Comparison of the Effect of Injection Enoxaparin Versus Conventional Treatment on Amniotic Fluid Index in Borderline Oligohydramnios in Third Trimester of Pregnancy: A Randomized Control Trial in a Tertiary Care Hospital

Background: Oligohydramnios is defined as AFI less than or equal to 5 cm. A borderline AFI has been defined as an AFI of 5.1 cm to 8 cm3. The incidence of borderline AFI compared with a normal AFI (8.1 cm to 18 cm) is 6% to 44% in different studies. A decrease in amniotic fluids leads to serious complications for the mother and fetus. The study objective was to evaluate if an injection of Enoxaparin improves the amount of liquor in oligohydramnios in the third trimester of pregnancy.

Methodology: A randomized control trial was conducted in a Tertiary care obstetrics center. Total number of participants were 130. These participants were divided into two groups, each consisting of 65 participants. Group A received conventional treatment(intravenous fluid, tablet Aspirin, and rest in lateral position), while Group B received an injection of enoxaparin in addition to conventional treatment. AFI measurements were performed in the radiology department by radiologists using standard 4 quadrant measurements, twice weekly after the initiation of the treatment. The weight of the baby was noted at birth and admission to neonatal intensive care was noted to assess the health of the neonate. Data was analyzed on SPSS (statistical package for social sciences) version 23.

Results: In group A, the AFI increased after treatment in 47(72.3%) patients, remained static in 6(9.2%)patients, and decreased in 12(18.4%) patients. Whereas in group B, AFI increased in 31(68.8%)patients and decreased in 14(31.3%)patients, p= 0.334.

Conclusion: The findings in the current study did not demonstrate any significant effect of the use of injection enoxaparin in improving borderline oligohydramnios. Further research is needed to apply this research to the general population.