(812) Amniotic fluid volume and perinatal outcomes in women with preeclampsia in a low resource country

Objective: To determine:
1. The prevalence of oligohydramnios in women with preeclampsia
2. The adverse perinatal outcomes associated with preeclampsia
3. The association between oligohydramnios and preeclampsia disease severity
4. The association between oligohydramnios and adverse perinatal outcomes in women with preeclampsia

Study Design: A cross-sectional study at the Korle Bu Teaching Hospital which assessed a total of 130 pregnant women from 28 weeks to 42 weeks gestation: 10 had preeclampsia and oligohydraamnios on one arm, and the rest had preeclampsia but no oligohydramnios on the other arm. All participants had their amniotic fluid index assessed by ultrasound. This assessment was repeated weekly and the last measurement taken before delivery was used for the analysis of amniotic fluid volume data. The perinatal outcomes were also recorded.

Results: The prevalence of oligohydramnios in women with preeclampsia was 7.7%. Adverse perinatal outcomes associated with preeclampsia were preterm delivery(50%), stillbirth(10%), poor APGAR scores at one and five minutes (36.1% and 17.7%), low birth weight (46.1%), and NICU admission (40.0%). There was no association between pre-eclampsia disease severity and oligohydramnios in women with preeclampsia and there was no association between oligohydramnios and adverse perinatal outcomes in women with preeclampsia. Male sex (p=0.02), gestational age at delivery (p=0.010) and birth weight (p=0.042) were the factors associated with adverse perinatal outcomes in women with preeclampsia.

Conclusion: Adverse perinatal outcomes associated with preeclampsia were preterm birth, stillbirth, poor APGAR scores, low birth weight and NICU admission. The lack of association between oligohydramnios and adverse perinatal outcomes; as well as the lack of association between oligohydramnios and severe preeclampsia suggests that it may not be beneficial for clinicians in low resource countries to use amniotic fluid volume as a marker for determining when preeclampsia is severe enough to warrant delivery or less severe enough to allow conservative management