Differences in amniotic fluid patterns and fetal biometric parameters in third trimester pregnancies with and without diabetes.
OBJECTIVE
The amniotic fluid index (AFI) has been increasingly used in the assessment of fetal well-being. We conducted the study to evaluate and compare the amniotic fluid index in third trimester normal and diabetic human pregnancy and to assess the correlation between the AFI and the fetal biometric parameters.


METHODS
Real-time ultrasound was performed to evaluate the AFI (four-quadrant technique), and to measure the biparietal diameter, head circumference, abdominal circumference, and femur length in 225 normal and 120 diabetic pregnant women from 27 to 42 weeks of gestation. Each patient was studied only once.


RESULTS
AFI in normal pregnancies was less than that in diabetic pregnancies throughout the gestational ages studied (27-42 weeks). In normal pregnancy, the mean AFI was 14.0 cm at 27 weeks and decreased to 11.4 cm at 42 weeks (r = 0.25, p = 0.0005), whereas in diabetic pregnancies, the values remained stable throughout the gestational ages studied. There exist significant differences in AFI, estimated fetal weight, estimated fetal weight %, abdominal circumference, abdominal circumference %, and head circumference to abdominal circumference ratio between the two groups. In both normal and diabetic pregnancies, there is a positive correlation between the AFI and the percentile of abdominal circumference (p < 0.0001), and between the AFI and the percentile of estimated fetal weight (p < 0.0001).


CONCLUSIONS
This study provides gestational age-specific values of the AFI in normal and diabetic pregnancies. Diabetic pregnancy has greater AFI values than normal pregnancy between 27 and 42 weeks. The AFI correlates to the percentile of the estimated fetal weight and the abdominal circumference in both groups, suggesting that there may be a relationship between increased AFI and large for gestational age fetus independent of diabetes.
Kofinas
Alexander
A
Department of Obstetrics and Gynecology, Kofinas Perinatal and Fertility Institute, New York Methodist Hospital, Brooklyn, New York, USA. unborn@kofinasperinatal.org
Kofinas
George
G
D000328:Adult; D000653:Amniotic Fluid; D016640:Diabetes, Gestational / Q000378:metabolism*; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D006801:Humans; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000502:physiology*