Neonatal outcomes are similar between patients with resolved and those with persistent oligohydramnios.

BACKGROUND

Oligohydramnios (defined as amniotic fluid volume < 5 cm or deepest vertical pocket < 2 cm) is regarded as an ominous finding on prenatal ultrasound. Amniotic fluid, however, is not static, and to date, there have been no studies comparing perinatal outcomes in patients who are diagnosed with oligohydramnios which resolves and those who have persistent oligohydramnios.

STUDY DESIGN

This is a secondary analysis of a NIH-funded retrospective cohort study of singleton gestations delivered at a tertiary-care hospital between 2002 and 2013 with mild hypertensive disorders, and/or fetal growth restriction. Maternal characteristics, delivery and neonatal information were abstracted by trained research nurses. Patients with a diagnosis of oligohydramnios were identified, and those with resolved versus persistent oligohydramnios at the time of delivery were compared. The primary outcome was a composite of neonatal resuscitation at delivery: administration of oxygen, bag-mask ventilation, continuous positive airway pressure, intubation, chest compression, or cardiac medication administration. Secondary outcomes included fetal growth restriction, timing and mode of delivery.

RESULTS

Of 527 women meeting study criteria, 42 had oligohydramnios that resolved prior to delivery, while 485 had persistent oligohydramnios. There were no significant differences in patient demographics between groups. The gestational age at diagnosis was significantly lower for patients with resolved versus persistent oligohydramnios (median 33.0 (interquartile range (IQR) 29.1-35.9) vs. 38.0 (IQR 36.4-39.3); p <0.001). There was not a substantial difference in rate of neonatal resuscitation (41% vs. 32%, p=0.31). Patients with resolved oligohydramnios were more likely to have developed FGR than those with persistent oligohydramnios (55% vs. 36%; p<0.02). There were no significant differences for gestational age at delivery, birth weight, or NICU admission.

CONCLUSIONS

Patients whose oligohydramnios resolved were diagnosed earlier, yet had similar rates of neonatal resuscitation but higher rates of FGR than those who had persistent oligohydramnios.

Informations de copyright

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Déclaration de conflit d'intérêts

The authors declare that they have no conflict of interest.