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Amniotic fluid disorders and the effects on prenatal result: a retrospective accomplice study

• H. Alenizy^i,2,
• S. Alenazi^three,
• S. Alnasser³,
• N. Alanazi³,
• K. Alsowinea³,
• L. Alharbi^three &
• B. Alfaifi³

BMC Pregnancy and Childbirth volume 21, Commodity number:75 (2021) Cite this commodity

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Abstract

Background

The amniotic fluid is a protective liquid nowadays in the amniotic sac. Two types of amniotic fluid disorders have been identified. Get-go refers to polyhydramnios, which is an immoderate volume of amniotic fluid with an Amniotic Fluid Index (AFI) greater than 24 cm. 2nd includes oligohydramnios, which refers to decreased AFI i.e., less than 5 cm. This study aims to; a) identify the maternal risk factors associated with amniotic fluid disorders, b) assess the effect of amniotic fluid disorders on maternal and fetal result c) examine the mode of delivery in pregnancy complicated with amniotic fluid disorders.

Methods

A comparative retrospective cohort report pattern is followed. Sample of 497 meaning women who received care at Rex Abdullah bin Abdul-Aziz University Hospital (KAAUH) between January 2017 to October 2019 was included. Data were collected from electronic medical reports, and was analyzed using descriptive statistics. Clan of qualitative variables was conducted past Chi-foursquare test, where p-value < 0.05 was considered statistically pregnant.

Results

Among the collected data, 2.eight% of the cases had polyhydramnios and xi.vii% patients had oligohydramnios. 1 example of even so born was identified. A statically significant association was found between polyhydramnios and late term deliveries (P = 0.005) and cesarean section (CS) rates (P = 0.008). The rate of term deliveries was equal in normal AFI and oligohydramnios grouping (P = 0.005). Oligohydramnios was by and large associated with vaginal deliveries (P = 0.008). Oligohydramnios and polyhydramnios were constitute to be associated with diabetes mellitus patients (P = 0.005), and polyhydramnios with gestational diabetes patients (P = 0.052). Other maternal chronic diseases showed no issue on amniotic fluid index, although it might cause other risks on the fetus.

Conclusion

Diabetes mellitus and gestational diabetes are the most important maternal take a chance factors that can cause amniotic fluid disorders. Maternal and fetal outcome data showed that oligohydramnios associated with gestational age at term and low neonatal birth weight with high rates of vaginal deliveries, while polyhydramnios associated with gestational historic period at tardily term and high birth weight with higher rates of CS.

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Groundwork

The amniotic fluid is the protective liquid present in the amniotic sac, and mainly composed of h2o and solids, including proteins, carbohydrates, lipids and phospholipids, enzymes, hormones and chemic substances urea, uric acid, creatinine, electrolytes. It is developed from the membrane plasma by the development of fetus and serves as a protective absorber for the growing fetus. It has antibacterial properties to protect the growing fetus from infection, as well it facilitates the exchange of nutrients, h2o and biochemical products between mother and fetus. Different types of fetal cells are further nowadays which includes; peel, respiratory, intestinal, urinary tract and stalk cells, hair and blood cells, all of which aid in the growth of fetus.

Amniotic Fluid Volume (AFV) does not change significantly from day to day, merely mostly it increases with the growth of fetus reaching a peak at 34 weeks of gestation (over 800 mL), after which it may starting time to subtract [1]. Yet, in certain cases Amniotic Fluid Index (AFI) of the amniotic fluid book is greater than 24 cm, the phenomenon is referred as polyhydramnios [ii]. Risk factors of polyhydramnios includes: maternal diabetes, fetal eye failure, aberrant swallowing and built infection [iii]. The degree of increment in the AFV is directly associated with the increase in adverse risk factors on mother and fetus prenatally. Some of these prenatally outcomes include preterm nascence, cesarean delivery [4], placental abruption, fetal malposition, macrosomia, umbilical string prolapse and maternal respiratory compromise [2].

