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Abstract
Background:
Intrauterine fetal growth restriction (IUGR) is a major contributor to adverse perinatal outcomes, particularly in low- and middle-income countries. Oligohydramnios, a condition characterized by reduced amniotic fluid volume, is frequently associated with IUGR and is considered an indicator of uteroplacental insufficiency. The combined presence of these conditions may further compromise fetal well-being and influence obstetric management.
Objective:
To evaluate the association of intrauterine fetal growth restriction with and without oligohydramnios and to compare maternal and perinatal outcomes between the two groups at a tertiary care hospital in Karachi.
Methods:
This prospective observational study was conducted over a period of one year in the Department of Obstetrics and Gynecology. A total of 150 pregnant women diagnosed with IUGR (estimated fetal weight <10th percentile) at a gestational age of ≥28 weeks were included. Participants were divided into two groups: IUGR with oligohydramnios (amniotic fluid index ≤5 cm) and IUGR with normal amniotic fluid. Data regarding maternal demographics, obstetric characteristics, mode of delivery, and neonatal outcomes were collected. Statistical analysis was performed using SPSS version 25, and associations were assessed using the Chi-square test with a significance level of p ≤0.05.
Results:
Among the 150 patients, 60 (40%) had IUGR with oligohydramnios, while 90 (60%) had IUGR with normal amniotic fluid. The presence of oligohydramnios was significantly associated with increased rates of cesarean section (65% vs 40%, p=0.01), fetal distress (30% vs 15%, p=0.02), and NICU admission (35% vs 18%, p=0.01). Additionally, neonates in the oligohydramnios group had lower mean birth weights. However, no statistically significant difference was observed in perinatal mortality between the two groups (p>0.05).
Conclusion:
Oligohydramnios in pregnancies complicated by IUGR is associated with increased obstetric interventions and adverse neonatal outcomes. Early identification and close antenatal surveillance are essential to optimize perinatal outcomes and guide timely clinical decision-making.