The Implication of Different Volumes of Amniotic Fluid in Predicting Neonatal Outcome

Authors

  • Najia Kasi Department of Obs and Gynae, Combined Military Hospital Rawalpindi (CMH) Multan, Pakistan.
  • Shaista Ambreen Department of Obs and Gynae, Combined Military Hospital Rawalpindi (CMH) Multan, Pakistan.
  • Shazia Awan Department of Obs and Gynae, Combined Military Hospital Rawalpindi (CMH) Multan, Pakistan.
  • Arshad Khushdil Department of Obs and Gynae, Combined Military Hospital Rawalpindi (CMH) Multan, Pakistan.
  • Lubna Noor Department of Obs and Gynae, Combined Military Hospital Rawalpindi (CMH) Multan, Pakistan.
  • Nidda Yaseen Department of Obs and Gynae, Combined Military Hospital Rawalpindi (CMH) Multan, Pakistan.
  • Sehrish Raja Department of Obs and Gynae, Combined Military Hospital Rawalpindi (CMH) Multan, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i1.563

Keywords:

Amniotic fluid index, Oligohydramnios, Neonatal outcomes, Cesarean delivery

Abstract

Background: Amniotic fluid index (AFI) variations has been associated with adverse perinatal outcomes, including increased cesarean delivery rates and neonatal complications. Accurate monitoring of AFI is essential for predicting and managing high-risk pregnancies effectively. Objective: To evaluate the predictive value of AFI for adverse perinatal outcomes, including neonatal morbidity and delivery mode, in term pregnancies. Study Design: Prospective cohort study. Duration and Place of Study: The study was conducted from June 2023 to December 2023 at the Department of Obstetrics and Gynaecology, CMH Multan. Methodology: A total of 60 term pregnancies were included, divided into two groups: Group A (AFI <5 cm) and Group B (AFI >5 cm). Patients were aged 18–40 years with singleton, non-anomalous pregnancies at ≥37 weeks gestation. Exclusion criteria included pre-existing medical conditions, multiple pregnancies, and prior cesarean delivery. AFI was measured using the four-quadrant technique, and neonatal outcomes such as Apgar scores, birth weight, NICU admissions, and respiratory distress were assessed. Non-stress test (NST) reactivity and delivery mode were also recorded. Results: Group A exhibited significantly higher rates of cesarean deliveries (66.7% vs. 20%, p<0.05), low Apgar scores (73.3% vs. 36.7%, p=0.004), and NICU admissions (80% vs. 46.7%, p=0.007) compared to Group B. Non-reactive NSTs were more frequent in Group A (33.3% vs. 6.7%). While low birth weight was more common in Group A (50% vs. 30%), the difference was not statistically significant (p=0.114). Conclusion: Low AFI is a significant predictor of adverse perinatal outcomes, including higher cesarean rates, poor neonatal outcomes, and increased NICU admissions. Routine AFI monitoring in term pregnancies is critical for identifying high-risk cases and improving neonatal outcomes, emphasizing its value in obstetric care.

Downloads

Download data is not yet available.

References

Shamsnajafabadi, H., & Soheili, Z.-S. (2022). Amniotic fluid characteristics and its application in stem cell therapy: A review. International Journal of Reproductive BioMedicine (IJRM), 20(8), 627–643. https://doi.org/10.18502/ijrm.v20i8.11752

Roy, A., Mantay, M., Brannan, C., & Griffiths, S. (2022). Placental Tissues as Biomaterials in Regenerative Medicine. BioMed Research International, 2022, 1–26. https://doi.org/10.1155/2022/6751456

David, A. L., & Spencer, R. N. (2022). Clinical assessment of fetal well‐being and fetal safety indicators. The Journal of Clinical Pharmacology, 62(S1). https://doi.org/10.1002/jcph.2126

Huri, M., Di Tommaso, M., & Seravalli, V. (2023). Amniotic fluid disorders: From prenatal management to neonatal outcomes. Children, 10(3), 561. https://doi.org/10.3390/children10030561

Shinde, A., Chaudhari, K., Dewani, D., & Shrivastava, D. (2023). Effect of amino acid infusion on amniotic fluid index in pregnancies associated with Oligohydramnios and fetal growth restriction. Cureus. https://doi.org/10.7759/cureus.39027

Whittington, J. R., Ghahremani, T., Friski, A., Hamilton, A., & Magann, E. F. (2023). Window to the womb: Amniotic fluid and postnatal outcomes. International Journal of Women's Health, 15, 117-124. https://doi.org/10.2147/ijwh.s378020

Mohammed, S. S., & Ahmed, A. A. (2024). Prevalence Rate, Probable Causes, and Perinatal Outcomes in Women With Oligohydramnios in Labor. PubMed, 16(5), e61290–e61290. https://doi.org/10.7759/cureus.61290

Hughes, D., Simmons, B., Magann, E., Wendel, M., Whittington, J. R., & Ounpraseuth, S. (2021). Amniotic fluid volume estimation from 20 weeks to 28 weeks. Do you measure perpendicular to the floor or perpendicular to the uterine contour? International Journal of Women's Health, 13, 1139-1144. https://doi.org/10.2147/ijwh.s340378

Bohîlțea, R. E., Dima, V., Ducu, I., Iordache, A. M., Mihai, B. M., Munteanu, O., Grigoriu, C., Veduță, A., Pelinescu-Onciul, D., & Vlădăreanu, R. (2022). Clinically relevant prenatal ultrasound diagnosis of umbilical cord pathology. Diagnostics, 12(2), 236. https://doi.org/10.3390/diagnostics12020236

