Publication:

Antenatal and intrapartum fetal surveillance in patients with oligohydramnios in a tertiary hospital

Background The evaluation of amniotic fluid is an important index for the early detection and follow-up of fetal pathology during pregnancy. The objective of the study is to know the nature of Doppler in study (AFI ≤5) and control group (AFI ≥5) and the relationship of AFI with nature of CTG in both groups.

Methods 50 singleton live pregnancies between 34-40 weeks gestation with well-established dates with AFI 5 or less for the study group. 50 singleton live pregnancies between 34-40 weeks gestation with well-established dates with AFI more than 5 were selected for the control group. Ultrasound examination was done for all women whenever they visited the hospital at/after 34 weeks of gestation. AFI was obtained sonographically. Antenatal fetal surveillance using Doppler, NST tracings and intrapartum fetal surveillance using CTG was done in all patients.

Results 62 (62%) patients in the study group (AFI ≤5) were found to have deranged Doppler values in contrast to just 30 (30%) patients in the control group (AFI >5). An inverse relationship was found between the amount of amniotic fluid and the number of patients having abnormal Doppler in the study group. Suspicious or pathological CTG was more common in study group (67%) than the control group (22%).

Conclusions Oligohydramnios has the most consistent association with IUGR. Severe oligohydramnios have more probabilities of having abnormal Doppler due to uteroplacental insufficiency. During intrapartum fetal assessment, suspicious or pathological CTG was more common in patients with oligohydramnios due fetal hypoxia during uterine contractions, cord compression and head compression. Hence patients with oligohydramnios should be put on regular antenatal surveillance to reduce the fetal complications and to improve the labour outcome.