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Korean Journal of Obstetrics & Gynecology 2007;50(12):1685-1694.
Published online December 1, 2007.
The effect of oligohydramnios on the adverse perinatal outcome and clinical characteristics in uncomplicated term pregnancies.
Hyun Young Ahn, Yeon Hee Kim, Ari Kim, Mi Won Seo, Ok Kyung Kim, Guisera Lee, Sa Jin Kim, Jong Chul Shin
Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea. jcshin@catholic.ac.kr
Abstract
OBJECTIVE
The purpose of this study was to assess the effect of the isolated oligohydramnios on the perinatal outcome in uncomplicated term pregnancies. METHODS: We used data from Jan 2002 to Dec 2005 in all uncomplicated pregnancies between 37 and 41weeks and 6 days of gestation with a singleton fetus, underwent monitoring with serial determination of AFI. Oligohydramnios was defined by ultrasonographic determination of AFI < or =5 cm. Exclusion criteria were PROM, maternal medical complications and fetal anomalies detected by prenatal ultrasound. We investigated the mode of delivery, birth weight, birth weight <10th percentile, 1 and 5 min Apgar score, umbilical cord pH and base excess, and meconium stained amniotic fluid (MSAF). We also assessed the predictive value of obstetric factors associated with adverse perinatal outcome. We used statistics analysis by Chi-square test, independent-samples T test using SPSS 14.0 V. RESULTS: 2,491 patients met our inclusion criteria. Oligohydramnios was diagnosed in 8.63% (215/2,491). There was significantly difference in cesarean section for fetal distress between those with oligohydramnios vs. normal AFI (43.8% vs.4.1%). Patients with oligohydramnios had significantly lower SGA (15.3% vs. 5.7%), lower Apgar score at 1 min<7 (7.9% vs. 3.3%), and higher rate of MSAF (31.2% vs. 18.4%) than those with normal AFI. There were musculoskeletal abnormalities in 10/215 (4.6%) and urogenital abnomralites in 53/215 (24.6%). CONCLUSION: Isolated oligohydramnios in uncomplicated term pregnancies is associated with an increased adverse perinatal outcome. Nulliparity, advanced maternal age, MSAF, SGA, and lower BPP were significantly associated with the adverse perinatal outcomes.
Key Words: Oligohydramnios, Amniotic fluid index, Lower-risk pregnancy, Perinatal outcome


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