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The Association between Isolated Oligohydramnios at Term and Pregnancy Outcomes

العلاقة بين قلّة السائل الأمنيوسي المعزولة بتمام الحمل ونتائج الحمل

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 Publication date 2021
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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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.


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Research summary
تتناول هذه الدراسة العلاقة بين قلة السائل الأمنيوسي المعزولة بتمام الحمل ونتائج الحمل في حالات الحمل منخفضة الخطورة. تم إجراء الدراسة بأثر رجعي في مستشفى تشرين الجامعي في اللاذقية، سوريا، وشملت 190 حالة حمل مع قلة السائل الأمنيوسي المعزولة و200 حالة حمل مع مستوى طبيعي من السائل الأمنيوسي. أظهرت النتائج أن قلة السائل الأمنيوسي المعزولة ترتبط بزيادة معدلات تحريض المخاض والولادة القيصرية، ولكن بعد ضبط العوامل المربكة باستخدام تحليل الانحدار اللوجستي متعدد المتغيرات، لم تظهر قلة السائل الأمنيوسي المعزولة ارتباطًا مستقلًا بزيادة خطر نتائج الحمل السلبية. خلصت الدراسة إلى أن قلة السائل الأمنيوسي المعزولة بحد ذاتها لا ترتبط بزيادة المراضة التوليدية، وأن التداخلات الطبية مثل تحريض المخاض قد تكون مسؤولة عن الفروق الملحوظة في معدلات النتائج السلبية.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة مهمة نحو فهم تأثير قلة السائل الأمنيوسي المعزولة على نتائج الحمل. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، الدراسة بأثر رجعي مما قد يؤدي إلى تحيز في اختيار العينات. ثانيًا، لم يتم تضمين بعض العوامل المربكة المحتملة مثل مشعر كتلة الجسم (BMI) الوالدي. ثالثًا، كانت الدراسة وحيدة المركز مما قد يحد من تعميم النتائج. وأخيرًا، لم يتم إجراء تقييم حجم السائل الأمنيوسي بالتصوير التسلسلي بالأمواج فوق الصوتية لجميع النساء، مما قد يؤثر على دقة النتائج. على الرغم من هذه القيود، تقدم الدراسة رؤى قيمة وتوصيات مهمة لإدارة حالات قلة السائل الأمنيوسي المعزولة بتمام الحمل.
Questions related to the research
  1. ما هي العلاقة بين قلة السائل الأمنيوسي المعزولة ونتائج الحمل السلبية؟

    الدراسة أظهرت أن قلة السائل الأمنيوسي المعزولة ترتبط بزيادة معدلات تحريض المخاض والولادة القيصرية، ولكنها ليست مرتبطة بشكل مستقل بزيادة خطر نتائج الحمل السلبية بعد ضبط العوامل المربكة.

  2. ما هي العوامل المربكة التي تم ضبطها في الدراسة؟

    تم ضبط عوامل مثل تحريض المخاض والخروس باستخدام تحليل الانحدار اللوجستي متعدد المتغيرات.

  3. ما هي التوصيات الرئيسية للدراسة؟

    تشير الدراسة إلى أنه لا يوجد ما يبرر التحريض الروتيني للمخاض في جميع حالات قلة السائل الأمنيوسي المعزولة بتمام الحمل، وأن تدبير هذه الحالات ينبغي أن يكون بشكل فردي.

  4. ما هي القيود الرئيسية للدراسة؟

    القيود تشمل التصميم بأثر رجعي، عدم تضمين بعض العوامل المربكة مثل مشعر كتلة الجسم الوالدي، كون الدراسة وحيدة المركز، وعدم إجراء تقييم حجم السائل الأمنيوسي بالتصوير التسلسلي بالأمواج فوق الصوتية لجميع النساء.


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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