Evaluation of Amniotic Fluid volume with Ultrasound at Term Pregnancy and its Correlation to Perinatal outcome


ABSTRACT: BACKGROUND: recognition of abnormal amniotic fluid volume before delivery may alert the clinician to situations of potentially high prenatal risk. pregnancies complicated by extremes of amniotic fluid volume also experiences increase maternal & neonatal morbidity. OBJECTIVE: To identify the incidence of fetal morbidity & mortality associated with abnormal liquor volume compared with those having normal liquor volume at term pregnancy.Study design: A prospective cohort study.Setting: The study was conducted at Al-Elwiya Maternity Teaching Hospital, during the period from Mar. 2011 to Apr. 2012.PATIENTS AND METHODS: Three hundred fifty one pregnant women at their term were collected for the study. The participants were classified according to the amniotic fluid volume into 3 groups: Group 1: (244) those with normal liquor volume (maximum vertical pocket 3-8 cm), Group 2: (63) those with oligohydramnios ( maximum vertical pocket <3cm), Group 3: (44) pregnants having polyhydramnios ( maximum vertical pocket > 8 cm). Multiple pregnancy, preterm, postterm pregnancy or those with ruptured fetal membranes had been excluded. The fetal outcome of the groups were analysed & data arranged in tables & subjected to statistical study.RESULTS: In oligohydramnios group, hypertensive disorders & IUGR were 17.4% & 9.52% respectively, while in polyhydramnios women with diabetes diseases were 22.7% versus1.64% in the control group. In oligohydramnios group, low birth weight , intrapartum complications & admission to NICU were more significant with incidence of 9.59%, 39.6%, 46% respectively versus 0.04%, 5.33%, 11.07% for control respectively. Fetal congenital anomalies, early neonatal complications , macrosomia, low Apgar score& early neonatal death were more in polyhydramnios group as follow: 18.18%, 29.25%, 15.9% , 18.18% & 9.09% respectively compared with the control which were 0.41%, 8.6%, 5.74% respectively & there were no recorded cases of low Apgar score or early neonatal complications in the control group. CONCLUSION: Largest vertical pocket less than 3cm at term is associated significantly with higher incidence of hypertensive disorders & IUGR. It was highly significant in predicting neonatal admission (NICU ) & intrapartum complications. While when the largest vertical pocket is more than 8cm, diabetes disease, fetal macrosomia, congenital anomalies, low Apgar score, early neonatal complications & neonatal death are more frequently seen.