects were evaluated on the basis of predesigned and pretested proforma with respect to history, clinical examination and ultrasonography. Results: Majority of the women i.e. 66% and 62% were less than 25 years of age in the study group and control group respectively. A vast majority of the women (40% and 48%) were primigravida. Labour had to be induced in 80% of the women in study group but only in 10% incontrol group and the difference was highly significant (p <0.001). The caesarean section rate was 52% in the study group as compared to 22% in the control group which was significant (p value= 0.0018). There was no statistical difference in the meconium staining of the liquor in the two groups. There was statistically significant difference (p <0.05) in the rate of fetal distress in the two groups (34% in group I and 12% in group II), thus indicating that oligohydroamnios is associated with high rate of intrapartum fetal heart rate abnormalities. 35% of the women with induced labour had fetal distress in study group and 20% of women with induced labour had fetal distress in control group (p= 0.50), Thus, induction of labour does not seem to be cause of increased rate of fetal distress. There was no neonatal death. Perinatal complication was found in only 10% of neonates in study group and 4% in control group and difference was not significant. Interpretation: The present study supports the association of low amniotic fluid index (<8cm) with higher rate of intrapartum fetal distressin Indian pregnant women. This study also supports the association of low amniotic fluid volume to higher rates of caesarean section but no association was found between amniotic fluid volume and incidence of meconium staining of liquor. The present study also didn’t suggest any association of poor Apgar score at 5 min and neonatal complications with low amniotic fluid volume.
Keywords:Maternal and Fetal Outcome; Singleton Pregnancies.
Corresponding Author : Deepti Dahiya, Senior Resident, Dept. of Obstetrics and Gynecology, Pt B. D. Sharma, PGIMS Rohtak, Haryana 124514, India.