DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20202709

Relationship between the amniotic fluid index at term and the perinatal outcome

Bhumika H. Dobariya, Shree A. Jani, Ajesh N. Desai

Abstract


Background: Amniotic fluid index (AFI) is commonly used to estimate amniotic fluid volume. A proper AFI is between 10 and 24 centimetres. If it is below 5 cm, it is can represent oligohydramnios, and in case AFI is above 24 cm, it can represent polyhydramnios. This study was undertaken to determine whether measuring AFI at term is useful in the prediction of perinatal outcome.

Methods: A prospective study of 250 pregnant women with gestational age between 37 and 42 weeks was conducted at Sola Civil Hospital. AFI was measured in each patient using the Phelan’s technique and the perinatal outcome was studied. The results were analysed and presented in the form of tables and graphs.

Results: Total 250 patients were studied. Out of them, 33 patients (13.2%) had AFI <=5, 215 (86%) had AFI between 6 and 24; and 2 patients (0.8%) had AFI >=25.19 out of 33 (57.57%) patients with AFI <= 5, had to undergo caesarean section, out of which, 12 caesarean sections (63.15%) were taken for non-reassuring foetal status. 36.27% (78/215) of patients with AFI between 6 and 24 underwent caesarean section, out of which 38.46% (30/78) underwent caesarean section for non-reassuring foetal status.

Conclusions: In the presence of oligohydramnios, the rates of LSCS due to foetal distress, the occurrence of low Apgar score and of low birth weight are higher than in patients with normal liquor at term. Thus, measuring the amniotic fluid index at term can be helpful in the prediction of perinatal outcome.


Keywords


Amniotic fluid index, Caesarean section, Perinatal outcome, Phelan's technique, Term pregnancy

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References


Singhal SR, Gupta R, Sen J. Low amniotic fluid index as a predictor of adverse perinatal outcome â An Indian perspective. Clin Mother Child Health. 2015;2015.

Chamberlain PF, Manning FA, Morrison I, Harman CR, Lang CR. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gynecol. 1984;150(3):2459.

Nageotte MP, Towers CV, Asrat T, Freeman RK. Perinatal outcome with the modified biophysical profile. Am J Obstet Gynecol. 1994;170(6):1672-6.

Gumus II, Koktener A, Turhan NO. Perinatal outcomes of pregnancies with borderline amniotic fluid index. Arch Gynecol Obstet. 2007;276(1):17-9.

Griffin M, Attilakos G, Greenwood R, Denbow M. Amniotic fluid index in low risk, post-dates pregnancies. Fetal Diagnos Ther. 2009;26(4):212-5.

Robert W Bales, Chapter 3 Obstetrics, question number 76. Lipsky MS, King MS, Susman JL, Bales, Robert W, Hunsaker, Matthew L editors, Family Medicine Certification Review. Lippincott Williams and Wilkins; 2007:127-161.

Morris JM, Thompson K, Smithey J, Gaffney G, Cooke I, Chamberlain P, et al. The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study. Int J Obstet Gynaecol. 2003;110(11):989-94.

Phelan JP, Ahn MO, Smith CV, Rutherford SE, Anderson E. Amniotic fluid index measurements during pregnancy. J Reprod Med. 1987;32:601-4.

Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis. Am J Obstet Gynecol. 1999;181(6):1473-8.

Locatelli A, Vergani P, Toso L, Verderio M, Pezzullo JC, Ghidini A. Perinatal outcome associated with oligohydramnios in uncomplicated term pregnancies. Arch Gynecol Obstet. 2004;269(2):130-3.

Morris JM, Thompson K, Smithey J, Gaffney G, Cooke I, Chamberlain P, et al. The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study. Br J Obstet Gynaecol. 2003;110(11):989-94.

Rutherford SE, Phelan JP, Smith CV, Jacobs NA. The four-quadrant assessment of amniotic fluid volume: an adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987;70(3):353-6.

Baron C, Morgan MA, Garite TJ. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Am J Obstet Gynecol. 1995;173(1):167-74.

Sarno AP, Ahn MO, Brar HS, Phelan JP, Platt LD. Intrapartum Doppler velocimetry, amniotic fluid volume, and fetal heart rate as predictors of subsequent fetal distress. Am J Obstet Gynecol. 1989;161:1508-14.

Sarno AP, Ahn MO, Phelan JP. Intrapartum amniotic fluid volume at term; association of ruptered membranes, oligohydramnios and increased fetal risk. J Reprod Med. 1990;35:719-23.

Robson SC, Crawford RA, Spencer JAD, Lee A. Intrapartum amniotic fluid index and its relationship to fetal distress. Am J Obstet Gynecol. 1992;166:78-82.

Voxman EG, Tran S, Wing DA. Low amniotic fluid index as a predictor of adverse perinatal outcome. J Perinatol. 2002;22(4):282-5.

Grubb DK, Paul RH. Amniotic fluid index and prolonged antepartum fetal heart rate decelerations. Obstet Gynecol. 1992;79(4):558-60.