Objective: To study the factors associated with oligohydramnios and its related neonatal morbidity and mortality. Materials and Methods: This was a 10-year retrospective nested case-control study conducted at a level ...Objective: To study the factors associated with oligohydramnios and its related neonatal morbidity and mortality. Materials and Methods: This was a 10-year retrospective nested case-control study conducted at a level 2 maternity ward. Given that the prevalence of oligohydramnios ranges between 0.5% and 8%, the sample size of the cases was calculated using the following formula: n = (z/∆)2 × p(1 − p). We selected 20 controls for each case. Data were exported to Excel and analyzed using the Statistical Package for Social Sciences (SPSS) and R Studio 4.1.3 software. The maximal deepest pocket of amniotic fluid or the amniotic fluid index was used to establish the diagnosis. Qualitative variables were described as proportions relative to the total. Data were compared using the chi-square test when normality conditions were met or non-parametric tests otherwise. The significance threshold was set at 0.05. Results: Out of a cohort of 56,775 deliveries, we collected 145 cases of oligohydramnios and 2953 controls. The prevalence of preeclampsia was seven times higher in cases of oligohydramnios (OR = 7.7 [5.12;11.7]). The prevalence of small-for-gestational-age (SGA) fetuses was four times higher in the case group (OR = 4.3 [3.04;6.21]). Oligohydramnios were associated with an increased risk of labor artificial induction and cesarean sections respectively 4.51 ([2.95;6.99]) and 3.41 ([3.03;3.78]). Perinatal asphyxia was nearly three times more frequent in children born in the context of oligohydramnios (OR = 2.7 [1.38;5.30]). Vaginal delivery and SGA were not associated with neonatal morbidity or mortality in cases of oligohydramnios. Conclusion: Oligohydramnios is associated with obstetric pathologies and increased neonatal morbidity and mortality. However, vaginal delivery and labor induction do not impact neonatal morbidity and mortality. The risk of perinatal asphyxia in oligohydramnios requires special monitoring in the delivery room. Further studies on the relationship between fetal heart patterns during and asphyxia in oligohydramnios will need to be conducted.展开更多
Objective:To compare the renal artery(RA)flow indices(RI and PI)among normohydramnios,idiopathic oligohydramnios,and polyhydramnios and determine applicability of fetal RA Doppler indices in predicting the preg-nancy ...Objective:To compare the renal artery(RA)flow indices(RI and PI)among normohydramnios,idiopathic oligohydramnios,and polyhydramnios and determine applicability of fetal RA Doppler indices in predicting the preg-nancy outcome.Methods:Total 1063rd trimester pregnant patients were divided into cases and controls based on amniotic fluid index.Routine antenatal and color Doppler(including kidneys)ultrasound was performed for all patients in this study.The postnatal follow-up was done,and the pregnancies having poor outcomes in terms of NICU admissions were assessed.Results:Statistically significant differences were noted when comparing RI and PI values of normohydramnios(0.91±0.04 and 2.38±0.21,respectively)with oligohydramnios(1.02±0.07 and 2.99±0.38,respectively)and poly-hydramnios(0.90±0.12 and 2.7±0.84,respectively)independently(p value<0.05).Our study demonstrated an increase in NICU admissions in the fetus having raised values of RI and PI.Conclusion:Fetal RA RI and PI can be used as an antenatal predictor for the pregnancy outcome associated with idiopathic oligohydramnios;however,fetal RA PI was found to be a better predictor for the pregnancy outcome than fetal RA RI value in our study.展开更多
Oligohydramnios of late pregnancy is an extremely important signal of a life threatening to the fetus, which severely affect the prognosis of perinatal and makes perinatal mortality rate 5 times higher. [1].As one of ...Oligohydramnios of late pregnancy is an extremely important signal of a life threatening to the fetus, which severely affect the prognosis of perinatal and makes perinatal mortality rate 5 times higher. [1].As one of the conditions that should be prevented in late pregnany, timely discovery and treatment of oligohydramnios can significantly reduce the perinatal mortality rate and improve the quality ofperinatal [2] We will make a summary on the influence of oligohydramnios in late pregnancy outcome in this article. Normally, amniotic fluid volume increases with the passes of gestational week and the volumes increases to about 800ml during late pregnancy to full-term pregnancy.We call it oligohydramnios when if the volume is less than 300m1.[3].展开更多
