Impact of abnormal amniotic fluid index on maternal and perinatal outcomes in term pregnancies

Amniotic fluid, the protective medium within the amniotic sac, plays a vital role in fetal development and maternal well-being during pregnancy. Abnormal amniotic fluid index (AFI), including oligohydramnios (AFI ≤ 2 cm) and polyhydramnios (AFI ≥ 8 cm), is associated with various maternal and fetal complications such as preeclampsia (6.6%), antepartum hemorrhage (3.1%), gestational diabetes (3.5%), prematurity, and intrauterine growth restriction. The objective of this study was to evaluate fetomaternal outcomes in full-term pregnancies with abnormal AFI, with the aim of informing delivery timing and improving both maternal and neonatal outcomes. Furthermore, the study explores the utility of ultrasonography and Doppler imaging in identifying and managing high-risk cases. A prospective observational study was conducted on 60 term pregnancies meeting the inclusion criteria after obtaining informed consent. The incidence of oligohydramnios was 5.33%, and polyhydramnios was 2%. Most cases were observed in women aged 20 to 24 years, with a higher prevalence among primigravida. Oligohydramnios was frequently associated with postdated pregnancy, whereas polyhydramnios was predominantly linked to maternal diabetes. Both conditions were significantly associated with increased rates of cesarean delivery, fetal distress, and neonatal intensive care unit admissions. The findings emphasize the clinical significance of regular AFI monitoring, particularly beyond 37 weeks of gestation. Ultrasonography, coupled with Doppler studies, proved valuable in early detection and informed decision-making, ultimately contributing to better perinatal outcomes. Early identification and timely intervention in pregnancies complicated by abnormal AFI can reduce adverse fetomaternal outcomes and guide clinicians in optimizing delivery management strategies.