Abstract:

Background: One of the many variables used to evaluate fetal health and forecast perinatal outcomes is amniotic fluid volume. An amniotic fluid index (AFI) of less than 5 cm measured quantitatively by ultrasound has been used to define oligohydramnios and a predictor of adverse pregnancy outcomes. However, borderline (low normal) AFI has been linked with adverse pregnancy outcome though the predictive accuracy is uncertain due to conflicting results from different studies, some studies denies the association while some identifies pregnancy outcomes with a borderline AFI with greater risk of meconium-stained fluid, cesarean delivery for a fetal heart rate that is non reassured, low Apgar scores, and extended neonatal unit admission.

Methodology: This was a comparative cross sectional study design involving 345 pregnant women admitted and planned for delivery at Bugando Medical Center. The participants were screened for borderline AFI and enrolled. Assessment of perinatal outcomes for those enrolled candidates were recorded soon to 24 hours after birth, in determining an association between borderline AFI with perinatal outcome. Data was collected using a questionnaire and ultrasound machine and analysis was done using STATA version 15. The association between outcome variables and borderline AFI in pregnancy was determined by using bivariate logistic regression analysis using OR, 95% CI and a p-value cut-off of 0.25 on bivariate and <0.05 in multivariate logistic regression.

Results: The mean age of study participants was 28 years. The prevalence of pregnant women with Borderline AFI was 21.9% (76/347). Delivery by induction of labor, emergency caesarean section, meconium stained liquor, admission to neonatal unit and low birth weight were more common on the borderline group as compared to normal group. Additionally, emergency caesarean section (OR 2.88; 95% CI 1.6-5.2, p-value <0.001), meconium stained liquor (OR 4.6; 95% CI 2.7-8.1, p-value <0.001), low birthweight (OR 8.9; 95% CI 2.7-30,p value<0.001) were significantly associated with borderline AFI.

Conclusion and Recommendation: Close antepartum and intrapartum fetal surveillance is required for pregnancies with borderline AFI measured quantitatively because they are linked to adverse fetomaternal outcomes like emergency caesarean delivery, meconium stained liquor, low birthweight and neonatal admission.