Ideal Labour admission test (LAT) is the tool to identify labouring mothers at risk for adverse perinatal outcome so as to strategise and manage course of labour. Amniotic fluid index (AFI) is an important factor in biophysical profile during antenatal foetal surveillance. The present study is undertaken to determine the efficacy and reliability of Amniotic fluid index as LAT and it’s relation to perinatal outcome.
Material and Methods: This Two years prospective observational study where 500 cases fulfilling exclusion and inclusion criterias were included. The AFI was calculated for all patients in active labor by USG and grouped into ≤ 5 (GpA), 6-8(Gp B), ≥ 9 (Gp C). After confinement, details of the labor, delivery and neonatal outcome were recorded to derive conclusion.
Results: Among 500 cases, 43(8.6%) were in Gp A, 153(30.6%) in Gp B, rest 304 (60.8%) were in Gp C category. Gp A had significantly high nonreactive NST in 33(76.7%),Meconium stained liquor in 32(74.4%%), emerency LSCS in 34 (79%) cases in comparison to 38.6%, 41.2% and 22.2% in Gp B and further low in Gp C.
Significant neonatal morbidity, in terms of low Apgar score <7 at 1 and 5 Min in 34(79.1%) 17(39.5%, with 38(88.4%),neonates requiring NICU admission were observed in Gp A which were significantly higher in comparison to other groups.
The Sensitivity and specificity of Oligohydramnios in predicting foetal outcome was 59.1% and 75%, while its PPV and NPV was 62.8% and 85%
Conclusion: AFI is a valuable and reliable tool as admission test for predicting labour and perinatal outcome. In presence of oligohydramnios (AFI ≤ 5), is associated signinificantly with increase operative delivery for foetal distress and perinatal morbidity. Determination of AFI can be used as an adjunct to other fetal surveillance methods.