Borderline Amniotic Fluid Index in Nigerian Pregnant Women is Associated with Worse Fetal Outcomes

Abstract

Background: The amniotic fluid index (AFI) is one of the parameters used to assess fetal well-being and predict perinatal outcomes. There is, however, a dearth of studies on the pregnancy outcomes of women with borderline AFI in Nigerian and African women. Aim: To compare the pregnancy outcomes of Nigerian women with borderline and normal amniotic fluid index. Subjects and Methods: This was a prospective cohort study conducted at two health facilities in Delta State, Southern Nigeria. A total of 114 pregnant women attending the antenatal clinics with singleton pregnancies at gestational age 37 to 41 + 6 weeks were recruited over a 5-month period. Fifty-seven subjects with borderline amniotic fluid index were matched with an equal number of subjects with the normal amniotic fluid index for gestational age, age of the parturient, and parity. These women were followed up till delivery, and pregnancy outcomes were determined. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 22 software. Results: The results showed that borderline amniotic fluid index was associated with increased risk of adverse pregnancy outcomes including intrapartum fetal distress, Appearance, Pulse, Grimace, Activity, and Respiration (Apgar) score <7 in 5 min, and birthweight <2.5 kg, and these were statistically significant (P = 0.04, 0.01, and 0.04, respectively). Conclusions: Borderline AFI is associated with an increased risk of adverse pregnancy outcomes in low-risk Nigerian women.

Evaluation of Perinatal Outcomes in Pregnant Women With Low Amniotic Fluid Index

“…According to the results of our study, the three adverse outcomes of respiratory distress, hospitalization in NICU, and length of hospitalization were statistically significantly different between the two groups with normal and borderline AFI (p<0.001) and in the borderline group was more than the normal group. Similar to the results of the present study, according to a study that was conducted with the aim of comparing perinatal outcomes in two groups with borderline and normal AFI, fetal distress in the group with borderline AFI was higher than in the group with normal AFI ( 3 ).…”

“…The normal volume of amniotic fluid plays an important role in the proper growth and development of the fetus ( 1 , 2 ) and it is an accurate measure to evaluate the proper placental function ( 3 , 4 ). Early diagnosis and interventions is one of the most important goals of perinatal care ( 5 ).…”

“…The common method used to measure amniotic fluid volume is the use of the amniotic fluid index (AFI) in ultrasound, based on which the largest vertical amniotic fluid pocket in each of the four quadrants of the uterus is selected and then added together ( 7 , 8 ). AFI is one of the parameters used to evaluate fetal well-being, predict adverse perinatal outcomes and perform necessary interventions to improve these outcomes ( 3 , 9 ). The normal range of AFI is 8–24 cm.…”

“…The normal range of AFI is 8–24 cm. AFI in the range of 5.1–8 cm is borderline oligohydramnios, and AFI of 5 cm or less are defined as oligohydramnios ( 3 , 7 ).…”

“…According to studies, oligohydramnios can be associated with adverse pregnancy outcomes such as fetal distress, meconium aspiration, preterm labor, cesarean section, low birth weight, low APGAR score, NICU admission, fetal and neonatal death ( 3 , 7 , 14 , 15 ). However, the results of studies are conflicting for both oligohydramnios and borderline oligohydramnios due to differences in inclusion criteria, gestational age, and definition of oligohydramnios ( 3 , 7 , 16 , 17 ). Therefore, the purpose of this study was to determine the relationship between low amniotic fluid level and perinatal outcomes.…”