Publication:

Effect of borderline amniotic fluid index in last trimester on perinatal outcome in eastern India: a prospective observational study

Background This study was done to evaluate the impact of borderline amniotic fluid index (AFI) on perinatal outcomes in term pregnancies.

Methods This prospective observational study was conducted between January and June 2024. A total of 120 pregnant women at term (37-40 weeks) were divided into two groups: group A (n=60) with normal AFI (8-24 cm) and group B (n=60) with borderline AFI (5-8 cm). Participants were followed until delivery and up to 7 days postpartum with assessment of maternal and neonatal outcomes.

Results Baseline maternal characteristics were comparable between groups. The borderline AFI group had significantly higher rates of fetal distress requiring caesarean delivery (30.0% versus 13.3%, p=0.026), meconium-stained amniotic fluid (36.7% versus 16.7%, p=0.013), and NICU admissions (23.3% versus 10.0%, p=0.048). Neonates in the borderline AFI group had lower birth weights (3042±384g versus 3186±352g, p=0.034), lower umbilical cord pH (7.24±0.08 versus 7.28±0.07, p=0.004), and more early neonatal complications (18.3% versus 6.7%, p=0.045). Subgroup analysis revealed poorer outcomes in pregnancies with AFI 5-6.5 cm compared to AFI 6.6-8 cm.

Conclusions Borderline AFI at term is associated with adverse perinatal outcomes and should be considered a risk factor requiring closer antenatal monitoring and modified intrapartum management. The risk appears to increase with decreasing AFI values, even within the borderline range.