A Study on Impact of Borderline Oligohydrmnios on Fetomaternal Outcomes in Term Pregnancies with Cerebroplacental Ratio >1

Background: Oligohydramnios is described as decreased amniotic fluid volume relative to gestational age. Semi quantitatively it is described using the Amniotic Fluid Index (AFI) which is calculated by adding the depth in centimeters of the largest vertical pocket in each of four equal uterine quadrants. AFI less than or equal to 5 cm is defined as oligohydramnios. A Borderline Oligohydramnios (BO) is defined as AFI 5.1-8 cm. Objectives: To evaluate fetomaternal outcomes in term pregnancies with borderline oligohydramnios (Amniotic Fluid Index [AFI] 5–8 cm) and a cerebroplacental ratio (CPR) >1. Methods: This prospective analytical study was conducted at the Department of Obstetrics and Gynecology, Rajiv Gandhi Institute of Medical Sciences, Adilabad, involving 100 term (37–40 weeks) singleton pregnant women with AFI 5–8 cm and CPR >1, confirmed by Doppler ultrasound. Data were analyzed to assess Obstetric outcomes and perinatal outcomes. Results: The mean maternal age was 25.01 years (SD 3.98), with 48% aged 21–25 years. Gestational age distribution was 35% at 37 weeks, 29% at 38 weeks, 24% at 39 weeks, and 12% at 40 weeks. Obstetric outcomes included 38% NVD, 27% induced NVD, 20% assisted vaginal delivery, and 15% LSCS. Induction was used in 49% of cases (Foley’s catheter and prostaglandin E1). Perinatal complications included meconium-stained liquor (33%), low Apgar scores (23%), LBW (20%), fetal distress (19%), RDS (18%), NICU admissions (9%), and perinatal mortality (2%). Significant associations were found between gestational age and meconium-stained liquor (p=0.004) and RDS (p=0.02). No significant differences in perinatal outcomes were observed between cesarean and non-cesarean deliveries in mothers with CPR >1, suggesting safe vaginal delivery in this subgroup. Conclusion: Term pregnancies with borderline oligohydramnios and CPR >1 can achieve favorable fetomaternal outcomes with a high rate of vaginal deliveries and low severe perinatal complications. CPR >1 is a valuable marker for identifying cases suitable for vaginal delivery, reducing unnecessary cesarean sections while ensuring fetal well-being.