Backgrounds:At present,there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios.This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dino...Backgrounds:At present,there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios.This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter(SBC)in term nulliparous women with borderline oligohydramnios.Methods:We conducted a retrospective cohort study from January 2016 to November 2018.During the study period,a total of 244 cases were enrolled.Of these,103 cases were selected for induction using dinoprostone and 141 cases were selected for induction with SBC.The pregnancy outcomes between the two groups were compared.Primary outcomes were successful vaginal delivery rates.Secondary outcomes were maternal and neonatal adverse events.Multivariate logistic regression was used to assess the risk factors for vaginal delivery failure in the two groups.Results:The successful vaginal delivery rates were similar between the dinoprostone group and the SBC group(64.1%[66/103]vs.59.6%,[84/141]P=0.475),even after adjustment for potential confounding factors(adjusted odds ratio[aOR]:1.07,95%confidence interval[CI]:0.57-2.00,P=0.835).The incidence of intra-amniotic infection was lower in the dinoprostone group than in the SBC group(1.9%[2/103]vs.7.8%[11/141],P<0.001),but the presence of non-reassuring fetal heart rate was higher in the dinoprostone group than in the SBC group(12.6%[13/103]vs.0.7%,[1/141]P<0.001).Multivariate logistic regression showed that nuchal cord was a risk factor for vaginal delivery failure after induction with dinoprostone(aOR:6.71,95%CI:1.96-22.95).There were three factors related to vaginal delivery failure after induction with SBC,namely gestational age(aOR:1.51,95%CI:1.07-2.14),body mass index(BMI)>30 kg/m^(2)(aOR:2.98,95%CI:1.10-8.02),and fetal weight>3500 g(aOR:2.49,95%CI:1.12-5.50).Conclusions:Term nulliparous women with borderline oligohydramnios have similar successful vaginal delivery rates after induction with dinoprostone or SBC,with their advantages and disadvantages.In women with nuchal cord,the risk of vaginal delivery failure is increased if dinoprostone is used in the induction of labor.BMI>30 kg/m^(2),large gestational age,and estimated fetal weight>3500 g are risk factors for vaginal delivery failure after induction with SBC.展开更多
Potter syndrome is a rare congenital malformation that primarily affects male fetuses;it is characterized by pulmonary hypoplasia, skeletal malformation, and kidney abnormalities. The pressure of the uterine wall due ...Potter syndrome is a rare congenital malformation that primarily affects male fetuses;it is characterized by pulmonary hypoplasia, skeletal malformation, and kidney abnormalities. The pressure of the uterine wall due to oligohydramnios leads to an unusual facial appearance, abnormal limbs in abnormal positions, or contractures. The fetus generally dies soon after birth due to respiratory insufficiency. The baby was a live preterm male, born to a 30-year-old multigravida, out of a non-consanguineous marriage via cesarean section. There was no liquor at the time of delivery. The baby did not cry immediately after birth and required resuscitation, followed by mechanical ventilation. Multiple congenital anomalies suggestive of Potter’s syndrome were noted including facial features, flattened nose, low protruding ear, retrognathism, and epicanthal folds with unilateral atresia of the choana. Chest X-ray showed small volume lung fields suggestive of pulmonary hypoplasia, and we had on ultrasonography bilateral polycystic kidney disease on ultrasonography. At 42 hours of life, the baby developed tachypnea and severe chest retractions and died due to respiratory insufficiency. Our case highlights the importance of regular prenatal checks and examinations in each pregnancy, which helps to collect suspected cases and improve knowledge of this syndrome for better management.展开更多
