Effect of Oligohydramnios on Fetal Heart Rate Patterns during Term Labor Induction

Abstract

Objective To estimate the effect of oligohydramnios on fetal heart rate (FHR) patterns in patients undergoing induction of labor (IOL) at term.

Study Design Secondary analysis of a prospective cohort study of consecutive term, singleton deliveries from 2010 to 2015. We included all patients who underwent IOL. Our primary outcomes were electronic fetal monitoring (EFM) characteristics in the 2 hours preceding delivery. Outcomes were compared between those induced with oligohydramnios and those induced without a diagnosis of oligohydramnios. Our secondary outcome was composite neonatal morbidity. Logistic regression was used to control for confounders.

Results Of 3,787 patients who underwent IOL, 147 had a diagnosis of oligohydramnios and 3,640 were included in the no oligohydramnios group. There was no significant difference in EFM characteristics between the two groups. There was no difference in composite neonatal morbidity. In patients with oligohydramnios, EFM patterns with baseline tachycardia for 30 minutes or greater were significantly associated with composite neonatal morbidity (31.3 vs. 5.3% adjusted odds ratio 8.63, 95% confidence interval 2.18, 34.1]).

Conclusion Term patients undergoing IOL with oligohydramnios had EFM patterns that did not differ from their induced peers.

Keywords

electronic fetal monitoring - fetal heart rate - induction of labor - oligohydramnios

Note

This study was presented in poster format at the 36^th annual meeting of the Society for Maternal-Fetal Medicine, Atlanta, GA, February 1–6, 2016.

• References

• 1 Rossi AC, Prefumo F. Perinatal outcomes of isolated oligohydramnios at term and post-term pregnancy: a systematic review of literature with meta-analysis. Eur J Obstet Gynecol Reprod Biol 2013; 169 (02) 149-154
• 2 Ek S, Andersson A, Johansson A, Kublicas M. Oligohydramnios in uncomplicated pregnancies beyond 40 completed weeks. A prospective, randomised, pilot study on maternal and neonatal outcomes. Fetal Diagn Ther 2005; 20 (03) 182-185
• 3 Callen PW. Amniotic fluid volume: its role in fetal health and disease. In: Callen PW. , ed. Ultrasonography in Obstetrics and Gynecology. Philadelphia, PA:: Saunders;; 2008: 758-779
• 4 Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis. Am J Obstet Gynecol 1999; 181 (06) 1473-1478
• 5 Cahill AG, Tuuli MG, Stout MJ, López JD, Macones GA. A prospective cohort study of fetal heart rate monitoring: deceleration area is predictive of fetal acidemia. Am J Obstet Gynecol 2018; 218 (05) 523.e1-523.e12
• 6 American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol 2009; 114 (01) 192-202
• 7 Hofmeyr GJ, Lawrie TA. Amnioinfusion for potential or suspected umbilical cord compression in labour. Cochrane Database Syst Rev 2012; 1 (01) CD000013
• 8 Hasegawa J, Matsuoka R, Ichizuka K. , et al. Intrapartum fetal heart rate pattern in oligohydramnios. Fetal Diagn Ther 2008; 24 (03) 267-270
• 9 Hadar A, Sheiner E, Hallak M, Katz M, Mazor M, Shoham-Vardi I. Abnormal fetal heart rate tracing patterns during the first stage of labor: effect on perinatal outcome. Am J Obstet Gynecol 2001; 185 (04) 863-868
• 10 Gabbe SG, Ettinger BB, Freeman RK, Martin CB. Umbilical cord compression associated with amniotomy: laboratory observations. Am J Obstet Gynecol 1976; 126 (03) 353-355
• 11 Novikova N, Hofmeyr GJ, Essilfie-Appiah G. Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour. Cochrane Database Syst Rev 2012; (09) CD000176
• 12 Epplin KA, Tuuli MG, Odibo AO, Roehl KA, Macones GA, Cahill AG. Effect of growth restriction on fetal heart rate patterns in the second stage of labor. Am J Perinatol 2015; 32 (09) 873-878
• 13 Locatelli A, Vergani P, Toso L, Verderio M, Pezzullo JC, Ghidini A. Perinatal outcome associated with oligohydramnios in uncomplicated term pregnancies. Arch Gynecol Obstet 2004; 269 (02) 130-133
• 14 Naveiro-Fuentes M, Prieto AP, Ruiz RS, Badillo MPC, Ventoso FM, Vallejo JLG. Perinatal outcomes with isolated oligohydramnios at term pregnancy. J Perinat Med 2016; 44 (07) 793-798
• 15 Ashwal E, Hiersch L, Melamed N, Aviram A, Wiznitzer A, Yogev Y. The association between isolated oligohydramnios at term and pregnancy outcome. Arch Gynecol Obstet 2014; 290 (05) 875-881
• 16 Tita AT, Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clin Perinatol 2010; 37 (02) 339-354
• 17 Shankaran S, Laptook AR, Ehrenkranz RA. , et al; National Institute of Child Health and Human Development Neonatal Research Network. Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med 2005; 353 (15) 1574-1584
• 18 Dhillon R. The management of neonatal pulmonary hypertension. Arch Dis Child Fetal Neonatal Ed 2012; 97 (03) F223-F228
• 19 Silverman WA, Andersen DH. A controlled clinical trial of effects of water mist on obstructive respiratory signs, death rate and necropsy findings among premature infants. Pediatrics 1956; 17 (01) 1-10