Impact of Low Amniotic Fluid Index at Term Pregnancy on Perinatal Outcome

Abstract

Introduction: The amniotic fluid volume is an indicator of fetal wellbeing. Low Amniotic fluid index (AFI) is associated with several adverse perinatal outcomes. Its assessment is an essential component of antenatal fetal surveillance. Aim: The study is carried out to evaluate perinatal outcome in low AFI patients as oligohydramnios can reflect fetal jeopardy. It can also guide an obstetrician whether further evaluation needed or not as well as timing of delivery. Methodology: A prospective cohort study was done on 200 pregnant patients admitted in Obstetrics & Gynaecology, Dhaka Medical College & Hospital meeting the inclusion & exclusion criteria included in this study. Among them 100 patients belong to group- A had low AFI (≤5) and group B comprises 100 patients with normal AFI (>5). Assessment of perinatal outcome done by APGAR score at 1 and 5 minutes, birth weight, admission into NICU, still birth & early neonatal death and mode of delivery. Result: In this study, significance difference observed between two group in APGAR score at 1 min, low birth weight and mode of delivery. 36% from Group-A and 21% of Group-B neonates were found having low APGAR score (<7) at 1 minute which was improved after 5 min. Analyzing the birth weight data, 35% newborn from Group-A and 14% from Group-B were found low birth weight. Caesarean section higher (84%) in Group-A and vaginal delivery higher (64%) in Group-B. No significant difference observed between both group in APGAR score at 5 min, NICU admission & perinatal death. Conclusion: It has been observed that low APGAR score at 1 min, low birth weight and mode of delivery have statistically significant relationship with low amniotic fluid index (AFI≤5).