Publication:

Association of amniotic fluid index with feto-maternal outcomes: a prospective observational study

Background Amniotic fluid index (AFI) serves as a critical marker for foetal wellbeing. Abnormal AFI values such as oligohydramnios and polyhydramnios have been associated with adverse pregnancy outcomes. Objective was to assess the association between AFI and feto-maternal outcomes amongst pregnant women between 32 and 40 weeks of gestation.

Methods This prospective observational study was conducted at Holy Family Hospital, New Delhi, from July 2022 to March 2024. A total of 150 women with singleton pregnancies were evaluated and categorized into four groups based on AFI: oligohydramnios ( 18 cm). Clinical, intrapartum, and neonatal outcomes were analysed.

Results Of the 150 participants, 14% had oligohydramnios, 23.3% borderline low, 39.3% normal, and 23.3% polyhydramnios. Oligohydramnios was significantly associated with preterm birth (47.6%, p<0.0001), low birth weight (57.1%, p<0.0001), emergency caesarean (61.9%, p<0.0001), NICU admissions (71.4%, p=0.004), and low APGAR scores at 1 and 5 minutes (61.9%; p=0.001 and 23.8%; p=0.0009, respectively). Polyhydramnios was strongly associated with gestational diabetes mellitus (51.4%, p<0.0001) and increased birth weight.

Conclusions Abnormal AFI, particularly oligohydramnios, is significantly associated with adverse feto-maternal outcomes. Routine assessment of AFI should be emphasized in late pregnancy to enable timely intervention.