AMNIOTIC-FLUID INDEX AND PERINATAL MORBIDITY

Our purpose was: (1) to determine whether assessment of amniotic fluid index in high risk patients with a reactive nonstress test (NST) allo wed improved recognition of the fetus at risk for perinatal morbidity than a reactive NST alone; and (2) to determine the optimal low amniot ic fluid index (AFI) which should prompt clinical concern. The last NS T performed within a week of delivery and amniotic fluid index were re trospectively compared with various indices of perinatal morbidity. In fetuses with a reactive NST, decreasing AFI was directly correlated w ith a risk of 5-minute Apgar score of less than 7 and delivery for fet al distress. When various subgroupings of AFI were compared, 7 cm or g reater appeared to have a better inverse correlation with the indices of morbidity than lower cut-off values. The addition of AFI assessment to the standard NST allows better prediction of perinatal morbidity t han the NSTs alone. Seven centimeters appears to be a reasonable cut-o ff for clinical concern.