Correlation Of Ultrasound-Measured Amniotic Fluid Index With Fetal Distress And Neonatal Health Outcomes

Abstract

Background: Abnormal amniotic fluid volume is associated with adverse maternal, fetal, and neonatal outcomes. The amniotic fluid index (AFI), measured during obstetric ultrasonography, an important parameter for assessing fetal well-being and guiding clinical management.

Objective: To determine the correlation of ultrasound-measured AFI with fetal distress and neonatal health outcomes.

Methods: This retrospective cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Northwest General Hospital and Research Centre, Peshawar, from September 2025 to March 2026. A convenience sample of 152 singleton pregnancies at 28 weeks of gestation or later was included. Eligible records documented oligohydramnios (AFI < 5 cm) or polyhydramnios (AFI > 24 cm), together with intrapartum and neonatal outcomes. Fetal distress, mode of delivery, meconium-stained liquor, neonatal intensive care unit (NICU) admission, neonatal birth weight, and Apgar scores at 1 and 5 minutes were recorded. Data were analyzed in SPSS version 20 using chi-square, Pearson correlation, and Spearman correlation tests. A p value

< .05 was considered statistically significant.

Results: Of 152 participants, 116 (76.3%) had oligohydramnios and 36 (23.7%) had polyhydramnios. AFI category was significantly associated with fetal distress (χ² = 49.185, p <

.001), mode of delivery (χ² = 7.408, p = .006), NICU admission (χ² = 56.102, p < .001), and meconium-stained liquor (χ² = 4.592, p = .032). Oligohydramnios was associated with higher frequencies of fetal distress, cesarean delivery, NICU admission, and meconium-stained liquor. AFI showed significant positive correlations with neonatal birth weight (Pearson r = .900; Spearman ρ = .683), Apgar score at 1 minute (r = .775; ρ = .686), and Apgar score at 5 minutes (r = .773; ρ = .693), all p < .001. Maternal weight was not significantly correlated with AFI (r =

.117, p = .152).

Conclusion: Ultrasound-measured AFI was significantly associated with fetal distress and neonatal health outcomes. Early recognition and management of abnormal AFI, particularly oligohydramnios, may support timely obstetric intervention and improve neonatal outcomes.