Abstract
Objective
The management of isolated oligohydramnios (IO) in post/term pregnancies is controversial.
The aim of this paper was to review outcomes of term and post-term pregnancies with
IO versus normal amniotic fluid (AF) at labor assessment.
Study design
A search in PubMed, Medline, EMBASE, and reference lists was performed. Inclusion
criteria for articles selection: singleton pregnancy, definition of olgohydramnios
as AFI <5 cm, AF assessment at 37–42 gestational weeks. Exclusion criteria: fetal malformations,
preterm delivery, premature rupture of membranes, intrauterine growth restriction.
Perinatal outcomes were: obstetric intervention for non-reassuring fetal heart rate
(cesarean section, operative delivery), meconium-stained AF, Apgar score <7 at 5 min, umbilical artery pH <7.0, small for gestational age infants (SGA), admission
to neonatal intensive care unit (NICU) and perinatal death. Meta-analysis compared
outcomes of pregnancies with IO vs normal AF. Inter-studies heterogeneity was tested.
Pooled odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Differences
between the two groups were considered significant if 95% CI did not encompass 1.
MOOSE guidelines were followed.
Results
Four articles provided 679 (17.2%) cases with IO and 3264 (82.8%) with normal AF.
Obstetric interventions occurred more frequently in the IO than normal AF group (IO:
89/679, 13% vs normal; AF: 166/3354, 5%; OR: 2.30; 95% CI: 1.00–5.29). Meta-analysis
did not show differences with regard to meconium, Apgar, pH, SGA, NICU and perinatal
death.
Conclusion
In term or post-term pregnancies, IO is associated with increased risk of obstetric
interventions but outcomes are similar to those of pregnancies with normal AF.
Keywords
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References
- Oligohydramnios: ultrasonically detected incidence and subsequent fetal outcome.American Journal of Obstetrics and Gynecology. 1983; 147: 407-410
- A survey of pregnancies complicated by decreased amniotic fluid.American Journal of Obstetrics and Gynecology. 1984; 149: 355-361
- Oligohydramnios in uncomplicated pregnancies beyond 40 completed weeks. A prospective, randomised, pilot study on maternal and neonatal outcomes.Fetal Diagnosis and Therapy. 2005; 20: 182-185
- Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis.American Journal of Obstetrics and Gynecology. 1999; 181: 1473-1478
- Measuring inconsistency in meta-analyses.BMJ. 2003; 327: 557-560
- Induction of labor and perinatal outcome: the impact of the amniotic fluid index.European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2006; 129: 124-127
- Perinatal outcome associated with oligohydramnios in uncomplicated term pregnancies.Archives of Gynecology and Obstetrics. 2004; 269: 130-133
- Isolated oligohydramnios in term pregnancy as an indication for induction of labor.Journal of Maternal-Fetal and Neonatal Medicine. 2007; 20: 221-224
- Amniotic fluid index in the uncomplicated term pregnancy. Prediction of outcome.The Journal of Reproductive Medicine. 2001; 46: 589-592
- Reducing stillbirths: screening and monitoring during pregnancy and labour.BMC Pregnancy Childbirth. 2009; 9: S5
- Obstetricians’ attitudes towards ‘isolated’ oligohydramnios at term.Journal of Obstetrics and Gynaecology. 2007; 27: 574-576
- Induction of labor in the nineties: conquering the unfavorable cervix.Obstetrics and Gynecology. 1997; 90: 235-239
- Is oligohydramnios in postterm pregnancy associated with redistribution of fetal blood flow?.American Journal of Obstetrics and Gynecology. 1995; 173: 519-522
- Amniotic fluid index and single deepest pocket: weak indicators of abnormal amniotic volumes.Obstetrics and Gynecology. 2000; 96: 737-740
Article info
Publication history
Published online: March 25, 2013
Accepted:
March 8,
2013
Received in revised form:
March 6,
2013
Received:
December 28,
2012
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