In contrast, AFI of the amniotic volume less than v cm is referred as oligohydramnios [5]. Risk factors of oligohydramnios includes: premature rupture of membranes, intrauterine growth restriction and nascence defects [3]. Oligohydramnios impede normal fetal movement, retarded fetal growth and development leading towards fetal deformities, umbilical cord compression, while in some cases death may happen depending on gestational age. In the first trimester subtract in AFI is an ominous finding, the fetus usually undergo abortion. However, in the 2nd trimester the prognosis majorly depends by and large on the etiology, borderline/low normal amniotic fluid volume which generally accept a skillful prognosis, on the other mitt astringent oligohydramnios often lead to fetal death [6]. Whereas, in the third trimester many cases of oligohydramnios are idiopathic. The occurrence of a threatening fetal outcome is related to the umbilical cord compression, utro-placental insufficiency and meconium aspiration [v].

Amniotic Fluid Book (AFV) reflects the state of pregnancy and possible adverse complications and outcome, due to which assessment of AFV has been part of every 2d and third trimester ultrasound examination. In that location are three standard methods for AFV cess, commencement includes qualitative and other two are semiquantitative. Qualitative assessment is the first step in which the ultrasonographer subjectively report if the pregnancy is normal, oligo or polyhydramnios. With experienced examiners, the quality of the test tin be equal to the semiquantitative tests [single deepest pocket (SDP), amniotic fluid index (AFI)] which are performed when there is an abnormality constitute in the qualitative examination, specifically amongst patients with increased chance of pregnancy complications and patients in 3rd trimester. Both SDP and AFI are practiced indicators for normal AFV. However, AFI overly diagnose oligohydramnios, and SDP overly diagnose polyhydramnios.

Due to the observed increase in cases of poly and oligohydramnios, this study estimated the effect of amniotic fluid disorders on prenatal outcome and reassess the reasons associated with information technology in Saudi Arabia. Besides, the relationship between maternal demographics and its result on amniotic fluid disorders in Kingdom of saudi arabia are further observed.

Specific objectives

1. 1.

   To identify the maternal risk factors associated with amniotic fluid disorders.

2. 2.

   To assess the outcome of amniotic fluid disorders on maternal and fetal effect.

3. three.

   To identify the mode of delivery in pregnancy complicated with amniotic fluid disorders.

Methods

This report followed a comparative retrospective accomplice written report pattern. Patients who received care at a secondary infirmary i.e., Rex Abdullah Bin Abdul-Aziz University Infirmary (KKAUH) in its obstetrics & gynecology section between Jan 2017–Oct 2019 were included. The study was approved by the institutional review board in Princess Nourah bint Abdulrahman Academy's (PNU) collage of medicine.

The electronic medical reports of normal and abnormal obstetrical ultrasound examinations reviewed during the study flow were searched. These ultrasounds were taken every bit function of routine check-upward or when prescribed by the consulted physician. Patients were included in the cohort, if they had at least one scan conducted past expert radiologists in our ultrasound unit.

A formulated information collection canvas was filled from each patient file without any intervention. Which included the following: demographic data, past medical history, past surgical history, obstetrics & gynecology history, intraoperative complications, postoperative complications and neonatal outcomes. Neonatal outcomes encompass living status, gender, APGAR score, nascency weight, admission of baby and congenital malformations. The cohort was stratified into 3 groups based on AFI: normal AFI, polyhydramnios (AFI ≥ 24 cm), oligohydramnios (AFI ≤ 5 cm). The gestational age of pregnancy at the time of delivery was considered as the gestational calendar week for measurement. The analysis excluded multiple pregnancy, because in multiple pregnancy, chronicity is important for perinatal outcomes. Since the number of multiple pregnancies was minimal it would accept been hard to know the effect of chronicity on outcomes.

Patients having mild case polyhydramnios or oligohydramnios were rarely given intervention. Withal, with moderate and severe cases options like amniotic fluid drainage or pharmacological intervention, the patient'south consent and medico's assessment of the scenario varied. Patients with gestational diabetes were given handling to treat information technology which in many cases also helped in resolving polyhydramnios or oligohydramnios.

