Maternal and Foetal Outcome in Pregnancies With Borderline Amniotic Fluid Index in a Study in a Tertiary Care Hospital

Abstract

BACKGROUNDAmniotic fluid volume significantly affects the perinatal outcome, hence necessitates its measurement. Many methods are practised worldwide with every method having both advantage and limitations. Sonographic measurements help in assessing amniotic fluid volume antenatally and in intrapartum period as it is non-invasive and easy to use. Also, it is comparable with invasive methods. MATERIALS AND METHODSStudy was conducted in Mahatma Gandhi Memorial Government Hospital, attached to KAP Viswanatham Government Medical College, Trichy. The study period was from August 2012 to April 2014. Samples were 50 in group A and 50 in group B. Group A-Antenatal women admitted with borderline AFI 5 to 8 cm with singleton pregnancy who have completed 37 weeks with intact membrane. Group B-Antenatal women with Normal AFI 8 to 24 cm admitted as inpatients. RESULTSIn this study, 17 patients were below 20 years; 78 patients were between 21 to 30 years; and 5 patients were above 30 years. In this study out of 50 patients, 6, 16, 13 and 15 belonged to Gestational age of 37, 38, 39 and 40 weeks respectively and 6, 12, 17 and 15 patients belong to 37, 38, 39 and 40 weeks of gestation respectively. The mode of delivery in this study showed that 52 patients delivered by caesarean section (LSCS) and 48 patients by Labour natural which had P value of 0.423 (p >0.05) which is insignificant. The nature of amniotic fluid among group A was clear in 36 patients and meconium stained in 14 patients. Among group B, 78 patients had clear amniotic fluid and 22 had meconium-stained amniotic fluid. This is insignificant as the P value is 0.148 (p>0.05) which signifies that the nature of amniotic fluid does not depend solely on AFI level but also on other factors too. Implies that the mode of delivery doesn't significantly differ with amniotic fluid index. CONCLUSIONAssessing amniotic fluid antenatally and intrapartum foetal surveillance in means of Amniotic fluid index and Non-stress test helps in monitoring of foetus throughout antenatal period and also during labour. Identifying the way the foetus behaves during labour in borderline amniotic fluid index patients by means of foetal heart rate tracings (NST) helps in picking up foetal distress earlier and leads to deliver a neonate with good Apgar reducing the perinatal adverse outcome.

Maternal and perinatal outcomes, and associated factors in isolated borderline oligohydramnios: a cross-sectional analytical study

“…Studies have already proven that the nature and volume of amniotic fluid significantly affects the perinatal outcome. 21 Nature of the amniotic fluid is a predictor of fetal tolerance during labour, and its alterations is associated with an increased risk of abnormal heart rhythms and meconium fluid. Phelan et al studied amniotic fluid index during pregnancy and concluded that its usefulness in the evaluation of fetal monitoring throughout pregnancy.…”