Publication:

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

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.