The statistical analysis was washed using Statistical Package of Social Sciences (SPSS). Descriptive statistics in terms of frequency and percentages was used to draw criteria of studied sample. Clan of qualitative variables was conducted by chi-square exam. P-value less than 0.05 volition exist considered as statistically significant. Confidentiality of the nerveless data was ensured, and the information was only used for scientific research purposes. The methodology adhered to the STROBE guidelines which can be seen in supplementary Table ane.

Results

Medical records of 597 patients were reviewed in this study, among them 453 (91.1%) were Saudis, effectually 388 (78%) were ≤ 35 years old. About 288 (57.nine%) of the maternal BMI scores were ≥ 30. Around 124 (24.9%) of the patients were primigravida, still 373 (75.one%) of them were multigravida. Chronic medical illnesses were reported around 74 (14.8%). These patients were likewise getting acceptable treatment for their chronic diseases, specifically in cases when there's loftier adventure of pregnancy or mother'due south health being afflicted. Bulk of the cases i.east., 425 (85.v%) had normal amniotic fluid index (AFI). However, 14 (2.8%) had polyhydramnios, and 58 (11.7%) had oligohydramnios (Table 1).

Tabular array ane Demographic Data of the Mothers (Frequency)

Full size tabular array

The results (Table 2) showed that almost half of the neonate were boys 246 (49.5%), and the other half were girls 251 (50.5%). Only one case notwithstanding born was identified 0.two%, while 496 (99.viii%) were born alive. Bulk of the patients were delivered at term 424 (85.3%), whereas, other 31 (half-dozen.ii%) and 42 (eight.v%) had a preterm and belatedly term delivery respectively. The APGAR score of < 7 at 1 min and 5 mins interval was found in 3 and 2 children respectively. About 405 (81.vi%) of them were admitted to nursery and the rest 91 (18.3%) were admitted to NICU. While, the congenital anomalies were diagnosed in 31(six.3%) of neonates.

Table 2 Frequency of Neonatal Outcome

Full size table

At that place is no significant association betwixt maternal age and the occurrence of amniotic fluid disorders. Amniotic fluid disorders found to be higher in multigravida and BMI group ≥30 with not-significant P-value. A statically significant association was establish between gestational age at commitment and amniotic fluid disorders, polyhydramnios with belatedly term deliveries. Besides, the rate of term deliveries was equal in normal AFI and oligohydramnios group (P = 0.005). Withal, the rate of caesarean section (CS) was higher amidst pregnancies complicated with polyhydramnios, and oligohydramnios was establish to be majorly associated with vaginal deliveries (P = 0.008). Oligohydramnios was associated with neonatal birth weight < 2.5 kg and > two.5 kg, and polyhydramnios was associated with neonatal birth weight ≥ 2.5 Kg (P < 0.01). Cardiovascular and renal congenital anomalies were diagnosed in neonates with polyhydramnios and oligohydramnios respectively with a not-significant P-value. (Table three).

Table iii Association Between the Types of Amniotic Fluids

Full size table

Results in Tabular array 4 point a remarkable significant clan between oligo and polyhydramnios and patients with diabetes mellitus (P = 0.005), and gestational diabetes patients (P = 0.052). However, in that location was no significant association betwixt oligo or polyhydramnios and hypertension, heart disease, bronchial asthma, hypothyroidism and anemia.

Table 4 Association Betwixt Past Maternal History or chronic illness with Polyhydramnios and Oligohydramnios

Full size table

Discussion

The above results were based on the information obtained from the electronic medical records of 597 patients admitted in the department of obstetrics and gynecology at KAAUH, during Jan 2017 to Oct 2019. According to the results, fourteen.8% of the sample had dissimilar chronic medical disease, where 75.one% were multigravida. Besides, fourteen (2.8%) of the sample were diagnosed as polyhydramnios and 58 (11.7%) of the cases were oligohydramnios based on their amniotic fluid index. Regarding the fashion of delivery, ten (71.4%) of polyhydramnios cases required caesarean section, and almost all cases of aberrant amniotic fluids showed no significant association with built malformation. The most pregnant maternal risk factors associated with amniotic fluid disorders include diabetes mellitus and gestational diabetes.

