Pregnancy oucomes and Associated Factor among Women with Oligohy Dramnios At ≥37 Weeks of Gestation in the two Teaching Hospitals in Addis Ababa, Ethiopia: Cohort Study
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Date
2023-06
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Addis Ababa University
Abstract
Background -Oligohydramnios is a state of deficient amniotic fluid defined objectively using ultrasound measurements as SDP less than 2 centimetres and/or amniotic fluid index less than 5 centimetres. It has been correlated with conditions that threaten health of the fetus. The aim of the study is to assess determinants of adverse maternal and perinatal outcomes in women with singleton pregnancy with oligohydramnios at and after 37+0 weeks in Addis Ababa university two teaching hospitals.
Methods-. A prospective cohort study at the 2 teaching hospitals of Addis Ababa University namely Tikur Anbesa specialized (TASH) and Gandhi Memorial Hospital (GMH) from December 1, 2022 to May 31, 2023.Using whole population sampling method, 213 women diagnosed with oligohydramnios at or beyond 37 completed week of gestation were recruited. The data was analysed using SPSS version 25 and descriptive statistics was used as presented and the association between variables was done using chi square for categorical variables and t-test for continuous. Bivariate and multivariate regression analysis was also used. Result – During the study period, oligohydramnios was found in 3.8% of all deliveries. Over all cesarean rate was 41.8 % and the commonest indication was Non-reassuring fetal heart rate pattern followed by non-reassuring fetal meconium- stained amniotic fluid (MSAF). A significant half (50.5%) had adverse perinatal outcomes. The commonest reason for NICU admission was Meconium Aspiration Syndrome (73.9 %). Gestational age and low 1st minute Apgar score had a positive correlation with the degree of oligohydramnios. The multivariate logistic regression showed obstetrics comorbidities were 2.9 folds likely to result in Adverse birth outcome (AOR=2.9, 95%CI=1.13, 7.41) and spontaneous labor increased composite adverse birth outcome by 6.5 folds (AOR=6.5, 95%CI=1.64, 25.95). Neonates with Adverse birth outcomes 8.6 times likely to be delivered by Cesarean section (AOR=8.6, 95%CI=1.64, 25.95).
Conclusion - Oligohydramnios is a common obstetric complication with significant neonatal and maternal complications. Adverse neonatal outcomes were observed significantly in women with oligohydramnios who had other obstetric conditions. The mere presence of oligohydramnios was not an indication for cesarean delivery