Study of low amniotic fluid index and its effect on perinatal outcome

Abstract

AFI may be an important predictor for deciding timing of delivery and adverse maternal and fetal outcome. Hence, we aimed at determining whether an antepartum low amniotic fluid index (AFI) is a predictor of adverse perinatal outcome in normal pregnancy and to determine a threshold level of AFI that could predict an adverse outcome. This study was conducted as an observational study on a total of 100 antenatal females presenting with term pregnancy at Department of Obstetrics and Gynecology, Lord Mahavir Civil Hospital, Ludhiana during study period. Detailed history and clinical examination was done. AFI was assessed with help of USG. The study was conducted on a total of 100 antenatal females. AFI was <5 in 38%. Low AFI was associated with LSCS and negative fern test was statistically significant (p<0.05). We observed a significant association of low AFI with low birth weight, poor APGAR score at 1 as well as 5 minutes and higher risk of NICU admission (p<0.05). The area under the curve and sensitivity as well as specificity at cutoff (4.5) was maximum for NICU admission followed by LSCS (p<0.05). AFI is an important determinant of adverse maternal and fetal outcome. AFI <5 is associated with adverse maternal outcome in the form of higher operative delivery and adverse fetal outcome i.e. low birth weight, meconium stained liquor, low APGAR score and higher NICU admission. Intensive intrapartum care along with fetal surveillance may help in minimizing adverse perinatal outcomes.