Majority of the mothers had live born neonates, and but single case (0.2%) of stillbirth was documented with no obvious reason due to the lack of data. Similarly, a study conducted at Rex Abdul-Aziz University Hospital in Jeddah showed that 5356 out of 5432 patients enrolled in the written report had liveborn neonates, which represented 98.6% [7], this divergence in percentage might exist due to the large sample size enrolled in their study in comparison to the enrolled sample used in this research. More than twenty% neonates of full deliveries got admitted in NICU due to diverse medical reasons such as lower APGAR score or built anomalies, out of which 18.3% of 496 liveborn neonates were admitted to NICU that were included in this written report. Here, 6.2% of full babies were diagnosed with congenital anomalies, 22.6% of them were cardiovascular, while 54.8% were renal. Although, no relation was established with amniotic fluid disorders, the per centum is significantly higher compared to the previous study where 160 out of 5432 (2.nine%) babies were diagnosed with congenital malformations [7].

In the present report, the maternal age was divided into ii age groups i.e. participants less or equal to 35 years, and participants with above 35 years of age. Yet, virtually of the study participants (77.4%) were beneath 35 years, and the occurrence of amniotic fluid disorders was the same compared to the other age group (22.6%) of above or equal to 35 years. Thus, no association was constitute between maternal historic period and amniotic fluid disorders. Corresponding to some other report done in Ondokuz Mayis University, Turkey, maternal age has no effect on perinatal and neonatal outcomes [viii].

A statically significant clan was establish between gestational historic period at commitment and amniotic fluid disorders, polyhydramnios cases were mostly associated with late term deliveries which defined as a commitment after 42 weeks of gestation (P = 0.005), while the rate of term deliveries was equal in normal AFI and oligohydramnios group. These results are in contrast with another research conducted in Spain, which stated that oligohydramnios and polyhydramnios cases were associated with shorter gestational historic period [9] Information technology could be due to the balmy cases of polyhydramnios or successful treatment that the mothers underwent.

Among our nerveless sample, the rate of cesarean deliveries was higher in polyhydramnios cases comparison to normal cases, as mentioned past Yefet & Daniel-Spiegel [10] that, "This was attributed to an increased rate of elective surgeries because of suspected macrosomia". In add-on, the charge per unit of vaginal deliveries was greater amidst oligohydramnios cases. These results are in contrast with those proposed by a enquiry conducted in India which stated that the rate of vaginal deliveries was 2nd highest later cesarean deliveries [11]. Besides, 14 cases of polyhydramnios and 43 cases of oligohydramnios neonates weighted more than or equal to 2.5 Kg, whereas, 15 (25.9%) cases of oligohydramnios neonates were 2.5 Kg or less than it. A highly considerable association was plant between polyhydramnios cases and neonates who weighted ≥2.five kg. However, most of the neonates who weighted < 2.5 kg were diagnosed as oligohydramnios. Same association was plant in a previous research which proved that the amniotic fluid disorders are mostly associated with lower birth weight [9].

No obvious relation was established betwixt high torso mass alphabetize (BMI above 25) and amniotic fluid disorders. Besides, more than half of the sample were obese 57.9, and 32.4% were overweight. Correspondingly, some other research conducted in 2016 revealed that KSA is considered as the 15th nearly obese country with rate of 33.vii% amid population, thus no relation can be established [12]. However, there were increased cases of poly and oligohydramnios and congenital anomalies in this report, this could be because majority of them are obese or overweight as maternal obesity is linked to pregnancy complications and neonatal outcomes [13].