Batool, A., Sultana, M., Sher, Z., Fayyaz, S., Sharif, A., & Faisal, N. (2024). Correlation between oligohydramnios and anaemia in the third trimester of pregnancy: A study in a tertiary care hospital in Pakistan. PubMed, 65(3), 313–319. https://doi.org/10.60787/nmj-v65i3-438

Dermitzaki, N., Loukopoulos, T., Zikopoulos, A., Vatopoulou, A., Stavros, S., & Skentou, C. (2023). Genetic disorders underlying Polyhydramnios and congenital hypotonia: Three case reports and a review of the literature. Cureus, 15(12). https://doi.org/10.7759/cureus.50331

Preda, A., Ștefan, A. G., Preda, S. D., Comănescu, A. C., Forțofoiu, M., Vladu, M. I., Forțofoiu, M., & Moța, M. (2022). Transient Polyhydramnios during pregnancy complicated with gestational diabetes mellitus: Case report and systematic review. Diagnostics, 12(6), 1340. https://doi.org/10.3390/diagnostics12061340

Wu, F.-T., & Chen, C.-P. (2024). Too Much of a Good Thing: Updated Current Management and Perinatal Outcomes of Polyhydramnios. Journal of Medical Ultrasound, 32(4), 285–290. https://doi.org/10.4103/jmu.jmu_83_24

Argaiz, E. R., Koratala, A., & Reisinger, N. (2021). Comprehensive Assessment of Fluid Status by Point-of-Care Ultrasonography. Kidney360, 2(8). https://doi.org/10.34067/kid.0006482020

Recker, F., Gembruch, U., & Strizek, B. (2024). Clinical ultrasound applications in obstetrics and gynecology in the year 2024. Journal of Clinical Medicine, 13(5), 1244. https://doi.org/10.3390/jcm13051244

Ota, E., da Silva Lopes, K., Middleton, P., Flenady, V., Wariki, W. M., Rahman, M. O., Tobe-Gai, R., & Mori, R. (2020). Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: An overview of Cochrane systematic reviews. Cochrane Database of Systematic Reviews, 2020(12). https://doi.org/10.1002/14651858.cd009599.pub2

Bhagat, M., & Chawla, I. (2013). Correlation of amniotic fluid index with perinatal outcome. The Journal of Obstetrics and Gynecology of India, 64(1), 32-35. https://doi.org/10.1007/s13224-013-0467-2

Bakhsh, H., Alenizy, H., Alenazi, S., Alnasser, S., Alanazi, N., Alsowinea, M., Alharbi, L., & Alfaifi, B. (2021). Amniotic fluid disorders and the effects on prenatal outcome: A retrospective cohort study. BMC Pregnancy and Childbirth, 21(1). https://doi.org/10.1186/s12884-021-03549-3

Moin, S., Mushtaq, R., Iftikhar, B., Khan, M., Akram, N. A., & Fatima, S. (2020). Low amniotic fluid index (AFI) as a predictor of adverse fetal outcomes in the third trimester of pregnancy. Pakistan Armed Forces Medical Journal, 70(Suppl-1), S69-73. https://pafmj.org/PAFMJ/article/view/3796

Ulker, K., & Ozdemir, I. A. (2011). The Relation of Intrapartum Amniotic Fluid Index to Perinatal Outcomes. Kafkas Journal of Medical Sciences, 1(1), 1–7. https://doi.org/10.5505/kjms.2011.32042

Lajber, F., Habib, H., & Khaliq S, et al. (2020). Role of low AFI on perinatal outcome in term pregnancies. Pak J Med Health Sci, 14(3), 1498-501.

Gunasingha, H., Hemapriya, S., & Mendis, S. (2022). A Comparison of Amniotic Fluid Index versus Single Deepest Vertical Pocket Measurement at Term as a Predictor of Adverse Perinatal Outcome. Open Journal of Obstetrics and Gynecology, 12(10), 1062–1078. https://doi.org/10.4236/ojog.2022.1210089

Bhagat, M., & Chawla, I. (2013). Correlation of Amniotic Fluid Index with Perinatal Outcome. The Journal of Obstetrics and Gynecology of India, 64(1), 32–35. https://doi.org/10.1007/s13224-013-0467-2

Dwivedi, R., Depan, A., Yadav, K., & Samariya, M. (2019). Evaluation of amniotic fluid volume and its relation to perinatal outcome. International Journal of Reproduction Contraception Obstetrics and Gynecology, 8(6), 2449–2449. https://doi.org/10.18203/2320-1770.ijrcog20192448

Taha, W. S., Galal, S. K., & Alshawaf, M. (2024). Amniotic Fluid Turbidity via Ultrasound before 34 Weeks of Pregnancy and Neonatal Outcomes. Al-Azhar International Medical Journal /Al-Azhar International Medical Journal, 5(4). https://doi.org/10.58675/2682-339x.2358

Sultana, S., Akbar Khan, M. N., Khanum Akhtar, K. A., & Aslam, M. (2008). Low amniotic fluid index in high-risk pregnancy and poor apgar score at birth. J Coll Physicians Surg Pak, 18(10), 630-4. https://www.jcpsp.pk/archive/2008/Oct2008/09.pdf

Downloads

Published

2025-01-31

Issue

Vol. 3 No. 1 (2025): Indus Journal of Bioscience Research

Section

Original Article

License

Copyright (c) 2025 Indus Journal of Bioscience Research

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

The Implication of Different Volumes of Amniotic Fluid in Predicting Neonatal Outcome. (2025). Indus Journal of Bioscience Research, 3(1), 769-774. https://doi.org/10.70749/ijbr.v3i1.563