Published: 2021-07-26

Correlation of amniotic fluid index with fetomaternal outcome

Vidyasagara M., Chandrashekhar T., Sunil S. Raikar


Background: Amniotic fluid acts like a protective cover around the baby. Advances in ultrasound have increased early detection of abnormal amniotic fluid volumes. Any variation in the amniotic fluid volume warrants antenatal foetal surveillance.

Methods: 300 pregnant women between 37 to 40 weeks of gestation were included in the study. A detailed history, examination and ultrasound was done. Pregnant women were divided into 3 groups’ i.e. normal liquor, oligohydramios and polyhydramnios. All the women were closely monitored during labour and puerperium. Follow-up was done till 7 days post-delivery. Maternal and neonatal data were collected.

Results: 300 pregnant women were included in the study, out of which 221 had normal amniotic fluid index (AFI), 64 had oligohydramnios and 15 had polyhydramnios. All baseline characteristics were comparable between the groups except body mass index (BMI). Incidence of meconium stained liquor was significantly higher in oligohydramnios compared to normal AFI and polyhydramnios groups (34.4% versus 10.5% versus 13.3%; p=0.0001). Caesarean section rates were significantly higher in polyhydramnios and oligohydramnios compared to normal AFI group (73.3% versus 70.3% versus 19.9%; p=0.0001). Higher cases of low birth weight were recorded in oligohydramnios group compared to normal AFI and polyhydramnios group group (32.8% versus 18.6% versus 13.3%; p=0.011). Neonatal intensive care unit (NICU) admissions were higher in oligohydramnios (35.9%) and polyhydramnios (33.3%) compared to normal AFI group (35.9% versus 33.3% versus 12.7%; p=0.0001).

Conclusions: Abnormal liquor volumes are associated with increased caesarean section rates, NICU admissions and neonatal mortality. Careful assessment of pregnant women is imperative for proper counselling and management.


Oligohydramnios, Polyhydramnios, Caesarean section, NICU admission, AFI

Full Text:



Brace RA, Cheung CY. Regulation of amniotic fluid volume: evolving concepts. Advances in Fetal and Neonatal Physiology. 2014:49-68.

Ackerman CM, Moore TR, Lipkind HS. Abnormal Amniotic Fluid Volume. Protocols for High‐Risk Pregnancies: An Evidence‐Based Approach. 2020;407-19.

Lim KI, Butt K, Naud K, Smithies M. Amniotic Fluid: Technical Update on Physiology and Measurement. J Obstet Gynaecol Can. 2017;39(1):52-8.

Rabie N, Magann E, Steelman S, Ounpraseuth S. Oligohydramnios in complicated and uncomplicated pregnancy: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017;49(4):442-9.

Matěcha J, Nováčková M. Idiopathic polyhydramnios. Ceska Gynekol. 2020;85(6):417-21.

Smith G, Moraitis AA, Wastlund D, Thornton JG, Papageorghiou A, Sanders J, et al. A systematic review and cost-effectiveness analysis of the case for screening nulliparous women in late pregnancy using ultrasound. Health Technology Assessment. 2020.

Panda S, Jayalakshmi M, Shashi Kumari G, Mahalakshmi G, Srujan Y, Anusha V. Oligoamnios and Perinatal Outcome. J Obstet Gynecol India. 2017;67(2):104-8.

Thobbi VA, Sabahath S. A study of perinatal outcome in patients with low Amniotic Fluid Index (AFI). Age. 2017;20(40):60.

Geetha SK, Saraswathi K, Puri MS. Correlation of Amniotic Fluid Index (AFI) with Maternal and Perinatal Outcome in Antenatal Patients at Term Gestation. Ann Romanian Soc Cell Biol. 2021;3587-98.

Mathuriya G, Verma M, Rajpoot S. Comparative study of maternal and fetal outcome between low and normal amniotic fluid index at term. Int J Reprod Contracept Obstet Gynecol. 2017;6(2):640-4.

Chaudhary R, Dhama V, Singh S, Singh M. Correlation of reduced amniotic fluid index with neonatal outcome. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2401-6.

Ravi S, Allirathinam A, Priya S, Priya P, Radhakrishnan S. Normal and abnormal liquor volume and its correlation with perinatal outcome. New Indian J OBGYN. 2019;5(2):113-9.

Tajinder K, Ruchika S. Feto-Maternal Outcome in Pregnancies with Abnorma l AFI. IOSR J Dent Med Sci. 2016;15(4):71-5.

Bhagat M, Chawla I. Correlation of amniotic fluid index with perinatal outcome. J Obstet Gynecol India. 2014;64(1):32-5.

Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, et al. Short-term and long-term effects of caesarean section on the health of women and children. The Lancet. 2018;392(10155):1349-57.

Mascarello KC, Horta BL, Silveira MF. Maternal complications and cesarean section without indication: systematic review and meta-analysis. Rev Saúde Pública. 2017;51:105.

Tuffnell D. Medicolegal issues in obstetrics. Obstet Gynaecol Reprod Med. 2019;29(1):12-4.

Cegolon L, Mastrangelo G, Maso G, Dal Pozzo G, Ronfani L, Cegolon A, Heymann WC, Barbone F. Understanding factors leading to primary cesarean section and vaginal birth after cesarean delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015. Sci Rep. 2020;10(1):1-8.

Bastakoti R, Dangol A, Pradhan N. Amniotic Fluid Index and Perinatal outcome in term pregnancy in Dhulikhel hospital. J KIST Med Coll. 2021;3(1):27-32.