It has been noted that the occurrence of polyhydramnios was highly related to chronic disease of diabetes mellitus with P-value equal to 0.005. Similar value was shown with mothers who suffered from gestational diabetes mellitus, every bit outlined in one of the relevant articles that the about notable maternal risk factor backside polyhydramnios is diabetes mellitus [iii] which was also associated with the cases represented oligohydramnios. Hence, it can exist said that past maternal history of diabetes mellitus is the chief adventure factor backside amniotic fluid disorders according to the inquiry event. Other maternal chronic diseases showed no effect on amniotic fluid index although information technology might crusade other risks on the fetus. Similarly, no association was constitute betwixt hypertensive disorder of pregnancy and oligohydramnios, which could be due to the balmy cases or treatment received by the mothers.

This study has important implications, as the findings may aid medical experts in providing proper counselling regarding pregnancy related complications found among virtually of the Saudi women. It will further help medical experts to consider all the risk factors associated to the amniotic fluid disorders and its affect on maternal and fetal event. These findings may serve as highly useful in reducing the risks associated to the amniotic fluid disorders [xiv]. The written report was limited as it was a single center study. Also, the effects of treatment for chronic conditions of mothers and its impact on the amniotic fluid disorder was not studied due to the availability of limited information.

Conclusion

Findings of this study confirms that maternal risk factors which were associated with amniotic fluid disorders included diabetes mellitus and gestational diabetes. Regarding the maternal and fetal outcomes, the results indicated that oligohydramnios associated with gestational age at term and neonatal birth weighted < two.v kg, and polyhydramnios associated with gestational age at late term and neonatal nativity weighted > two.5 Kg. Regarding the fashion of commitment, it was constitute that CS was college among pregnancies which were complicated due to polyhydramnios while oligohydramnios was more often than not associated with vaginal deliveries.

Availability of information and materials

The datasets used and analyzed during the electric current study are available from the corresponding author on reasonable asking.

Abbreviations

AFI:

Amniotic Fluid Alphabetize

AFV:

Amniotic Fluid Volume

BMI:

Body Mass Index

CS:

Cesarean Section

KAAUH:

King Abdullah bin Abdul-Aziz Academy Infirmary

NICU:

Neonatal Intensive Care Unit

PNU:

Princess Nourah bint Abdulrahman University

SDP:

Single Deepest Pocket

SPSS:

Statistical Package of Social Sciences

References

1. Ross MG, Beall MH. Physiology of amniotic fluid book regulation [Cyberspace]. teksmedik.com. 2018. https://teksmedik.com/uptodate19/d/topic.htm?path=physiology-of-amniotic-fluid-volume-regulation. Accessed 26 Mar 2020.

2. Beloosesky R, Ross MG. Polyhydramnios [Cyberspace]. 2018. https://teksmedik.com/uptodate19/d/topic.htm?path=polyhydramnios. Accessed 26 Mar 2020

   Google Scholar

3. Amniotic Fluid Problems/Hydramnios/Oligohydramnios. Children'due south Hospital of Philadelphia. https://www.chop.edu/weather-diseases/amniotic-fluid-problemshydramniosoligohydramnios. Accessed 26 Mar 2020.

4. Mathew M, Saquib S, Rizvi SG. Take chances factors and outcome. Saudi Med J. 2008;29(ii):256–60.

   PubMed  Google Scholar

5. Beloosesky R, Ross MG. Oligohydramnios. 2018 https://teksmedik.com/uptodate19/d/topic.htm?path=oligohydramnios. Accessed 26 Mar 2020.

   Google Scholar

6. Morris RK, Meller CH, Tamblyn J, Malin GM, Riley RD, Kilby Dr., Robson SC, Khan KS. Association and prediction of amniotic fluid measurements for adverse pregnancy outcome: systematic review and meta-assay. Bjog: Bjog-Int J Obstet Gy. 2014;121(six):686–99. https://doi.org/10.1111/1471-0528.12589.

   CAS  Commodity  Google Scholar

7. Fida NM, Al-Aama J, Nichols West, Alqahtani M. A prospective report of congenital malformations amongst live built-in neonates at a university hospital in western Saudi arabia. Saudi Med J. 2007;28(ix):1367.

