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Register a new userThe Association between Isolated Oligohydramnios at Term and Pregnancy Outcomes
العلاقة بين قلّة السائل الأمنيوسي المعزولة بتمام الحمل ونتائج الحمل
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Tishreen University ورقة بحثية
Publication date
2021
fields
Medicine
and research's language is
العربية
Authors
لؤي حسن( باحث )
Created by
Shamra Editor
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توجد بيانات متضاربة بشأن الآثار الناجمة عن قلة السائل الأمنيوسي المعزولة على نتائج الحمل بتمام الحمل. الهدف: لتقييم العلاقة بين قلة السائل الأمنيوسي المعزولة بتمام الحمل ونتائج الحمل في حالات الحمل منخفض الخطورة. المواد والطرق: كانت هذه دراسة حشدية بأثر رجعي لحالات الحمل عند التمام مع موجودات صدوية لقلة السائل الأمنيوسي المعزولة (مشعر السائل الأمنيوسي > 5 سم) بين عامي 2017 و2019، أجريت في قسم التوليد وأمراض النساء في مستشفى تشرين الجامعي، اللاذقية، سوريا، خلال الفترة ما بين كانون الثاني 2019 – كانون الثاني 2020. تمت مقارنة النتائج مع مجموعة شاهد من الحمول ذات مشعر السائل الأمنيوسي الطبيعي (5-25 سم). تم استبعاد حالات الحمل المختلطة بارتفاع التوتر الشرياني, الداء السكري, نمو الجنين المنحرف, أو التشوهات الصبغية/الهيكلية. تضمنت النتائج السلبية: الولادة القيصرية, انخفاض درجة أبغار، دخول العناية المركزة لحديثي الولادة، متلازمة استنشاق العقي، أو التنبيب. النتائج: بشكل عام، تمت مقارنة 190 حالة حمل مختلط بقلة السائل الأمنيوسي المعزولة مع 200 حالة حمل منخفض الخطورة مع AFI طبيعي. ترافقت قلة السائل الأمنيوسي المعزولة مع معدل أعلى لتحريض المخاض (29.8% مقابل 4%، (p < 0.05، معدّلٍ أعلى للولادات القيصرية (21.6% مقابل 13%, P<0.05) ونتائج الحمل السلبية (13.2% مقابل 7%, P<0.05). بعد ضبط عوامل الإرباك المحتملة مثل تحريض المخاض والخروسات باستخدام تحليل الانحدار اللوجستي متعدد المتغيرات، لم تترافق قلة السائل الأمنيوسي المعزولة بشكل مستقل مع زيادة خطر نتائج الحمل السلبية (نسبة أرجحية: 1.07, فاصل ثقة 95%: 0.9 – 1.31, 0.87P= ). الخلاصة: لا تترافق قلة السائل الأمنيوسي المعزولة في حد ذاتها بزيادة المراضة التوليدية.
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.
References used
Elsandabesee D, Majumdar S, Sinha S (2007) Obstetricians’ attitudes tow ards ‘isolated’ oligohydramnios at term. J Obstet Gynaecol 27(6):574 – 576 .
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