Obstetric outcome of pregnancies with borderline versus normal amniotic fluid index at term: an analytical cross sectional study

Authors

  • Siddhika Bhangale Department of Reproductive Medicine, Yashoda Hospital and IVF Center, Kamothe, Navi Mumbai, Maharashtra, India
  • Varsha Kose Department of Obstetrics and Gynecology, NKPSIMS and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20221449

Keywords:

Borderline amniotic fluid index, Maternal outcome, Perinatal outcome, Operative delivery

Abstract

Background:Amniotic fluid plays a vital role in the normal growth of fetus and promotes normal musculoskeletal development. Amniotic fluid index (AFI) is preferred method of amniotic fluid measurement in pregnancy which is done by ultrasonography. The normal range of AFI is between 5-24 cm. Any value above 24 cm is considered hydramnios and below 5 cm as oligohydramnios. More accepted range for borderline amniotic fluid index is 5-8 cm. The objective of this analytical cross-sectional, study was carried out to characterize maternal and fetal risks associated with borderline AFI in pregnancies, compared with normal amniotic fluid index.

Methods:This study included 180 women fulfilling inclusion criteria. 90 women were in borderline AFI group and 90 women in normal AFI group. Both were compared based on maternal outcome such as mode of delivery- normal vaginal delivery, instrumental, LSCS. Indication of instrumental, caesarean section and associated maternal morbidity, perinatal morbidity and mortality was compared.

Results:Out of 90 women, 41 women delivered vaginally (45.55%), 30 by instrumental (33.33%) and 19 by LSCS (21.11%).  26 NICU admission in borderline AFI group 13 were due to neonatal jaundice, 5 were due to respiratory distress, 3 due to sepsis, 2 due to seizures, 1 had necrotizing enterocolitis, 1 was due to persistent tachypnea, 1 due to severe hypoglycemia. In borderline AFI group 3.3% perinatal mortality was reported.

Conclusions:Maternal morbidity, perinatal morbidity and mortality was higher in borderline AFI group as compared to normal AFI group. There is a significant association of amniotic fluid volume with the maternal morbidity, perinatal morbidity and perinatal mortality.

 

Author Biography

Siddhika Bhangale, Department of Reproductive Medicine, Yashoda Hospital and IVF Center, Kamothe, Navi Mumbai, Maharashtra, India

FELLOW IN REPRODUCTIVE MEDICINE

References

Gupta KA, Hasabe RA, Aggarwal S. Pregnancy outcome after antepartum diagnosis of oligohydramnios at or beyond thirty seven completed weeks in rural India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;4(6):1811-6.

Ahmar R, Parween S, Kumari S, Kumar M. Neonatal and maternal outcome in oligohydramnios: a prospective study. Int J Contemp Pediat. 2018;5(4):1409-13.

Chamberlain PF, Manning FA, Morrison I, Harman CR, Lange IR. Ultrasound evaluation of amniotic fluid volume. I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gynecol. 1984;150(3):245-9.

Banks EH, Miller DA. Perinatal risks associated with borderline amniotic fluid index. Am J Obstet Gynecol. 1999;180(6):1461-3.

Casey BM, McIntire DD, Bloom SL, Lucas MJ, Santos R, Twickler DM, et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol. 2000;182(4):909-12.

Locatelli A, Zagarella A, Toso L, Assi F, Ghidini A, Biffi A. Serial assessment of amniotic fluid index in uncomplicated term pregnancies: prognostic value of amniotic fluid reduction. J Matern Fetal Neonatal Med. 2004;15(4):233-6.

Chauhan SP, Hendrix NW, Morrison JC, Magann EF, Devoe LD. Intrapartum oligohydramnios does not predict adverse peripartum outcome among high risk parturient. Am J Obstet Gynaecol 1997;176:1130-8.

Ott WJ. Reevaluation of the relationship between amniotic fluid volume and perinatal outcome. Am J Obstet Gynecol. 2005;192(6):1803-9.

Asgharnia M, Faraji R, Salamat F, Ashrafkhani B, Dalil HSF, Naimian S. Perinatal outcomes of pregnancies with borderline versus normal amniotic fluid index. Iran J Reprod Med. 2013;11(9):705-10.

Guin G, Punekar S, Lele A, Khare S. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume. J Obstet Gynaecol India. 2011;61(6):652-5.

Bushra N, Zeeshan K, Ejaz S, Mushtaq J, Waheed K, Khanum A. Frequency of Caesarean Section in Pregnancies with Borderline Amniotic Fluid Index at Term. Ann King Edward Med Uni. 2017;23(2).

Chate P, Khatri M, Hariharan C. Pregnancy outcome after diagnosis of oligohydramnios at term. Int J Reprod Contracept Obstet Gynecol. 2016;2(1):23-6.

Jagatia K, Singh N, Patel S. Maternal and fetal outcome in oligohydramnios: A study of 100 cases. Int J Med Sci Public Health. 2013;2(3):724.

Saxena R, Patel B, Verma A. Oligohydramnios and its perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2020;9(12):4965.

Chandra P, Kaur SP, Hans DK, Kapila AK. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Obstet and Gynae Today. 2000;5(8):478-81.

Sriya R, Singhai S. Perinatal outcome in patients with amniotic fluid index <5 cm. J Obstet Gynaecol India. 2001;51(5):98-100.

Umber A. Perinatal Outcome in Pregnancies Complicated by Isolated Oligohydramnios at Term. Annals. 2009;15:35-7.

Kaur P, Desai D, Taraiya A. A study on the perinatal outcome in cases of oligohydramnos. Int J Reprod Contracept Obstet Gynecol. 2016;5(1):98-109.

Wolff F, Schaefer R. Oligohydramnios--perinatal complications and diseases in mother and child. Geburtshilfe Frauenheilkd. 1994;54(3):139-43.

Downloads

Published

2022-05-26

Issue

Section

Original Research Articles