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

Main Article Content

Abdul Basit
Tayaba Mazhar
Fazilat Jamala
Muhammad Ihsanullah
Fatima Tanveer

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.

Article Details

How to Cite
Basit, A., Mazhar, T., Jamala, F., Ihsanullah, M., & Tanveer, F. (2023). Adverse Fetal Outcomes in Patients with Low Amniotic Fluid Index: Presenting Care Hospital Setting. Journal of Health and Rehabilitation Research, 3(2), 1229–1233. https://doi.org/10.61919/jhrr.v3i2.375
Section
Articles
Author Biographies

Abdul Basit, MTI Khyber Teaching Hospital/ Khyber Medical College Peshawar.

FCPS PGR, Department of Obs & Gyane.

Tayaba Mazhar, Khyber Teaching Hospital- Peshawar

Associate Professor Gynae C Unit.

Fazilat Jamala, North West General Hospital & Research Center-Hayatabad-Peshawar/Khyber Medical University Peshawar

Assistant Professor Obs & Gynae.

Muhammad Ihsanullah, Lady Reading Hospital- Peshawar

Paeds Medicine Department.

References

Moin S, Mushtaq R, Iftikhar B, Khan M, Akram NA, Fatima S. Low amniotic fluid index (AFI) as a predictor of adverse fetal outcomes in the third trimester of pregnancy. Pakistan Armed Forces Medical Journal. 2020 Jan 27;70(Suppl-1):S69-73.

Thobbi VA, Sabahath S. A study of perinatal outcome in patients with low Amniotic Fluid Index (AFI). Age. 2017;20(40):60.

Sharif N, Qasim A. Perinatal outcome in pregnant females at term having low amniotic fluid index. The Professional Medical Journal. 2021 Aug 31;28(09):1358-64.

Krispin E, Berezowsky A, Chen R, Meizner I, Wiznitzer A, Hadar E, Bardin R. Updating the amniotic fluid index nomograms according to perinatal outcome. The Journal of Maternal-Fetal & Neonatal Medicine. 2020 Jan 2;33(1):113-9.

Vijay C, George S. To Study the Association of Low Amniotic Fluid Index and Adverse Perinatal Outcomes in Third Trimester of Pregnancy. Journal of South Asian Federation of Obstetrics and Gynaecology. 2023 May 11;15(2):153-8.

Sardana P, Sewalkar M. Pregnancy outcome in amniotic fluid index less than five in term low risk pregnancy at Pravara Rural Hospital, Loni. Indian J Basic Appl Med Res. 2019;8:5-15.

Choi SR. Borderline amniotic fluid index and perinatal outcomes in the uncomplicated term pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine. 2016 Feb 1;29(3):457-60.

Sharma M, Sharma G, Verma A. Umbilical Artery Systolic/Diastolic Ratio and Amniotic Fluid Index in Prediction of Adverse Perinatal Outcome in Term Pregnancies. International Journal of Applied and Basic Medical Research. 2022 Apr;12(2):76.

Mousavi AS, Hashemi N, Kashanian M, Sheikhansari N, Bordbar A, Parashi S. Comparison between maternal and neonatal outcome of PPROM in the cases of amniotic fluid index (AFI) of more and less than 5 cm. Journal of Obstetrics and Gynaecology. 2018 Jul 4;38(5):611-5.

Geetha SK, Saraswathi K, Puri MS. Correlation of Amniotic Fluid Index (AFI) with Maternal and Perinatal Outcome in Antenatal Patients at Term Gestation. Annals of the Romanian Society for Cell Biology. 2021 Mar 27:3587-98.

Manisha DA, Tembhare D. Maternal And Fetal Outcomes In Term Pregnancies With Decreased Amniotic Fluid. European Journal of Molecular & Clinical Medicine. 2020 Dec 30;7(11):3584-91.

Tembhare A, Manisha A. Assessment of Correlation between Amniotic Fluid Index (AFI) and Feto-maternal Outcomes of In-term Pregnancies. Journal of Pharmaceutical Research International. 2021 Dec 30:480-6.

Kaur P, Desai DA, Taraiya A. A study on the perinatal outcome in cases of oligohydramnios. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016 Jan 1;5(1):98-110.

Tabasum S, Sher Z, Mushtaq S, Mukhtar A, Sharif S, Rasheed F. Comparison of Umbilical Artery Doppler and Amniotic Fluid Index in Prediction of Obstetrical and Perinatal Outcome≥ 34 Weeks of Gestation. Journal of The Society of Obstetricians and Gynaecologists of Pakistan. 2022 Sep 4;12(3):179-82.

Elsadek AH, Atef AM, Salama DN, Abdallah LM, Saada SM. Sonography Assessment of Amniotic Fluid Volume as a Predictor of Fetal Outcome in Low-Risk Pregnancy. The Egyptian Journal of Hospital Medicine. 2022 Jul 1;88(1):3022-8.

Wax JR, Pinette MG. The amniotic fluid index and oligohydramnios: a deeper dive into the shallow end. American journal of obstetrics and gynecology. 2022 Sep 1;227(3):462-70.

Shaker AA, Khalid SI, Fawzi HA. The association of amniotic fluid index measurement and pregnancy outcome. Medical Science. 2020;24(105):3035-40.

Chauhan R, Sahni S, Dubey A. A study on fetal outcome in patients with oligohydramnios. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2019 Feb 1;8(2):665-72.

Jeon HS, Lee SM, Jung YM, Oh S, Park JK, Lee EB, Park CW, Park JS, Han D, Jun JK. Proteomic biomarkers in mid-trimester amniotic fluid associated with adverse pregnancy outcomes in patients with systemic lupus erythematosus. PLoS One. 2020 Jul 17;15(7):e0235838.

Khan S, Bal H, Danish Khan I, Paul D. Feto-maternal Outcome in Patients with Gestational Diabetes Mellitus in Western India: A Two Years Follow up Study. Iranian Journal of Diabetes and Obesity. 2018 Sep 10;10(3):115-20.

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