Abstract
Objective
Preterm preeclampsia (PET) is associated with increased perinatal morbidity and mortality. Amniotic fluid index is a clinical tool for the assessment of fetal well-being. Indeed, the presence of oligohydramnios is associated with adverse perinatal outcome and is considered as a marker for reduced fetal perfusion. Therefore, the aim of this study is to determine the association between oligohydramnios and maternal and fetal outcome in patients with preterm PET.
Study Design
This retrospective follow-up study included women with singleton gestation and preterm PET that were divided into two groups: 1) women with oligohydramnios (n=81); and 2) women with a normal amount of amniotic fluid (n=81) that were matched according to gestational age at delivery, severity of PET and year of delivery. Composite maternal morbidity included: preeclampsia complications, admission to maternal special care unit, magnesium sulphate treatment post partum and admission to intensive care unit. Composite neonatal morbidity included one or more of the followings: low Apgar score, perinatal death, cord blood pH<7.1, fetal distress, neonatal anemia and hypoglycemia.
Results
1) The prevalence of oligohydramnios among patients with PET who delivered preterm was 4.8% (81/1701). 2) Compared with women with preterm PET and normal amount of amniotic fluid, the study group had a significantly higher rate of intrauterine growth restriction (62.9% vs. 24.7%, P<0.01), and cesarean section (69.1% vs. 49.4%, P=0.01). 3) In a multiple logistic regression, oligohydramnios was an independent risk factor for increased neonatal morbidity (OR = 2.5). In contrast, the year of birth (OR=0.9) and gestational age at delivery (OR=0.4) had an independent protective effect against such morbidity. 4) The severity of PET was an independent risk factor for maternal morbidity (OR = 30.3).
Conclusions
In patients with preterm PET, oligohydramnios is an independent risk factor for fetal and/or neonatal morbidity. However, oligohydramnios does not contribute to the maternal morbidity associated with preterm PET.
Preterm preeclampsia (PET) is associated with increased perinatal morbidity and mortality. Amniotic fluid index is a clinical tool for the assessment of fetal well-being. Indeed, the presence of oligohydramnios is associated with adverse perinatal outcome and is considered as a marker for reduced fetal perfusion. Therefore, the aim of this study is to determine the association between oligohydramnios and maternal and fetal outcome in patients with preterm PET.
Study Design
This retrospective follow-up study included women with singleton gestation and preterm PET that were divided into two groups: 1) women with oligohydramnios (n=81); and 2) women with a normal amount of amniotic fluid (n=81) that were matched according to gestational age at delivery, severity of PET and year of delivery. Composite maternal morbidity included: preeclampsia complications, admission to maternal special care unit, magnesium sulphate treatment post partum and admission to intensive care unit. Composite neonatal morbidity included one or more of the followings: low Apgar score, perinatal death, cord blood pH<7.1, fetal distress, neonatal anemia and hypoglycemia.
Results
1) The prevalence of oligohydramnios among patients with PET who delivered preterm was 4.8% (81/1701). 2) Compared with women with preterm PET and normal amount of amniotic fluid, the study group had a significantly higher rate of intrauterine growth restriction (62.9% vs. 24.7%, P<0.01), and cesarean section (69.1% vs. 49.4%, P=0.01). 3) In a multiple logistic regression, oligohydramnios was an independent risk factor for increased neonatal morbidity (OR = 2.5). In contrast, the year of birth (OR=0.9) and gestational age at delivery (OR=0.4) had an independent protective effect against such morbidity. 4) The severity of PET was an independent risk factor for maternal morbidity (OR = 30.3).
Conclusions
In patients with preterm PET, oligohydramnios is an independent risk factor for fetal and/or neonatal morbidity. However, oligohydramnios does not contribute to the maternal morbidity associated with preterm PET.
Original language | English |
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Pages (from-to) | S307 |
Journal | American Journal of Obstetrics and Gynecology |
Volume | 204 |
Issue number | 1 |
DOIs | |
State | Published - 31 Jan 2011 |