Correlation of amniotic fluid index with fetomaternal outcome

Background: Amniotic fluid acts like a protective cover around the baby. Advances in ultrasound have increased early detection of abnormal amniotic fluid volumes. Any variation in the amniotic fluid volume warrants antenatal foetal surveillance.Methods: 300 pregnant women between 37 to 40 weeks of gestation were included in the study. A detailed history, examination and ultrasound was done. Pregnant women were divided into 3 groups’ i.e. normal liquor, oligohydramios and polyhydramnios. All the women were closely monitored during labour and puerperium. Follow-up was done till 7 days post-delivery. Maternal and neonatal data were collected.Results: 300 pregnant women were included in the study, out of which 221 had normal amniotic fluid index (AFI), 64 had oligohydramnios and 15 had polyhydramnios. All baseline characteristics were comparable between the groups except body mass index (BMI). Incidence of meconium stained liquor was significantly higher in oligohydramnios compared to normal AFI and polyhydramnios groups (34.4% versus 10.5% versus 13.3%; p=0.0001). Caesarean section rates were significantly higher in polyhydramnios and oligohydramnios compared to normal AFI group (73.3% versus 70.3% versus 19.9%; p=0.0001). Higher cases of low birth weight were recorded in oligohydramnios group compared to normal AFI and polyhydramnios group group (32.8% versus 18.6% versus 13.3%; p=0.011). Neonatal intensive care unit (NICU) admissions were higher in oligohydramnios (35.9%) and polyhydramnios (33.3%) compared to normal AFI group (35.9% versus 33.3% versus 12.7%; p=0.0001).Conclusions: Abnormal liquor volumes are associated with increased caesarean section rates, NICU admissions and neonatal mortality. Careful assessment of pregnant women is imperative for proper counselling and management.