DIAGNOSTIC ACCURACY OF AMNIOTIC FLUID INDEX IN DETERMINATION OF POOR APGAR SCORE AMONG FEMALES WITH POST-TERM PREGNANCY
Main Article Content
Keywords
Amniotic Fluid, Pregnancy, Ultrasound
Abstract
This study aimed to evaluate the diagnostic accuracy of amniotic fluid index to predict the poor Apgar score in females with postdate pregnancy in a tertiary care hospital taking poor Apgar score at birth as the gold standard. A cross-sectional study was conducted in the Obstetrics and Gynecology Department of Jinnah Hospital, Lahore from December 2023 to December 2024. A total of 300 pregnant women aged 20-40 years with <5 parity and gestation age 40-42 weeks according to ultrasound were included in the study. Ultrasound was performed in all subjects by a senior radiologist to assess the amniotic fluid index. Females were labeled as positive if AFI<5cm and negative if AFI>5cm.After 5 minutes of delivery, the Apgar score was measured and was labeled as poor if the Apgar score was <7 and was labeled as good if the Apgar score was >7. The results revealed the sensitivity of AFI as 89.62%, specificity 8.76%, PPV 34.92%, NPV 60.71% and overall diagnostic accuracy was 37.33%.With respect to gestational age, the sensitivity was 86.84%, specificity was 10.97%, PPV was 31.11%, NPV was 64.29% and diagnostic accuracy was 35% in women who were 42 weeks pregnant. In women with gestational age 41 weeks, sensitivity was 91.17%, specificity was 7.14%, PPV was 53.45%, NPV was 57.14% and diagnostic accuracy was 38.89%.In conclusion, the amniotic fluid index is a highly sensitive tool for the prediction of poor Apgar score; however, its overall diagnostic accuracy is not reliable individually without additional screening tools.
References
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12. Sekhon S, Rosenbloom JI, Doering M, Conner SN, Macones GA, Colditz GA, et al. Diagnostic utility of maximum vertical pocket versus amniotic fluid index in assessing amniotic fluid volume for the prediction of adverse maternal and fetal outcomes: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine. 2021;34(22):3730-3739.
13. Sharma M, Sharma G, Verma A. Umbilical artery systolic/diastolic ratio and amniotic fluid index in prediction of adverse perinatal outcome in term pregnancies. International Journal of Applied and Basic Medical Research. 2022;12(2):76-81.
14. Egagifo O, Omo-Aghoja LO, Adeyinka AT. Correlation of perinatal outcomes with amniotic fluid assessment techniques in high-risk pregnancies in a Tertiary Hospital in Southern Nigeria. African Health Sciences. 2021;21(3):1310-1320.
15. Taha WS, Galal SK, Moghazy SMA. Amniotic Fluid Turbidity via Ultrasound before 34 Weeks of Pregnancy and Neonatal Outcomes. Al-Azhar International Medical Journal. 2024;5(4):14.
2. Huri M, Di Tommaso M, Seravalli V. Amniotic fluid disorders: from prenatal management to neonatal outcomes. Children. 2023;10(3):561.
3. Bakhsh H, Alenizy H, Alenazi S, Alnasser S, Alanazi N, Alsowinea M, et al. Amniotic fluid disorders and the effects on prenatal outcome: a retrospective cohort study. BMC pregnancy and childbirth. 2021;21:1-7.
4. Dias BAS, Leal MdC, Esteves-Pereira AP, Nakamura-Pereira M. Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital. Cadernos de Saúde Pública. 2022;38:e00073621.
5. Gunnarsdóttir J, Swift EM, Jakobsdóttir J, Smárason A, Thorkelsson T, Einarsdóttir K. Cesarean birth, obstetric emergencies, and adverse neonatal outcomes in Iceland during a period of increasing labor induction. Birth. 2021;48(4):493-500.
6. Marwat SH, Naz MK, Riaz M, Sardar N, Hassan S, Naseem H. Amniotic Fluid Index and its relationship with Poor Apgar Score in Term Pregnancy. Journal of Health and Rehabilitation Research. 2023;3(2):650-654.