Inherited renal tubular dysgenesis(RTD),a rare,autosomal recessive disorder is caused by mutations in the genes encoding components of the renin-angiotensin pathway:angiotensinogen(AGT),renin(REN),angiotensin-converti...Inherited renal tubular dysgenesis(RTD),a rare,autosomal recessive disorder is caused by mutations in the genes encoding components of the renin-angiotensin pathway:angiotensinogen(AGT),renin(REN),angiotensin-converting enzyme(ACE),and angiotensinΙΙreceptor type 1(AGTR1).It characterized by the absence or poor development of renal tubules,and associated with oligohydramnios,Potter sequence and neonatal death due to renal or respiratory failure.We report a family with two mutations in the coding region of the ACE gene:a nonsense mutation in exon4(c.538C>T)and a frameshift deletion at nucleotide 3073 and nucleotide 3074 in exon20(c.3073_3074delTC).The mutations were in the compound heterozygous state causing disease,because each parent had their own mutation.展开更多
文摘Objective: To study the factors associated with oligohydramnios and its related neonatal morbidity and mortality. Materials and Methods: This was a 10-year retrospective nested case-control study conducted at a level 2 maternity ward. Given that the prevalence of oligohydramnios ranges between 0.5% and 8%, the sample size of the cases was calculated using the following formula: n = (z/∆)2 × p(1 − p). We selected 20 controls for each case. Data were exported to Excel and analyzed using the Statistical Package for Social Sciences (SPSS) and R Studio 4.1.3 software. The maximal deepest pocket of amniotic fluid or the amniotic fluid index was used to establish the diagnosis. Qualitative variables were described as proportions relative to the total. Data were compared using the chi-square test when normality conditions were met or non-parametric tests otherwise. The significance threshold was set at 0.05. Results: Out of a cohort of 56,775 deliveries, we collected 145 cases of oligohydramnios and 2953 controls. The prevalence of preeclampsia was seven times higher in cases of oligohydramnios (OR = 7.7 [5.12;11.7]). The prevalence of small-for-gestational-age (SGA) fetuses was four times higher in the case group (OR = 4.3 [3.04;6.21]). Oligohydramnios were associated with an increased risk of labor artificial induction and cesarean sections respectively 4.51 ([2.95;6.99]) and 3.41 ([3.03;3.78]). Perinatal asphyxia was nearly three times more frequent in children born in the context of oligohydramnios (OR = 2.7 [1.38;5.30]). Vaginal delivery and SGA were not associated with neonatal morbidity or mortality in cases of oligohydramnios. Conclusion: Oligohydramnios is associated with obstetric pathologies and increased neonatal morbidity and mortality. However, vaginal delivery and labor induction do not impact neonatal morbidity and mortality. The risk of perinatal asphyxia in oligohydramnios requires special monitoring in the delivery room. Further studies on the relationship between fetal heart patterns during and asphyxia in oligohydramnios will need to be conducted.
文摘Objective:To compare the renal artery(RA)flow indices(RI and PI)among normohydramnios,idiopathic oligohydramnios,and polyhydramnios and determine applicability of fetal RA Doppler indices in predicting the preg-nancy outcome.Methods:Total 1063rd trimester pregnant patients were divided into cases and controls based on amniotic fluid index.Routine antenatal and color Doppler(including kidneys)ultrasound was performed for all patients in this study.The postnatal follow-up was done,and the pregnancies having poor outcomes in terms of NICU admissions were assessed.Results:Statistically significant differences were noted when comparing RI and PI values of normohydramnios(0.91±0.04 and 2.38±0.21,respectively)with oligohydramnios(1.02±0.07 and 2.99±0.38,respectively)and poly-hydramnios(0.90±0.12 and 2.7±0.84,respectively)independently(p value<0.05).Our study demonstrated an increase in NICU admissions in the fetus having raised values of RI and PI.Conclusion:Fetal RA RI and PI can be used as an antenatal predictor for the pregnancy outcome associated with idiopathic oligohydramnios;however,fetal RA PI was found to be a better predictor for the pregnancy outcome than fetal RA RI value in our study.
文摘Oligohydramnios of late pregnancy is an extremely important signal of a life threatening to the fetus, which severely affect the prognosis of perinatal and makes perinatal mortality rate 5 times higher. [1].As one of the conditions that should be prevented in late pregnany, timely discovery and treatment of oligohydramnios can significantly reduce the perinatal mortality rate and improve the quality ofperinatal [2] We will make a summary on the influence of oligohydramnios in late pregnancy outcome in this article. Normally, amniotic fluid volume increases with the passes of gestational week and the volumes increases to about 800ml during late pregnancy to full-term pregnancy.We call it oligohydramnios when if the volume is less than 300m1.[3].
