Citation Information :
Vijay C, George S. To Study the Association of Low Amniotic Fluid Index and Adverse Perinatal Outcomes in Third Trimester of Pregnancy. J South Asian Feder Obs Gynae 2023; 15 (2):153-158.
Background and objectives: Amniotic fluid is the complex fluid surrounding the fetus in utero and gives a low resistance environment needed for the growth and development of the fetus. Clinical estimation of amniotic fluid volume forms a major part of the fetal assessment and outcome of pregnancy. A strong association between oligohydramnios and increased lower segment cesarian section (LSCS) rates and low birth weight exists. As very few studies have looked into perinatal outcomes and AFI, we conducted a study wherein we measured the amniotic fluid index (AFI) in mothers between 28 and 40 weeks of gestational age (GA) and looked into its association with maternal and perinatal outcomes.
Methods: This was a descriptive observational study on 108 patients in the Department of Obstetrics and Gynaecology, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India over a period of 2 years and we studied the association of AFI on maternal and perinatal outcomes. The data were collected from 6 November 2019 to 1 October 2021. Written and informed consent was obtained from patients agreeing to participate in the study. Ethical approval was obtained from the institutional ethics committee before the start of the study. Maternal and fetal outcomes were studied in the study subjects.
Results: This clinical study was conducted over a duration of 2 years on 108 pregnant women in the third trimester at St. John's Medical College and Hospital, Bengaluru, Karnataka, India. Nine patients were diagnosed with oligohydramnios. Hence, the prevalence of oligohydramnios was 8.3% in the study group. The most common presenting complaint or need for admission was safe confinement 48 (44.4%), followed by abdominal pain 40 (37%) and oligohydramnios 6 (5.6%). Majority of the pregnancies had a GA of 37–40 weeks (74.1%). The most mode of delivery was by LSCS (100%) in the AFI <5 cm group. In the AFI <5 cm group, 7 neonates had birth weight 2.5–4 kg.
Conclusion: Mode of delivery by LSCS seems to benefit the neonates in terms of lower incidence of non-reactive non-stress test (NST), low chance of meconium-stained liquor (MSL) and intrauterine death (IUD). Prompt decision for LSCS, even in the induced patients who are planned for vaginal delivery, is essential in preventing fetal morbidity such as MSL, fetal distress, and neonatal intensive care unit (NICU) admission.
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