SHOULD ASSESSMENT OF AMNIOTIC-FLUID VOLUME FORM AN INTEGRAL-PART OF ANTENATAL FETAL SURVEILLANCE OF HIGH-RISK PREGNANCY

This study was conducted to evaluate the role of the Amniotic Fluid in dex (AFI), used along with nonstress cardiotocography (NST) and fetal acoustic stimulation test (FAST), when required, in prediction of adve rse pregnancy outcome. Over a 3-year period 565 pregnant women had ant epartum fetal surveillance due to various high risk pregnancy factors and delivered within 7 days of the test. Antepartum fetal surveillance included nonstress cardiotocography together with estimation of AFI. Need for induction of labour, presence of meconium at rupture of membr anes, Caesarean section for fetal distress, Apgar score at 5 minutes, need for neonatal endotracheal intubation, admission to neonatal speci al care unit and perinatal death were the main outcome measures. Nonre active nonstress tests and Caesarean sections for fetal distress were more common and neonatal outcome was significantly poorer in patients with AFI < 5 cm than in those with higher AFI values. Of the 4 perinat al deaths in the group with AFI < 5 cm, 3 had a reactive NST within 7 days of fetal death. It is concluded that pregnancy outcome is often p oor in the presence of very low AFI and in these cases a reactive NST loses its usual reassuring value. It is suggested that AFI estimation should be included as an integral part of antepartum fetal surveillanc e of high risk pregnancies.