Perinatal Outcomes Associated with Oligohydramnios in Full-Term Neonates

Kim, Kyung Mo; Lee, Jung Hyun; Chun, Chung Sik

Abstract

PURPOSE: The purpose of this study is to identify whether oligohydramnios in uncomplicated term pregnancies has an independent effect on perinatal outcome.
METHODS
From Jan 2001 to Dec 2005, all uncomplicated pregnancies between 37 and 41(+6)weeks were included. Perinatal outcome was compared between cases with amniotic fluid index (AFI) < or =5 (n=264) and with AFI >5 (n=3,117), which is determined by measuring the vertical diameter of amniotic fluid pockets in four quadrants; an AFI less than 5 suggests oligohydramnios. Exclusion criteria were premature rupture of membranes, maternal diabetes, pregnancy induced hypertension, clinical suspicion of fetal growth restriction and fetal anomalies. Outcome measures were birth weight, small for gestational age neonates, Apgar score <7, meconium stained amniotic fluid, meconium aspiration syndrome, hospital day, NICU admission, fetal distress and use of neonatal resuscitation.
RESULTS
An AFI < or =5 was reported in 7.7% of cases. No significant differences in gestational age at delivery, nulliparity and maternal age were found in both groups. An AFI < or =5 were associated with an increased risk of small for gestational age, low Apgar score, NICU admission and prolonged hospital day. The incidences of meconium stained amniotic fluid, fetal distress and neonatal resuscitation were significantly higher in the cases with AFI < or =5, whereas the association between AFI < or =5 and meconium aspiration syndrome was statistically insignificant.
CONCLUSION
In our study, oligohydramnios was a poor prognostic factor for perinatal outcome in uncomplicated full-term neonates. Therefore decreased amniotic fluid should warrant proper neonatal management as well as increased antepartum surveillance.