SINGLE CENTRE, OPEN-LABEL & NON RANDOMIZED CLINICAL TRIAL TESTING LMWH EFFICACY ON PERINATAL OUTCOME INLATE SECOND TRIMESTER OLIGOHYDRAMNIOS CASES

Abstract

Objective: To find out low molecular weight heparin (LMWH) efficacy inlate second trimester oligohydramnios cases.

Study Design: Quasi-experimental study.

Place and Duration of Study: Combined Military Hospital Malir, from Jan to Jun 2017.

Methodology: A total of 30 patients having amniotic fluid index (AFI) <8 on ultrasound scan during their late second trimester phase were enrolled in the study after informed consent. Exclusion criteria included congenital anomalies on U/S, PPROM, and drug-induced oligohydramnios. Personal, medical and obstetric history was obtained for age, parity and co-morbids like hypertension, antiphospholipid syndrome, and previous oligohydramnios. Low molecular weight heparin was started at dose of 0.5mg/kg of body weight subcutaneously for 8-12 weeks and stopped 24 hours prior to delivery. Rescan for amniotic fluid index and fetal bio-metry assessment done every 2 weeks till date of delivery. Fetal outcome in terms of maturity, mode of delivery, birth weight, APGAR score and need for NICU admission were measured.

Results: There were 28 live births and two intrauterine deaths. Twelve patients were delivered normally and 18 had elective LSCS. Of twenty eight cases, eight were premature low birth weight (LBW) babies. Twenty six patients showed significant improvement in amniotic fluid index. Average birth weight was 2.5kg. Neonates showed an average APGAR score of 7. Eight neonates admitted in NICU (for prematurity and/or low birth weight) and discharged within a week.

Conclusion: Low molecular weight heparin plays significant role in treating oligohydramnios in cases with or without risk factors. However further studies with large sample............