A Clinical study of amniotic fluid index at or beyond 28 weeks of gestation and its relation to perinatal outcome


  • Monica Chetani Department of Obstetrics and Gynaecology, FNB Trainee Institute of Reproductive Medicine, Kolkata, India
  • . Deepika Department of Obstetrics and Gynaecology, ESI PGIMSR, Basaidarapur, New Delhi, India
  • Santosh Khajotia Department of Obstetrics and Gynaecology, Sardar Patel Medical College, Bikaner, Rajasthan, India
  • Swati Kochar Department of Obstetrics and Gynaecology, Sardar Patel Medical College, Bikaner, Rajasthan, India




Amniotic fluid, Gestation, Oligohydramnios


Background: Amniotic fluid plays a major role in the development of fetus. It provides a medium in which fetus can readily move, cushions the fetus against injuries, helps to maintain even temperature. Objective of present study was to investigate the perinatal outcome of ultrasonographically detected normal and decreased (Oligohydramnios) amniotic fluid index, at or beyond 28 weeks of gestation.

Methods: During this study 200 patients with singleton pregnancy were selected at or beyond 28 weeks of pregnancy and AFI was evaluated. On the basis of AFI measurement patients were divided in two groups. Perinatal outcome in pregnancies with AFI of <5cm were compared with those with normal AFI.

Results: There was significant correlation (p<0.001) between oligohyramnios and poor perinatal outcome. Incidence of LSCS, meconium stained liquor and low apgar score has significant correlation in patients with oligohydramnios. Incidence of low birth weight babies, NICU admissions and perinatal death was more were more are more in oligohydramnios cases. This is statistically significant (p<0.001).

Conclusions: AFI <5 cm at or beyond 28 weeks of gestational age in an indicator of poor perinatal outcome. AFI measurement in antepartum or intrapartum period can help to identify women who need increased antepartum surveillance for pregnancy complications and such women should be managed in a special unit to combat the complications effectively.


Brace RA, Wolf EJ. Normal amniotic fluid volume changes throughout pregnancy. Am J Obstet Gynecol 1989; 161:382-388.

Fernando A. Practical guide to high risk pregnancy and delivery. 2nd ed Mosby – year Book. Inc 1993; 30 : 150-59.

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

Ghike S, Reddy G, Ghike NW. Increasing severity of oligohydramnios: A risk factor for outcome. J South Asian Feder Obst Gynae 2013; 5(1):8-10.

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

Garmel SH, Chelmow D, Sha SJ. Oligohydramnios and appropriately grown fetus. Am J Perinatol 1997; 14:359-63.

Casey BM, Mc-Intire DD, Donald D. Pregnancy outcome after diagnosis of oligohydramnios at or beyond 34 weeks of gestation. Am J Obstet Gynecol 2000; 182 : 902-12.

Rainford M, Adair R, Scialli AR, Ghidini A, Spong CY. Amniotic fluid index in the uncomplicated term pregnancy. Prediction of outcome. J Reprod Med. 2001; 46(6):589-92.

Jandial C, Gupta S, Sharma S, Gupta M. Perinatal outcome after antepartum diagnosis of oligohydramnios at or Beyond 34 weeks of gestation. JK Sci 2007; 9(4) : 213-214.

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

Crowley P, Harlihy CO, Boylan O. The value of ultrasound measurement of amniotic fluid volume in the management of prolonged pregnancies. Br J Obstet Gynecol 1984; 91 : 444-48.

Rutherford SE, Jeffrey P, Phelan J, Smith CV, Jacobs N. The four quadrant assessment of amniotic fluid volume. An adjunct to antepartum fetal heart rate testing. Obstet Gynecol 197; 70 : 353.

Ergün A, Atay V, Pabuçcu R, Başer I, Duru NK, Tokaç G. Predictive value of amniotic fluid volume measurements on perinatal outcome. Gynecol Obstet Invest. 1998; 45(1):19-23.

Magann EF, Chouhan SP, Kinsella MJ. Antenatal testing among 1001 patients at high risk. The role of ultrasonographic estimate of amniotic fluid volume. Am J Obstet Gynecol 1999; 180 : 1330-1336.

Sarno AP Jr, Ahn MO, Brar HS. Intrapartum Doppler velocimetry, amniotic fluid volume and fetal heart rae as prediction of subsequent fetal distress. Am J Obstet Gynecol 1989; 16:1508-14.

Conway DL, Adkins WB, Shroedere B. Isolated oligohydramnios in the term pregnancy: Is it a clinical entity? J Matern Fetal Med 1998; 7:197-200.

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

Bachhav AA, Waikar MR. Low amniotic fluid index at term as a predictor of adverse perinatal outcome. J Evol Med Dent Sci 2013; 2(38) : 7221-26.

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






Original Research Articles