A Comparative Evaluation of Fetomaternal Outcomes in Singleton Pregnancies with Normal Versus Abnormal Amniotic Fluid Volume in a Tertiary Care Teaching Hospital

Background: Amniotic fluid plays a vital role in fetal growth and development, and abnormalities in its volume are associated with adverse maternal and neonatal outcomes. Assessment of the amniotic fluid index (AFI) is an important component of antenatal surveillance for identifying high-risk pregnancies.

Aim: To compare fetomaternal outcomes in singleton pregnancies with normal and abnormal amniotic fluid volume.

Materials and Methods: This hospital-based prospective comparative observational study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care teaching hospital over one year. A total of 450 singleton pregnancies between 28 and 40 weeks of gestation were enrolled. Based on ultrasonographic AFI, participants were categorized into normal AFI (n=370) and abnormal AFI (n=80) groups. Maternal outcomes, including gestational age at delivery, mode of delivery, and liquor characteristics, and neonatal outcomes, including birth weight, APGAR score, and NICU admission, were compared. Statistical analysis was performed using the Chi-square test and Student's t-test, with a p-value <0.05 considered statistically significant.

Results: Of the 450 pregnancies, 17.8% had abnormal AFI, comprising 66.3% oligohydramnios and 33.7% polyhydramnios. Abnormal AFI was significantly associated with a higher incidence of preterm delivery (p<0.001), caesarean section (p<0.001), meconium-stained liquor (p=0.018), low birth weight (p<0.001), APGAR score <7 at 5 minutes (p=0.003), and NICU admission (p<0.001). Maternal age and gravidity showed no significant association with AFI status.

Conclusion: Abnormal amniotic fluid volume, particularly oligohydramnios, is associated with significantly increased adverse fetomaternal outcomes. Routine antenatal assessment of the amniotic fluid index facilitates early identification of high-risk pregnancies and timely obstetric intervention, thereby improving maternal and neonatal outcomes