7. Talpur S, Kahn S, Abbas A, Asad S, Kousar T. To Analyse the Significance of Reduced Amniotic Fluid Index in Pregnancy and its Correlation with Perinatal Outcome. Journal of The Society of Obstetricians and Gynaecologists of Pakistan. 2021;11(3):217-219.
8. Sharif N, Qasim A. Perinatal outcome in pregnant females at term having low amniotic fluid index. The Professional Medical Journal. 2021;28(09):1358-1364.
9. Awan S, Tabasum S, Parveen T, Bhutto A, Mandvia A, Kaleem R, et al. Amniotic Fluid Index and Its Relationship with Poor Apgar Score in Term Pregnancy: Amniotic Fluid Index in Term Pregnancy. Pakistan Journal of Health Sciences. 2023:29-32.
10. Rajakaruna RMU, Karunaratne SMG, Thennakoon BNS. Predictive Value of Amniotic Fluid Index in Term Small for Gestational Age with Normal Doppler Studies for Perinatal Outcomes. Open Journal of Obstetrics and Gynecology. 2023;13(8):1339-1349.
11. Sultana S, Akbar Khan M, Khanum Akhtar K, Aslam M. Low amniotic fluid index in high-risk pregnancy and poor apgar score at birth. J Coll Physicians Surg Pak. 2008;18(10):630-634.
12. Sekhon S, Rosenbloom JI, Doering M, Conner SN, Macones GA, Colditz GA, et al. Diagnostic utility of maximum vertical pocket versus amniotic fluid index in assessing amniotic fluid volume for the prediction of adverse maternal and fetal outcomes: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine. 2021;34(22):3730-3739.
13. Sharma M, Sharma G, Verma A. Umbilical artery systolic/diastolic ratio and amniotic fluid index in prediction of adverse perinatal outcome in term pregnancies. International Journal of Applied and Basic Medical Research. 2022;12(2):76-81.
14. Egagifo O, Omo-Aghoja LO, Adeyinka AT. Correlation of perinatal outcomes with amniotic fluid assessment techniques in high-risk pregnancies in a Tertiary Hospital in Southern Nigeria. African Health Sciences. 2021;21(3):1310-1320.
15. Taha WS, Galal SK, Moghazy SMA. Amniotic Fluid Turbidity via Ultrasound before 34 Weeks of Pregnancy and Neonatal Outcomes. Al-Azhar International Medical Journal. 2024;5(4):14.
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Published
Mar 17, 2025
Article Details
How to Cite
Dr. Sumbal Altaf, Dr Sumaira Hafeez, Dr Bazla Younas, Dr Zainab Iftikhar, Dr Zahra Anwar, & Dr Shumaila Khalil. (2025). DIAGNOSTIC ACCURACY OF AMNIOTIC FLUID INDEX IN DETERMINATION OF POOR APGAR SCORE AMONG FEMALES WITH POST-TERM PREGNANCY. Journal of Population Therapeutics and Clinical Pharmacology, 32(2), 404-408. https://doi.org/10.53555/9xevp302
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Author Biographies
Dr. Sumbal Altaf
Consultant, Obstetrics & Gynaecology, Hameed Latif Hospital Lahore, Assistant Professor, Rashid Latif Khan University Medical College Lahore.
Dr Sumaira Hafeez
Registrar, Obstetrics & Gynaecology, University Hospital Limerick
Dr Bazla Younas
Consultant Obstetrics & Gynaecology, Sarwat Anwer Medical Complex Lahore
Dr Zainab Iftikhar
WMO, THQ Hospital, Shahkot
Dr Zahra Anwar
Speciality Registrar Obstetrics & Gynaecology, Diana Princess of Wales Hospital Grimsby
Dr Shumaila Khalil
Speciality Obstetrics & Gynaecology, Jinnah Post Graduate Medical Center, Karachi
How to Cite
Dr. Sumbal Altaf, Dr Sumaira Hafeez, Dr Bazla Younas, Dr Zainab Iftikhar, Dr Zahra Anwar, & Dr Shumaila Khalil. (2025). DIAGNOSTIC ACCURACY OF AMNIOTIC FLUID INDEX IN DETERMINATION OF POOR APGAR SCORE AMONG FEMALES WITH POST-TERM PREGNANCY. Journal of Population Therapeutics and Clinical Pharmacology, 32(2), 404-408. https://doi.org/10.53555/9xevp302