The Association between Isolated Oligohydramnios at Term and Pregnancy Outcomes

Conflicting data exist concerning the implications of isolated oligohydramnios on pregnancy outcome at term. Aim: To assess the association between isolated oligohydramnios at term and pregnancy outcome in low-risk pregnancies. Materials and Methods: This was a retrospective cohort study of term pregnancies with sonographic finding of isolated Oligohydramnios (amniotic fluid index (AFI) <5 cm) between 2017 and 2019, conducted at Obstetrics and Gynecology Department, Tishreen University Hospital, Lattakia, Syria, during the period between January 2019 – January 2020. Outcome was compared to a control group of pregnancies with normal AFI (5–25 cm). Pregnancies complicated by hypertension, diabetes, deviant fetal growth or chromosomal/ structural abnormalities were excluded. Composite adverse outcome included cesarean section delivery, low Apgar score, neonatal intensive care admission, meconium aspiration syndrome, or intubation. Results: Overall, 190 pregnancies complicated by isolated oligohydramnios were compared to 200 low-risk pregnancies with normal AFI. Isolated oligohydramnios was associated with a higher rate of induction of labor (29.8 % vs. 4 %, p < 0.05), cesarean section delivery (21.6 vs. 13 %, p < 0.05) and composite adverse outcome (13.2 % vs. 7 %, p < 0.05). However, after adjusting for potential confounders as induction of labor and nulliparity using multivariable logistic regression analysis, isolated oligohydramnios was not found to be independently associated with increased risk for composite adverse outcome (OR 1.07, 95 % CI 0.9–1.31, p = 0.87). Conclusion: Isolated oligohydramnios at term by itself is not associated with increased obstetrical morbidity.

The study of some affective factors on the success the vaginal birth with a prior cesarean

This study was executed at Al-Asaad hospital in Lattakia between the period 01/01/2014 and 30/06/2015 and included 95 pregnancies with a prior cesarean (a year and a half before) and also an elective cesarean was executed to 30 patients while a trial of labor was executed to 65 patients. In studying the delivery way on this section, we noticed the following:  The rate of the vaginal birth after a prior cesarean reached:  69.3% when patients exposed to a trial of labor.  42.8% when patients had an unexperienced pelvis  60% when patients had an experienced pelvis  0% the rateofhysterorrhexisof a prior cesarean after a vaginal birth with a prior cesarean.  0% the rate ofHysterectomy and no parenthood or embryonal death happened.  There is an Abgar Index decrease in the first minute with the new births in the event of a duplicate cesarean delivery twice than it is in the case of vaginal delivery.  When the repetition of the prior indication for the first cesarean, this will lead to the failure of the vaginal birth after a prior cesarean.

Induction of Labor With Unmedicinal Methods ( Via Membrane Stripping)

This study was made at ALASSAD Hospital-TISHREEN University in-LATTAKIA at the Department of Obestetrics and Gynecology in the period between 1/1/2013 and 1/1/2014. The number of patients the study was 190.Including140 cases have been holding membrane stripping and 50 cases without membrane stripping. According to Bishop –Scoring index we have estimated the uterine cervix in patients, then a Membrane- Stripping was made. Rate of response was 79.28% in cases of membrane stripping "then 54%in cases " without membrane striping ". In most cases of response ,we need to do the membrane stripping twice.Top of response was obtained when Bishop –Scoring index was between 4- 6 (Moderate ripening of the cervix). Rate of Vaginal Delivery was 87.85% in cases of membrane stripping and 76% without membrane stripping. The complications were limited in the study group included: 1-Infection( 0.58%). 2-Bleeding 0.58%. 3-PROM 1.16%. It means that Membrane Stripping was somehow safe.