Liquor amnii plays important role both in the development of the fetus and antenatal assessment of the fetal wellbeing. Its cushioning effect protects the fetus from external trauma whereas a decrease in liqor may leads to flexion contracture in the fetus. A decrease in the liqor volume, with intact membranes, in the third trimester indicates decreased utero-placental flow and maybe the indication for early termination of pregnancy.
Methods: This prospective study was conducted in the department of Obstetrics and Gynecology at Dr. Rajendra Prasad Government Medical College Kangra at Tanda, Himachal Pradesh from January 2018 to December 2018, where 100 expectant mothers with abnormal liqor volume were studied with an aim to evaluate AFI for the assessment of perinatal outcome after all required formalities.
Results: Out of 100 parturients studied 90 and 10 women had oligohydramnios and polyhydramnios respectively. 16(17.8%) women with oligohydramnios and 4(40%) women with polyhydramnios had preterm delivery. There were 20(22.2%) of women with PIH in the oligohydramnios group whereas none of the expectant mothers with polyhydramnios had PIH. Gestational diabetes mellitus was seen in polyhydramnios group women only and was present in 3(30%) women. In oligohydramnios group, NST was found to be non-reactive in 23(25.6 %) women and 58(64.4%) women required induction of labor. Meconium-stained liqor was found in 28(31.1%) women and CS was done in 59(65.6%) expectant mothers. 24(26.7%) neonates required NICU admissions as 12(12.3%) with respiratory distress, 5(5.5%) neonatal jaundice and 1 (1.1%) congenital pneumonia. There were 57(63.3%) neonates with LBW and 17(18%) neonates with VLBW. In polyhydramnios group, induction of labor was done in 3(30%) women. CS was done in 5(50%) women as 2(40%) for cord prolapse, 2(40%) for fetal distress and 1(20%) for NPOL. 2(20%) neonates were admitted to NICU with respiratory distress and one neonate had a congenital malformation in the form of tracheal stenosis. Two (20%) neonates had LBW and one (10%) had macrosomia.
Conclusion: Oligohydramnios was associated with an increased incidence of induction of labor, non-reactive NST, meconium-stained liqor and CS. Neonates born to women with oligohydramnios had increased incidence of a low Apgar score, respiratory distress, LBW and NICU admission. Parturients with polyhydramnios showed more association gestational diabetes mellitus and neonatal congenital anomalies. Almost all the patients had spontaneous labor but required cesarean section for cord prolapse and macrosomia.