DOI: https://doi.org/10.53350/pjmhs2023173161 ORIGINAL ARTICLE P J M H S Vol. 17, No. 3, March, 2023 161 Association of Adverse Perinatal Outcome with Oligohydramnios during Third Trimester of Pregnancy SADIA MUSTAFA 1 , MAHWISH SAIF 2 , MALIHA AMJAD 3 , FAIZA IQBAL 4 1,2,3,4 Senior Registrar, Shalamar Medical and Dental College Lahore Correspondence to Dr. Mahwish Saif, Email: drmahwish786@gmail.com ABSTRACT Background: For the growth and development of the unborn child, amniotic fluid is absolutely necessary. Strong interactions between the fetus, placenta, and parts of the mother are given their volume 1 . Oligohydramnios is defined as having an amniotic fluid index (AFI) <5th percentile or AFI 5 cm during pregnancy and no water at a depth of 23 cm before the cornea. This is a common problem that occurs in 35% of pregnancies during childbirth 2 . Aim: To determining the correlation between oligohydramnios in pregnant women who are late in pregnancy (3rd trimester) and adverse birth outcomes such as partial surgery, decreased Apgar score, and lower birth weight. Study design: Cohort study Study set up: Obstetrics and Gynecology Department, Fatima Memorial Hospital Lahore. Study period: six months starting15-01-2022 to 14-07-2022 Methods: 242 females were enrolled. Two groups of participants were created: group II had normal AFI and group I had oligohydramnios. Females given intra venous fluids to group I after ruling out any contra indication. The perinatal result was then documented. SPSS version 20 was used to enter and evaluate all of the gathered data. Results: In exposed group the mean age was 27.79±6.72 years, whereas in unexposed group the mean age was 28.25±6.77 years. The C-section was done in 124(51.2%) females. RR = 0.693 [1.25-3.49] While the Low Birth Weight and poor APGAR score has shown protective effect. Practical implication: Oligohydramniosmeans decreased amniotic fluid around the fetus. There is deficiency of amniotic fluid < 200 ml at a time. Approximately 8-10% of pregnant ladies may have decreased level of amniotic fluid but 5% have been confirmed diagnosis of oligohydramnios. Conclusion: So complications of surgery are directly related to the severity of oligohydramnios in pregnant women while low birth weight and poor APGAR scores has shown protective effect in women presented in last trimester of pregnancy. Keywords: Oligohydramnios, Low Birth Weight, Perinatal Outcome, APGAR SCORES, Pregnancy INTRODUCTION Amniotic fluid gives protection to the fetus and it is essential for the development and growth of the fetus. Strong communication between placenta, fetus and mother is needed to maintain its level 1 . Having an amniotic fluid index is what is meant by oligohydramnios (AFI)<5th percentile or AFI 5 cm during pregnancy and no liquid cm depth of 23 packs. This is a common problem that occurs in 35% of pregnancies during pregnancy 2 . Amniotic fluid level can be decreased in any trimester but it is most commonly seen in the latter stage of pregnancy. It has a connection to variety of birth defects such as fetal malformations and fetal, maternal and placental abnormalities 3 . Amniotic fluid can be measured in a variety of ways. Initially amniotic fluid was measured by amniocentesis which was difficult to perform and nowadays ultrasonic devices are used to measure amniotic fluid which include a single deep packet (SDP) process, 2-meter packs, and AFI because it is non-invasive and easy to perform. 4 Decrease in amniotic fluid volume has association with arrhythmias abnormal meconium retrieval, Apgar <7 points, and the introduction of the newborn care unit. Different studies have shown LSCS incidence was 54% in patients with lower amniotic fluid volume and 23% in patients whose amniotic fluid volume is normal.This was statistically significant (p <0)001) 7 . Another case- control research reveals that 64% of people had LSCS. decreased amniotic fluid volume group and 22% in normal amniotic fluid volume group. This was statistically significant (p <0.001). Apgar scores of 7 or less in 5 minutes were found in 16% and 6% of oligohydramnios cases and the standard AFI group, respectively (p> 0.05). Low Birth Weight: <2.5kg observed in 62% cases of patients with decreased amniotic fluid volume while in patients with normal amniotic fluid volume it is observed in 28% cases. (p<0.001) 8 . Myocardial infarction is the most common cause of ----------------------------------------------------------------------------------------- Received on 12-10-2022 Accepted on 26-02-2023 oligohydramnios. However, because amniotic fluid is primarily in the urine of babies during late pregnancy, slow fetal production and obstruction of the baby's urinary tract can also cause oligohydramnios. Physical swallowing in infants reduces water content, and a lack of swallowing or blockage in the intestines can lead to polyhydramnios. Newborns produce 5,00-1,200 ml of urine and ingest 210-790 ml of amniotic fluid a day 17 . Causes of oligohydramnios are: Pediatric urinary tract infections, etc. B. Renal aplasia, polycystic kidney disease and other obstruction of the urinary tract (such as the posterior urethral valves) 18 . Maternal diabetes or post mature syndrome when pregnancy lasts 42 weeks of pregnancy. (18) Common clinical features are short-term sensory sensitivity, unnecessary exposure to fetal components, and decreased volume of amniotic fluid. Hypoplasia and intrauterine impairment development. The amniotic membrane nodosum is also present (a lump in the area of the fetal amniotic membrane) 9 . There is controversy regarding association of oligohydramnios with pregnancy complications 10 . Absent or decrease in amniotic fluid volumeassociated with Potter Syndrome characterized by abnormal facial features, pulmonary hypoplasia and paralysis. A two-year-old genealogy of a baby is the most common cause of a baby's urinary deficiency 3 . The amount of amniotic fluid is tested by dividing the mother's uterus into four parts. Oligohydramnios is defined as the absence of an AFI of less than 7cm or a liquid packet of 23 cm depth in ultrasonography 4,7,11 . In one study, a 24-34 week decline in AFI pregnancy, including borderline AFI and oligohydramnios, was probably associated with severe fetal malformations, as well as a lack of disability, fetal development and childbirth. It's hard to preventbefore severe paralysis was more common in oligohydramnios (25%) and borderline AFI pregnancy (10%) than in normal water (2%) pregnancy 11 . Transplantation (intravenous and oral) has been shown to significantly improve amniotic fluid volume in the third trimester by separating oligohydramnios 12 . There is limited literature available in local setting. Therefore, the study was to investigate the association between oligohydramnios in pregnant women with late pregnancy and adverse maternal incidence.