A Comparative Evaluation of AFI Measurement Techniques and Their Association with Fetomaternal Outcomes in Late Pregnancy
DOI:
https://doi.org/10.65761/pjcr.2025.2.1.5Keywords:
Amniotic Fluid Index (AFI), Single Pocket, Four Pocket, Phelan’s Method, Chamberlain’s Method, PIH, PROM, IUGR, NICUAbstract
Monitoring fetal wellbeing, in the later stages of pregnancy is especially important, and requires accurate assessment of the Amniotic Fluid Index (AFI). The purpose of this study was to compare the single pocket (Phelan’s) and four pocket (Chamberlain’s) ultrasound technique for AFI measurement and to evaluate their relationship with fetomaternal outcome. Sensitivity and reliability of single pocket and four pocket methods of measurement of AFI, and the impact of abnormal third and fourth trimester AFI values on fetomaternal outcome. Mayo Hospital, Lahore was observed from January 2023 to December 2024 in a prospective observational manner. The study included 250 women, who were pregnant, in their third and fourth trimesters. Doppler ultrasonography was used to measure AFI both via single and four-pocket methods. Preeclampsia (PIH), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR) and NICU admission outcomes were recorded and analysed statistically. 24% of abnormal AFI cases were identified by the single pocket method and 46% by the four-pocket method. With single pocket method, mean AFI values were 5.24 ± 2.3 cm and, with four pocket method, mean AFI values were 13.38 ± 4.5 cm. Abnormal AFI especially as measured with the four-pocket method was significantly associated with PIH, PROM, IUGR and NICU admissions (p < 0.05). The four-pocket method is a more sensitive and comprehensive way of determining amniotic fluid volume compared to the single pocket method, which also shows a stronger relationship with fetomaternal complications. If this method were to be incorporated in routine obstetric care it could improve earlier and better detection and management of high-risk pregnancies
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