![]() Median AFI level is approximately 14 from week 20 to week 35, when the amniotic fluid begins to reduce in preparation for birth. Īn AFI between 8–18 is considered normal. To determine the AFI, doctors may use a four-quadrant technique, when the deepest, unobstructed, vertical length of each pocket of fluid is measured in each quadrant and then added up to the others, or the so-called "Single Deepest Pocket" technique. ĪFI is the score (expressed in cm) given to the amount of amniotic fluid seen on ultrasonography of a pregnant uterus. It is a separate measurement from the biophysical profile. The percentile curves of AFI obtained from the present study may be used to detect abnormalities of amniotic fluid for our population.Measurement used in fetal well-being Amniotic fluid indexĮstimate of amniotic fluid and an indicator of fetal well-beingĪmniotic fluid index ( AFI) is a quantitative estimate of amniotic fluid and an indicator of fetal well-being. Hence, it is recommended to follow up low risk antenatal women every two weeks after 34 weeks of pregnancy. Appreciable changes occurred in AFI values as gestation advanced by two weeks. Normative range for AFI values for late third trimester was established. ![]() AFI curve generated from the study varied significantly when compared with already published data, both from India and abroad. Significant drop in AFI was noted at two-week intervals. There was a gradual decline of AFI values as the gestational age approached term. The 5th percentile cut-off was 8.7 cm at 40 weeks. Starting from 34 weeks till 40 weeks, 50 ultrasound measurements were available at each gestational age. Cohen's d coefficient was used to examine the magnitude of change at different time intervals. Percentile curves (5th, 50th, and 95th centiles) were constructed for comparison with other studies. Statistical analysis was done using SPSS software (Version 16, Chicago, IL). Amniotic fluid index was obtained by adding these four measurements. Linear array transabdominal probe was used to measure the largest vertical pocket (in cm) in perpendicular plane to the abdominal skin in each quadrant. For the purpose of AFI measurement, the uterine cavity was arbitrarily divided into four quadrants by a vertical and horizontal line running through umbilicus. Women with gestational or overt diabetes mellitus, hypertensive disorders of the pregnancy, prelabour rupture of membranes, and congenital anomalies in the foetus and those who delivered before 40 completed weeks were excluded from the study. Only low risk singleton pregnancies with accurately established gestational age who were available for all weekly scan from 34 to 40 weeks were included in the study. The trend of amniotic fluid volume was studied with advancing gestational age. A prospective estimation of AFI was done in 50 healthy pregnant women from 34 to 40 weeks at weekly intervals. To establish reference standards for AFI for local population after 34 weeks of pregnancy and to decide an optimal scan interval for AFI estimation in third trimester in low risk antenatal women. However, before deciding the cut-off standards for abnormal values for a local population, what constitutes a normal range for specific gestational age and the ideal interval of testing should be defined. Very low values are associated with intrauterine growth restriction and renal anomalies of fetus, whereas high values may indicate fetal GI anomalies, maternal diabetes mellitus, and so forth. Amniotic fluid index (AFI) is one of the major and deciding components of fetal biophysical profile and by itself it can predict pregnancy outcome.
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