Affiliation:
1. Edith Wolfson Medical Center
2. Tel Aviv University
Abstract
Abstract
Background
We aimed to assess the association between isolated oligohydramnios in previous pregnancy and the incidence of placental related complications in subsequent pregnancy.
Methods
This was a retrospective cohort study of live singleton births from a single university affiliated medical center during an eleven-year period. We included women with two subsequent livebirth singleton deliveries at our center. A comparison was performed between subsequent pregnancies of women with isolated oligohydramnios in their first pregnancy (previous oligohydramnios group), and women without isolated oligohydramnios in their first pregnancy (control group). Patients for whom their first delivery was complicated by small for gestational age or pregnancy induced hypertension were excluded. The study groups were compared for obstetric and early neonatal outcomes, as well as recurrence of isolated oligohydramnios and a composite of placental related pregnancy complications, defined as one of the following complications: pregnancy induced hypertension, small for gestational age or placental abruption.
Results
A total of 218 in the previous oligohydramnios group and 5635 in the control group were compared. No differences were found between the groups in maternal age, body mass index, smoking and comorbidities. Gestational age at delivery was, 39.6 ± 1.1 vs. 39.3 ± 1.4 weeks, p = 0.001, in the oligohydramnios and controls respectively. Preterm birth rate was similar between the groups. As compared to controls, the previous isolated oligohydramnios group had a significantly higher incidence of oligohydramnios recurrence, 6.4% vs. 2.0%, p < 0.001, a higher rate of small for gestational age neonates, 7.8% vs. 4.4%, p = 0.02, and an overall higher rate of placental related disorders of pregnancy, 9.1% vs. 5.4%, p = 0.02.
Conclusion
Pregnancies complicated by isolated oligohydramnios are associated with an increased risk of placental related disorders in subsequent pregnancy. Isolated oligohydramnios may be the first sign of placental insufficiency and an independent manifestation of the placental related complications spectrum.
Publisher
Research Square Platform LLC
Reference17 articles.
1. Nabhan AF, Abdelmoula YA, “Amniotic fluid index versus single deepest vertical pocket as a screening test for preventing adverse pregnancy outcome,” Cochrane Database of Systematic Reviews, no. 3. John Wiley and Sons Ltd, 2008. doi: 10.1002/14651858.CD006593.pub2.
2. Beall MH, van den Wijngaard JPHM, van Gemert MJC, Ross MG, “Amniotic Fluid Water Dynamics,” Placenta, vol. 28, no. 8–9, pp. 816–823, Aug. 2007, doi: 10.1016/j.placenta.2006.11.009.
3. Oligohydramnios: Ultrasonically detected incidence and subsequent fetal outcome;Hill LM;Am J Obstet Gynecol,1983
4. Mercer LJ, Brown LG, Petres RE, Messer RH, Mexico N. “A survey of pregnancies complicated by decreased amniotic fluid,” 1984.
5. 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, vol. 290, no. 5, pp. 875–881, Nov. 2014, doi: 10.1007/s00404-014-3292-7.