Perinatal outcomes of pregnancies with borderline versus normal amniotic fluid index – A prospective study

Anamika Mishra; Ram Prasad Neupane; Pratap Narayan Prasad; Abhishek Kumar Thakur

Anamika Mishra Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Ram Prasad Neupane Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Pratap Narayan Prasad Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Abhishek Kumar Thakur

Keywords: Amniotic Fluid, Fetal Outcomes, Maternal Outcomes

Abstract

Introduction: Amniotic fluid cavity filled with liquor amnii is a natural floating bed for fetus required for its existence and growth in sterile environment, regulation of temperature, avoidance of external injury and reduction of impact of uterine contractions. Amniotic fluid has high influence on the fetal outcome and is directly related to the perinatal morbidity and mortality. This study aims to compare the pregnancy outcomes in patients with borderline AFI between 5-8 cm and normal AFI >/= 8-24 cm.

Method: This was a prospective observational study of 108 pregnant women. After Amniotic Fluid Index (AFI) assessment, they were categorized into two groups: those with AFI 5-8 cm (Group 1) and with AFI >/=8-24 cm (Group 2) accordingly. Pregnancy outcomes was noted in terms of mode of delivery, amniotic fluid colour & fetal birth weight.

Result: Six(11.1%) had instrumental delivery & 28 (51.8%) had Cesarean section in borderline AFI group. 6 (11.1%) had instrumental delivery & 14 (26%) had Cesarean section in normal AFI group. 28 (51.9%) had meconium stained amniotic fluid in borderline AFI group & 13 (24.1 %) had meconium stained amniotic fluid in normal AFI group. 110 (18.5%) newborns had fetal birth weight of <2.5 kg in borderline AFI group & 1 (1.9%) newborns had fetal birth weight <2.5 kg in normal AFI group.

Conclusion: Amniotic Fluid Index between 5-8 cm during term pregnancy has a significant association with higher rate of intervention during delivery, higher rate of meconium staining of liquor & a significantly higher rate of low birth weight.