A study on maternal and perinatal outcome in relation to amniotic fluid volume in pregnant women at term with or without risk factors

Abstract

Background and Objectives: Amniotic fluid index (AFI) is a quick, noninvasive and good indicator of fetal outcome in high-risk pregnancy. Amniotic fluid volume measured as AFI is a good predictor of fetal tolerance during labor. Materials and Methods: The present study consisted of n = 280 subjects (antenatal cases) with term gestations attending the Department of Obstetrics and Gynaecology at Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram (Dist.), Andhra Pradesh state, India, during the period between June 2018 to June 2020. Results: Among the total n = 280 study subjects n = 142 (50.9%) subjects were primipara while n = 138 (49.2%) were multipara. Among n = 224 (80.3%) subjects, majority were having AFI >8, n = 33 (11.8%) subjects were recorded having AFI ranging between 5-8 followed by n = 17 (6.1%) with AFI between 3 - 5 and n = 5 (1.8%) subjects with AFI ≤ 3. The correlation of gestational age and Amniotic Fluid Index was statistically not significant. Out of the total n = 21 study subjects with oligohydramnios all the n = 21 (100%) subjects went under emergency Lower Segment Caesarean Section (LSCS). Out of n = 230 patients with normal AFI, n = 134 (58.33%) underwent emergency LSCS followed by n = 79 (34.65%) had Full Term Normal Delivery (FTND) and n = 17 (7.39%) subjects had a pre-term vaginal delivery (PTVD). The observations were statistically significant. Among n = 29 subjects with polyhydramnios, n = 23 (79.31%) subjects underwent emergency LSCS, followed by n = 5 (17.2%) underwent FTND and n = 1 (3.44%) underwent PTVD, the observations were statistically significant. Oligohydramnios has a significant correlation with caesarean section for fetal distress, low birth weight babies and Neonatal Intensive Care Unit (NICU) admissions. Apgar score was compared among the three groups. The correlation of Apgar score at 5 minutes with amniotic fluid was found statistically significant. Conclusion: Careful antenatal evaluation and early detection of amniotic fluid abnormalities will reduce maternal / foetal morbidity and mortality more so in pregnancies at risk of an adverse pregnancy outcome. Determination of AFI should be used as an adjunct to other foetal surveillance methods. Choosing optimal mode of delivery could reduce maternal morbidities and improve labour outcome which will influence perinatal morbidity and mortality.