"Amniotic Fluid Index as a Predictor of Maternal and Neonatal Outcome in Low Risk Patients “A Non Randomized Comparative Prospective Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 8
Abstract
INTRODUCTION Obstetrics is concerned with human reproduction and as such is always a subject of considerable contemporary relevance. Quantification of amniotic fluid is an important component of the biophysical profile in ultrasound evaluation of the fetal wellbeing, especially in the third trimester.1 Assessment of amniotic fluid volume at term is often included in antepartum care as a method of evaluating mode of delivery and fetal monitoring. Alterations in AFI have classically been considered as an indicator of fetal compromise. In the present study we have evaluated the relationship between amniotic fluid volume and maternal and perinatal outcome in low risk pregnancies. AIMS & OBJECTIVES To determine predictive value of amniotic fluid index in term pregnancy for maternal outcome-Nature of liquor, Induction of labor, Mode of delivery, Perinatal outcome- Fetal distress, Infant APGAR Score, Admission in NICU, Perinatal mortality. MATERIAL AND METHODS The present study was a non-randomized comparative study carried out in the Department of Obstetrics & Gynecology at Kamla Raja Hospital, Gajra Raja Medical College, and Gwalior (M.P.) From February 2015 to August 2016.The study participants included 400 antenatal women at Kamla Raja Hospital with gestational age 37 weeks and above, admitted for delivery. On admission risk factors identified with detailed past, personal, medical and surgical history. Thorough obstetric examination done with clinical evaluation of oligohydramnios, patients were evaluated whether in labor or not, and admission CTG done .Ultra-sonographic evaluation of amniotic fluid index using the phelan's technique2 done. After assessment of AFI patients were divided into two groups with respect to AFI <5cm and AFI>5cm.The patient’s in-labor were allowed to progress spontaneously with intrapartum intermittent auscultation of FHR, intrapartum CTG recording done according the ACOG guidelines and progress of labor recorded by partogram charting. Outcome assessed in term of maternal and fetal outcome. CONCLUSION The above study concludes that amniotic fluid index <5 cm is a helpful tool in determining poor maternal and perinatal outcome in otherwise low risk patients. The study shows high statistical significance between low AFI and occurrence of non-reassuring FHR. Rate of induction of labor and incidence of cesarean section was high in patients with AFI <5cm. Incidence of meconium stained liquor was higher in patients with low AFI. The study shows higher incidence of low Apgar score, rate of admission to NICU and perinatal mortality in patients with AFI<5cm. Maternal morbidity is increased in patients with AFI< 5cm due to increased incidence of induction their labor and cesarean section and its associated complications. Patients with AFI<5cm should be intensively monitored with intermittent auscultation and four hourly intra-partum CTG to decrease perinatal morbidity and mortality.
Authors and Affiliations
Prof. Dr Sonal Kulshestha, Dr Renu Dubey Sharma
Keywords
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- EP ID EP380768
- DOI 10.9790/0853-1708023742.
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