Correlation between obstetric outcome and amniotic fluid index (AFI) in preterm prelabour rupture of membranes (PPROM)

Abstract

Background: The purpose was to determine whether AFI<5 cm after preterm premature rupture of the membranes (PPROM) is associated with an increased risk of maternal and perinatal morbidity.Methods: We performed a prospective case control study of 161 singleton pregnancies complicated by preterm prelabour rupture of the membranes (PPROM) in whom AFI was assessed. Patients were categorized in two groups on the basis of amniotic fluid index- AFI<5 cm or AFI ≥ 5 cm. Categorical data were tested for significance with the χ2 and Fisher exact tests. All 2-sided p values < 0.05 were considered significant.Results: Both groups were similar with respect to selected demographics, gestational age atrupture of the membranes, gestational age at the delivery, birth weight. Both groups were similar with respect to maternal chorio-amnionitis, abruption, mode of delivery, early onset neonatal sepsis and NICU stay. Patients with AFI<5 cm demonstrated greater frequency of C/S delivery for non-reassuring fetal tests.Conclusions: There is no significant difference between obstetric outcome in AFI<5 and AFI> 5 after PPROM between 24- and 37-weeks’ gestation.

The association of the amniotic fluid index (AFI) with perinatal fetal and maternal outcomes in pregnancies complicated by preterm premature rupture of membranes (PPROM)

“…Indeed, comparable to findings in our cohort, lack of association between AFI scores and adverse outcomes in pregnancies complicated by PPROM was also reported in other studies [5,15]. In a past study of 161 singleton pregnancies complicated by PPROM, authors reported that AFI < 5 cm and AFI ≥ 5 cm were similar in terms of gestational age at rupture of the membranes, gestational age at the delivery, mode of delivery, maternal chorioamnionitis, abruption, early onset neonatal sepsis and NICU stay as well as fetal birth weight [5]. No significant association of AFI with APGAR scores, neonatal RDS and maternal chorioamnionitis was also reported in another study [15].…”

“…Early recognition and appropriate treatment of PPROM is crucial for preventing potential adverse perinatal outcomes related to prematurity (i.e. neonatal morbidity and mortality) and for minimizing the risk of fetal and maternal complications [3][4][5][6]. However, PPROM continues to be a challenging condition in current obstetric practice in terms of controversies regarding the optimal timing and route of delivery to minimize maternal and perinatal morbidity [3,5].…”

“…Amniotic fluid index (AFI), a widely used method for evaluation of fetal well-being, is considered a useful parameter in this regard, given its potential in predicting adverse outcomes, aiding to decide on optimal mode of delivery in pregnancies complicated by PPROM [5,7,8]. Accordingly, presence of oligohydramnios (AFI < 5 cm) after PPROM has been suggested to be associated with increased likelihood of adverse fetal (i.e.…”

“…intrauterine growth restriction, fetal distress, pulmonary hypoplasia, respiratory distress syndrome, neonatal sepsis, necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia) and maternal (i.e. chorioamnionitis) perinatal outcomes, contributing to an increase in neonatal sepsis and mortality [5,[8][9][10][11][12].…”

“…However, the utility of AFI after PPROM in terms of adverse perinatal outcomes has not been extensively studied along with considerable controversy among the published studies [5,8,9,[12][13][14][15][16].…”