The role of amniotic fluid index in the management of postdate pregnancy.
OBJECTIVE
To evaluate the role of amniotic fluid index as a reliable fetal surveillance test in the management of postdate pregnancy.


METHODS
Cross-sectional analytical study.


METHODS
Hamdard University Hospital from May 2000 till May 2003.


METHODS
A total of 210 patients were studied. The antenatal fetal surveillance in these patients was based on ultrasound assessment of AFI twice weekly after 41 weeks. An abnormal AFI was defined as 6 cm , between 6 - 8 cm as equivocal and more than or equal to 8 as normal. Delivery outcome and early neonatal complications were main outcomes.


RESULTS
Rate of caesarean section (35.8%) in the women with AFI 6 cm was found significantly higher than 8.9% rate of caesarean section of the women having AFI > 6 cm (p = 0.001). Proportion of early neonatal complications was also significantly higher in the women with AFI 6 cm (p = 0.03). Out of a total 210 fetuses, 38 (18.1%) neonates were found with early complications, of these, 24 (63.2%) neonates were those whose AFI was 6 cm. Sensitivity of AFI was 63.2% while specificity was 83.1% as the power of reliable fetal surveillance.


CONCLUSIONS
AFI is a reliable fetal surveillance test. It may allow the conservative approach till 42 weeks to reduce the caesarean section rate due to failed induction of labour as well as perinatal morbidity and mortality.
Hassan
Anjum Ara
AA
Department of Obstetrics & Gynaecology, Hamdard College of Medicine & Dentistry, Hamdard University Hospital, Taj Medical Complex, M.A. Jinnah Road, Karachi-74400. amin493@hotmail.com
D000328:Adult; D000653:Amniotic Fluid; D002585:Cesarean Section; D003430:Cross-Sectional Studies; D005260:Female; D005323:Fetal Monitoring; D006801:Humans; D007751:Labor, Induced; D011247:Pregnancy; D011273:Pregnancy, Prolonged; D012680:Sensitivity and Specificity