Assessment of Amniotic Fluid Index by Ultrasonography and Its Association with Maternal and Fetal Outcomes: A Prospective Observational Study from A Tertiary Care Center in Maharashtra

Background: Amniotic fluid plays a crucial role in fetal development and well-being. Abnormalities in amniotic fluid volume, assessed using the amniotic fluid index (AFI), are associated with adverse maternal and fetal outcomes. Ultrasonographic evaluation of AFI serves as an important component of antenatal surveillance, particularly in the third trimester.

Objectives: To assess the amniotic fluid index using ultrasonography and evaluate its association with maternal and fetal outcomes.

Methods: This prospective observational study was conducted at a tertiary care center in Maharashtra from March 2025 to December 2025. A total of 48 pregnant women with singleton pregnancies beyond 28 weeks of gestation were included using a consecutive sampling technique. AFI was measured using Phelan’s four-quadrant technique and categorized as oligohydramnios (<5 cm), normal (5–24 cm), and polyhydramnios (>24 cm). Maternal outcomes (mode of delivery, complications) and fetal outcomes (birth weight, Apgar score, fetal distress, NICU admission) were recorded. Statistical analysis was performed using SPSS version 25, and associations were evaluated using Chi-square or Fisher’s exact test, with p<0.05 considered significant.

Results: Among 48 participants, 66.7% had normal AFI, while 20.8% and 12.5% had oligohydramnios and polyhydramnios, respectively. A significant association was observed between abnormal AFI and increased cesarean section rates (p=0.028). Low birth weight was significantly more common in the oligohydramnios group (60.0%) compared to the normal AFI group (18.8%) (p=0.012). Neonatal outcomes, including low Apgar score, fetal distress, and NICU admission, were significantly higher in abnormal AFI groups (p<0.05). Overall, adverse perinatal outcomes were significantly more frequent in oligohydramnios and polyhydramnios groups (50.0% each) compared to the normal AFI group (12.5%) (p=0.018).

Conclusion: Abnormal AFI is significantly associated with adverse maternal and fetal outcomes. Routine AFI assessment can aid in early detection of high-risk pregnancies and guide timely clinical interventions to improve perinatal outcomes.