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Abstract

Background: Amniotic fluid plays a critical role in fetal development, serving as a protective medium and a marker of placental function. The amniotic fluid index (AFI), measured via ultrasound, is a widely accepted tool for assessing fluid volume. Oligohydramnios, defined as an AFI ≤5 cm, has been linked to several adverse perinatal outcomes, including intrauterine growth restriction (IUGR), low birth weight, and neonatal morbidity. Early identification through routine antenatal screening is essential for timely intervention and improved maternal and fetal outcomes.
Objective: To determine the frequency of low amniotic fluid index (AFI) in women presenting for routine antenatal checkups and to compare fetomaternal outcomes between patients with low AFI and those with normal AFI levels.
Methods: This descriptive case series was conducted at the Department of Obstetrics and Gynaecology, Ch. Muhammad Akram Teaching and Research Hospital, Lahore, from December 2024 to February 2025. A total of 205 pregnant women meeting the inclusion criteria were enrolled using non-probability consecutive sampling. The AFI was assessed by ultrasound, with ≤5 cm defined as low. Patients were monitored throughout pregnancy and childbirth. Data were collected using a structured proforma and analyzed using SPSS version 26. Chi-square test was applied, and a p-value ≤0.05 was considered statistically significant.
Results: The mean maternal age was 30.40 ± 5.76 years. The average gestational age was 36.33 ± 1.72 weeks, and the mean birth weight was 3.01 ± 0.42 kg. Low AFI was observed in 14 patients (6.83%). Among these, 9 (27.3%) neonates had low birth weight compared to 5 (2.9%) in the normal AFI group (p < 0.001). Significant associations were also found between low AFI and meconium staining (50.0% vs 4.1%, p < 0.001), IUGR (50.0% vs 4.1%, p < 0.001), neonatal ICU admissions (42.9% vs 5.6%, p = 0.008), low APGAR scores (42.9% vs 2.7%, p < 0.001), cesarean delivery (13.1% vs 2.5%, p = 0.003), and neonatal death (66.7% vs 5.9%, p = 0.013).
Conclusion: Low amniotic fluid was identified in a notable proportion of patients and was significantly associated with adverse fetomaternal outcomes. Routine AFI monitoring during antenatal visits is crucial for identifying high-risk pregnancies and initiating timely interventions.