BORDERLINE AFI IN LAST TRIMESTER AND PERINATAL OUTCOME

Abstract

: Amniotic fluid index (AFI) is an important marker of fetal well-being in the last trimester of pregnancy. While oligohydramnios (AFI ≤ 5 cm) is well documented to be associated with adverse perinatal outcomes, the clinical significance of borderline AFI (5.1–8 cm) remains controversial. Identifying its impact on perinatal outcomes is crucial for obstetric management and neonatal care.Aim: To evaluate the association between borderline AFI in the last trimester and perinatal outcomes among pregnant women admitted at Government Medical College (GMC) Kathua from January 2024 to June 2024. Methods: This prospective observational study included 100 singleton pregnancies at ≥ 36 weeks gestation. Women were divided into two groups: Borderline AFI (5.1–8 cm) and Normal AFI (> 8–24 cm). Data collected included maternal demographics, mode of delivery, intrapartum events, and neonatal outcomes such as birth weight, Apgar scores, and NICU admissions. Statistical analysis was done using chi-square and t-tests, with p < 0.05 considered significant. Results: Women with borderline AFI had higher rates of caesarean sections for fetal distress (30% vs 12%), increased meconium-stained amniotic fluid (36% vs 18%), lower mean birth weight (2.70 ± 0.45 kg vs 3.10 ± 0.40 kg), higher NICU admissions (24% vs 8%), and more neonates with Apgar < 7 at 5 minutes (22% vs 6%). These differences were statistically significant.Conclusion: Borderline AFI in the last trimester is significantly associated with adverse perinatal outcomes including fetal distress, meconium-stained liquor, low birth weight, and increased NICU admissions. Close surveillance and timely obstetric intervention are recommended to improve neonatal outcomes in pregnancies with borderline AFI.