Maternal and Perinatal Outcomes of Induction of Labour in Oligohydramnios at Term - A Cross Sectional Study

Abstract

Background: Oligohydramnios is decreased amniotic fluid index of less than 5cm. It is associated with increased risk of fetal growth restriction, meconium aspiration syndrome, fetal distress necessitating early delivery. Many researchers concluded that induction of labour for oligohydramnios frequently led to caesarean section and operative delivery and neonates had higher neonatal intensive care unit admissions for respiratory distress.
Objective: To study the maternal and neonatal outcomes in women with oligohydramnios at term following induction of labour.
Materials and Methods: A prospective cross sectional study performed in a tertiary level healthcare setting in rural South India between April 2021 and July 2022. 150 women with singleton pregnancy with oligohydramnios at term (37 - 42weeks) who satisfied inclusion criteria were included. Women planned for elective caesarean section, conditions which precluded vaginal delivery, prelabour rupture of membranes, anomalous fetus, multiple pregnancy and maternal complications were excluded. Labour was induced and maternal and neonatal outcomes were recorded and appropriate statistical analysis was done using SPSS version 20 (trial version).
Results: The mean gestational age at recruitment was 38weeks 6 days± 5days and mean induction to delivery interval was 15.68 ± 7.51 hours. Most (64.7 %) delivered vaginally. 8.7 % had postpartum hemorrhage, 14.7 % had meconium staining of amniotic fluid. Only one neonate had Apgar less than 7 at 5 minutes. Neonatal intensive care unit admissions were commonly due to neonatal distress and average length of stay was 2.29 ± 0.5 days.
Conclusion: This study showed that labour induction in oligohydramnios at term resulted in more vaginal delivery rates and few maternal and neonatal complications emphasizing an increased intra-partum surveillance in view of the risk of meconium staining of amniotic fluid and non-reassuring fetal heart tracings to avoid adverse perinatal outcomes.