文摘Backgrounds:At present,there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios.This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter(SBC)in term nulliparous women with borderline oligohydramnios.Methods:We conducted a retrospective cohort study from January 2016 to November 2018.During the study period,a total of 244 cases were enrolled.Of these,103 cases were selected for induction using dinoprostone and 141 cases were selected for induction with SBC.The pregnancy outcomes between the two groups were compared.Primary outcomes were successful vaginal delivery rates.Secondary outcomes were maternal and neonatal adverse events.Multivariate logistic regression was used to assess the risk factors for vaginal delivery failure in the two groups.Results:The successful vaginal delivery rates were similar between the dinoprostone group and the SBC group(64.1%[66/103]vs.59.6%,[84/141]P=0.475),even after adjustment for potential confounding factors(adjusted odds ratio[aOR]:1.07,95%confidence interval[CI]:0.57-2.00,P=0.835).The incidence of intra-amniotic infection was lower in the dinoprostone group than in the SBC group(1.9%[2/103]vs.7.8%[11/141],P<0.001),but the presence of non-reassuring fetal heart rate was higher in the dinoprostone group than in the SBC group(12.6%[13/103]vs.0.7%,[1/141]P<0.001).Multivariate logistic regression showed that nuchal cord was a risk factor for vaginal delivery failure after induction with dinoprostone(aOR:6.71,95%CI:1.96-22.95).There were three factors related to vaginal delivery failure after induction with SBC,namely gestational age(aOR:1.51,95%CI:1.07-2.14),body mass index(BMI)>30 kg/m^(2)(aOR:2.98,95%CI:1.10-8.02),and fetal weight>3500 g(aOR:2.49,95%CI:1.12-5.50).Conclusions:Term nulliparous women with borderline oligohydramnios have similar successful vaginal delivery rates after induction with dinoprostone or SBC,with their advantages and disadvantages.In women with nuchal cord,the risk of vaginal delivery failure is increased if dinoprostone is used in the induction of labor.BMI>30 kg/m^(2),large gestational age,and estimated fetal weight>3500 g are risk factors for vaginal delivery failure after induction with SBC.
文摘Potter syndrome is a rare congenital malformation that primarily affects male fetuses;it is characterized by pulmonary hypoplasia, skeletal malformation, and kidney abnormalities. The pressure of the uterine wall due to oligohydramnios leads to an unusual facial appearance, abnormal limbs in abnormal positions, or contractures. The fetus generally dies soon after birth due to respiratory insufficiency. The baby was a live preterm male, born to a 30-year-old multigravida, out of a non-consanguineous marriage via cesarean section. There was no liquor at the time of delivery. The baby did not cry immediately after birth and required resuscitation, followed by mechanical ventilation. Multiple congenital anomalies suggestive of Potter’s syndrome were noted including facial features, flattened nose, low protruding ear, retrognathism, and epicanthal folds with unilateral atresia of the choana. Chest X-ray showed small volume lung fields suggestive of pulmonary hypoplasia, and we had on ultrasonography bilateral polycystic kidney disease on ultrasonography. At 42 hours of life, the baby developed tachypnea and severe chest retractions and died due to respiratory insufficiency. Our case highlights the importance of regular prenatal checks and examinations in each pregnancy, which helps to collect suspected cases and improve knowledge of this syndrome for better management.
文摘Inherited renal tubular dysgenesis(RTD),a rare,autosomal recessive disorder is caused by mutations in the genes encoding components of the renin-angiotensin pathway:angiotensinogen(AGT),renin(REN),angiotensin-converting enzyme(ACE),and angiotensinΙΙreceptor type 1(AGTR1).It characterized by the absence or poor development of renal tubules,and associated with oligohydramnios,Potter sequence and neonatal death due to renal or respiratory failure.We report a family with two mutations in the coding region of the ACE gene:a nonsense mutation in exon4(c.538C>T)and a frameshift deletion at nucleotide 3073 and nucleotide 3074 in exon20(c.3073_3074delTC).The mutations were in the compound heterozygous state causing disease,because each parent had their own mutation.