   PubMed  Google Scholar

8. Cakmak Celik F, Aygun C, Kucukoduk S, Bek Y. Maternal and neonatal outcomes in advanced maternal age: a retrospective cohort written report. J Matern-Fetal Neo M. 2017;30(20):2452–vi. https://doi.org/10.1080/14767058.2016.1253058.

   Article  Google Scholar

9. Martínez-Frías ML, Bermejo E, Rodríguez-Pinilla Due east, Frías JL. Maternal and fetal factors related to abnormal amniotic fluid. J Perinatol. 1999;19(7):514–20.

   Article  Google Scholar

10. Yefet E, Daniel-Spiegel E. Outcomes from polyhydramnios with normal ultrasound. Pediatrics. 2016;137(2):e20151948. https://doi.org/10.1542/peds.2015-1948.

    Article  PubMed  Google Scholar

11. Madhavi K, Rao PC. Clinical study of oligohydramnios, mode of delivery and perinatal issue. IOSR J Paring Med Sci. 2015;14(4):6–11.

    Google Scholar

12. Alqarni M. A review of prevalence of obesity in Saudi arabia. J Obes Eat Disord. 2016;ii(2):25. https://doi.org/10.21767/2471-8203.100025.

    Article  Google Scholar

13. Timur BB, Timur H, Tokmak A, Isik H, Eyi EG. The influence of maternal obesity on pregnancy complications and neonatal outcomes in diabetic and nondiabetic women. Geburtshilfe Frauenheilkd. 2018;78(4):400. https://doi.org/10.1055/a-0589-2833.

    Commodity  PubMed  PubMed Cardinal  Google Scholar

14. Magann Eastward, Ross MG. Assessment of amniotic fluid volume. 2018. https://teksmedik.com/uptodate19/d/topic.htm?path=assessment-of-amniotic-fluid-volume Accessed 26 Mar 2020.

    Google Scholar

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Acknowledgements

The authors are very thankful to all the associated personnel in any reference that contributed in/for the purpose of this research.

Funding

This enquiry is not funded by any resource.

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Affiliations

1. Clinical Sciences Section, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi arabia

   H. Bakhsh & H. Alenizy

2. Department of Obstetrics & Gynecology, Male monarch Abdullah bin Abdulaziz Academy Infirmary, Riyadh, Saudi Arabia

   H. Bakhsh & H. Alenizy

3. College of Medicine, Princess Nourah bint Abdulrahman Academy, Riyadh, Saudi arabia

   South. Alenazi, S. Alnasser, N. Alanazi, M. Alsowinea, Fifty. Alharbi & B. Alfaifi

Contributions

All authors have approved the manuscript. H. Bakhsh: correspondence, formulation, blueprint, analysis, assistants and editing. H. Alenizy: Analysis and writing. S. Alenazi: Analysis and writing. S. AlNasser: Analysis and writing. North. Alanazi: Analysis and writing. K. Alsowinea: Analysis and writing. Fifty. Alharbi: Analysis and writing. B. Alfaifi: Analysis and writing.

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Correspondence to H. Bakhsh.

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The study has been declared by the institutional review board in Princess Nourah bint Abdulrahman Academy (PNU), college of medicine. The study is registered nether IRB # KACST-KSA: H-01-R-059 [IRB Log No. 19–0222]. No licenses or permissions are required.

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Supplementary Information

Boosted file 1.

STROBE Argument—Checklist of items that should be included in reports of retrospective studies.

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Bakhsh, H., Alenizy, H., Alenazi, Southward. et al. Amniotic fluid disorders and the furnishings on prenatal outcome: a retrospective cohort study. BMC Pregnancy Childbirth 21, 75 (2021). https://doi.org/10.1186/s12884-021-03549-iii

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• Received: 24 June 2020

• Accepted: 08 January 2021

• Published: 22 January 2021

• DOI : https://doi.org/10.1186/s12884-021-03549-3

Keywords

• Amniotic fluid
• Disorders
• Parental outcome
• Saudi arabia

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