DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172914

The predictive value of amniotic fluid index for adverse perinatal outcome and suggested plan of action

Ritu Bawa, . Neerja

Abstract


Background: Modern obstetrics and perinatal medicine is concerned with recognition of a fetus at risk for death or damage in utero: quantifying the risk and determining the optimal time and mode of intervention. Objective of present study was to determine whether an antepartum amniotic fluid index (AFI) of 5.0cm or less is a predictor of adverse perinatal outcome.

Methods: This was a prospective study of 400 antenatal women booked at Muzaffarnagar Medical College during the year 2015-16 with gestational age between 36 and 41 weeks AFI was determined using the Phelan’s technique within 7 days of delivery or at the onset of labour. Perinatal outcome was compared between two groups i.e. AFI ≤5 and >5.

Results: An AFI of 5.0cm or less was significantly associated with higher cesarean section rate for fetal distress and low birth weight babies. There was no significant difference in APGAR score at 5 min. <7 between the two groups.

Conclusions: Determination of AFI is valuable for predicting fetal distress in labour requiring cesarean section. It can be used as an adjacent to other fetal surveillance methods. An AFI <5 detected after 36 weeks of gestation is an indicator of poor perinatal outcome.


Keywords


Amniotic fluid index, APGAR score, Cesarean delivery, Non-stress test

Full Text:

PDF

References


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

Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment with the four quadrant technique at 36-42 weeks gestation. J Reprod Med. 1987;32:540-2.

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;269:130-3.

Murray M editor. Antepartal fetal monitoring. In: antepartal and intrapartal fetal monitoring. New York: Springer Publishing Company; 2006:455-87.

Chandra P, Kaur SP, Hans DK, Kapika AK. The impact of amniotic fluid volume assessed intrapartum on perinatal outcome. Obstet Gynecol Today. 2000;5:478-81.

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

Kumar P, Iyer S, Ramkumar V. Amniotic fluid index: a new ultrasound assessment of amniotic fluid. J Obstet Gynecol India. 1991;41:10-2.

Casey BM, Mctire DD, Bloom SL, Lucas MJ, Santos R, Twickler DM et al. Pregnancy outcome after antepartum diagnosis of oligohydramnios at or beyond 34 weeks gestation. Am J Obstet Gynecol. 2000;1982:909-12.

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

Morries 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 Gynecol. 2003;110(11): 989-94.

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