Adverse Fetal Outcomes in Patients with Low Amniotic Fluid Index: Presenting Care Hospital Setting

Abstract

Background: Pregnancy is a critical period where various physiological parameters are monitored to ensure the well-being of both mother and fetus. Amniotic fluid index (AFI) is one such measure, with deviations from the norm, particularly low AFI, being associated with adverse fetal outcomes. This study delves into the correlation between low AFI and fetal well-being in a tertiary care setting. Objective: The aim of this study was to investigate the association between low AFI and adverse fetal outcomes and to quantify the impact of low AFI on fetal health during delivery in a tertiary care hospital. Methods: A prospective study was conducted on 100 pregnant women attending the Obstetrics and Gynecology Department of Khyber Teaching Hospital, Peshawar, from June 28 to September 27, 2023. AFI was measured using ultrasonography, with a particular focus on participants with an AFI of less than 5 cm. The study also included a systematic sample of patients across various gestational ages and recorded outcomes such as intrauterine growth restriction (IUGR), oligohydramnios-associated deformations, cord compression, variable decelerations in fetal heart rate, and the presence of meconium-stained amniotic fluid. Statistical analysis was performed using chi-square and t-tests, with a significance level set at p<0.05. Results: The mean AFI was 8.7 cm (SD = 1.5). Low AFI (<5 cm) was observed in 15% of the participants. Adverse outcomes included 6 cases of IUGR (6%), 4 cases of oligohydramnios-associated deformations (4%), 3 cases of cord compression (3%), 5 cases of variable decelerations in fetal heart rate (5%), and 8 cases of meconium-stained amniotic fluid (8%). A significant association was found between low AFI and adverse fetal outcomes (χ² = 8.43, p < 0.01). Conclusion: The study confirmed a significant correlation between low AFI and the presence of adverse fetal outcomes, emphasizing the importance of vigilant fetal monitoring and management in pregnancies with low AFI.