The Association between Oligohydramnios and the Risk of Malpresentation: A Meta-Analysis.

Background: There is no consensus on the role of oligohydramnios on the increased risk of fetal malpresentation. Therefore, we decided, for the first time, to collect all published studies on this topic to synthesize all available data through a systematic review and meta-analysis to evaluate the effect of oligohydramnios on the increased risk of fetal malpresentation.

Methods: A search was done in the following international electronic bibliographic databases: PubMed, Web of Science, and Scopus to April 2021. Heterogeneity among studies was determined by the Q-test and I2 statistic. Publication bias was assessed by Begg and Egger tests. The results were reported using odds ratio (OR) estimates with 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Stata software Version 14 (StataCorp).

Results: The meta-analysis identified 431 articles, comprising 227,351 participants, exploring the link between oligohydramnios and malpresentation. A significant association was found (OR, 1.79 [95% CI, 1.42-2.15]), indicating that oligohydramnios increases the risk of malpresentation. The analysis also revealed substantial heterogeneity among the included studies (I² = 80.2%; P < 0.001).

Conclusion: This meta-analysis provides robust evidence that oligohydramnios is a significant risk factor for fetal malpresentation. These findings underscore the critical importance of monitoring amniotic fluid levels during pregnancy. The results suggest that healthcare providers should prioritize the assessment of amniotic fluid volume in pregnant patients, especially those presenting with risk factors for oligohydramnios.