Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda.
Department of Physiology, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda.
BMC Pregnancy Childbirth. 2022 Aug 2;22(1):610. doi: 10.1186/s12884-022-04939-x.
Oligohydramnios is associated with poor maternal and perinatal outcomes. In low-resource countries, including Uganda, oligohydramnios is under-detected due to the scarcity of ultrasonographic services. We determined the prevalence and associated factors of oligohydramnios among women with pregnancies beyond 36 weeks of gestation at Mbarara Regional Referral Hospital (MRRH) in Southwestern Uganda.
We conducted a hospital-based cross-sectional study from November 2019 to March 2020. Included were women at gestational age > 36 weeks. Excluded were women with ruptured membranes, those in active labour, and those with multiple pregnancies. An interviewer-administered structured questionnaire was used to capture demographic, obstetric, and clinical characteristics of the study participants. We determined oligohydramnios using an amniotic fluid index (AFI) obtained using an ultrasound scan. Oligohydramnios was diagnosed in participants with AFI ≤ 5 cm. We performed multivariable logistic regression to determine factors associated with oligohydramnios.
We enrolled 426 women with a mean age of 27 (SD ± 5.3) years. Of the 426 participants, 40 had oligohydramnios, for a prevalence of 9.4% (95%CI: 6.8-12.6%). Factors found to be significantly associated with oligohydramnios were history of malaria in pregnancy (aOR = 4.6; 95%CI: 1.5-14, P = 0.008), primegravidity (aOR = 3.7; 95%CI: 1.6-6.7, P = 0.002) and increasing gestational age; compared to women at 37-39 weeks, those at 40-41 weeks (aOR = 2.5; 95%CI: 1.1-5.6, P = 0.022), and those at > 41 weeks (aOR = 6.0; 95%CI: 2.3-16, P = 0.001) were more likely to have oligohydramnios.
Oligohydramnios was detected in approximately one out of every ten women seeking care at MRRH, and it was more common among primigravidae, those with a history of malaria in pregnancy, and those with post-term pregnancies. We recommend increased surveillance for oligohydramnios in the third trimester, especially among prime gravidas, those with history of malaria in pregnancy, and those with post-term pregnancies, in order to enable prompt detection of this complication and plan timely interventions. Future longitudinal studies are needed to assess clinical outcomes in women with oligohydramnios in our setting.
羊水过少与产妇和围产期不良结局有关。在包括乌干达在内的资源匮乏国家，由于超声服务稀缺，羊水过少的检出率较低。我们旨在确定在乌干达西南部姆巴拉拉地区转诊医院（Mbarara Regional Referral Hospital，MRRH），妊娠 36 周以上的孕妇中羊水过少的患病率及其相关因素。
我们于 2019 年 11 月至 2020 年 3 月进行了一项以医院为基础的横断面研究。纳入的研究对象为妊娠 36 周以上的孕妇。排除标准为胎膜早破、处于活跃产程以及多胎妊娠的孕妇。使用经过验证的问卷调查表，对研究参与者的人口统计学、产科和临床特征进行评估。通过超声检查获取羊水指数（amniotic fluid index，AFI）来确定羊水过少。AFI≤5cm 的孕妇被诊断为羊水过少。我们采用多变量逻辑回归分析确定与羊水过少相关的因素。
我们共纳入了 426 名平均年龄为 27（标准差±5.3）岁的孕妇。426 名参与者中，40 名（9.4%（95%CI：6.8-12.6%））患有羊水过少。与羊水过少相关的因素有妊娠期间患疟疾（优势比[aOR]：4.6；95%CI：1.5-14，P=0.008）、初产妇（aOR：3.7；95%CI：1.6-6.7，P=0.002）和妊娠周数增加；与孕 37-39 周的孕妇相比，孕 40-41 周（aOR：2.5；95%CI：1.1-5.6，P=0.022）和孕 41 周以上（aOR：6.0；95%CI：2.3-16，P=0.001）的孕妇更可能发生羊水过少。
在 MRRH 就诊的孕妇中，约每 10 名孕妇中就有 1 名被诊断为羊水过少，羊水过少在初产妇、妊娠期间患疟疾的孕妇和过期产孕妇中更为常见。我们建议加强对第三孕期羊水过少的监测，特别是在初产妇、妊娠期间患疟疾的孕妇和过期产孕妇中，以便及时发现该并发症并计划进行及时干预。需要进一步开展前瞻性纵向研究，以评估本研究人群中羊水过少孕妇的临床结局。
