Role of Ultrasound in Early Diagnosis of Amniotic Fluid Abnormalities in Assessment of Fetal Maturity and Associated Fetal Congenital Anomalies

Abstract

Amniotic fluid plays a major role in the development of the fetus. Borderline AFI is defined between 5.1-10. Pregnancies with borderline AFI of 5-10 cm have shown outcomes such as non-reactive nonstress tests, fetal heart rate (FHR) deceleration, meconium aspiration, immediate caesarean delivery, low Apgar score, Low body weight, Neonatal intensive care unit admission and small gestational age. There are three types of amniotic fluid abnormalities Polyhydramnios, Oligohydramnios and anhydramnios. Ultrasound assessment of AF has an important implication in obstetric care, and it has become an integral and important component of pregnancy assessment. The sonographic method involves the measurement of the AF index (AFI), single deepest pocket (SDP) (largest vertical or largest transverse pocket). Aim of the work: Ultrasound evaluation of the amniotic fluid abnormalities in assessment of fetal maturity and associated fetal congenital anomalies. Results: there was 43 (64.18%) cases of oligohydramnios cases, 12 (48%) cases of the polyhydramnios cases, and in 2 (25%) case of the less than average cases. Amniotic fluid index ranged from 0.3 to 4.5 with a mean value of 2.58 ± 1.17 in Oligohydramnios cases, ranged from 26 to 35 with a mean value of 30.76 ± 3.47 in polyhydramnios cases, and ranged from 6 to 10 with a mean value of 7.37 ± 1.68 in less than average cases. The most congenital anomalies occurring type was mega cystitis in 12 (21.05%) cases followed by medullary cystic kidney disease in 11 (19.03%) cases in all cases with congenital
anomalies. Conclusion: The early diagnosis of pregnancies at risk for preventable perinatal handicap is a primary goal of the obstetric care providers. One of the most consistently used justifications for requesting obstetric ultrasound is early diagnosis of any obstetric abnormality as amniotic fluid abnormalities and any associated fetal anomalies before delivery which can provide a number of management options. In our study we concluded that, oligohydramnios is associated with intrauterine growth retardation (IUGR), fetal congenital anomalies. Also, severe polyhydramnios is associated with congenital malformations.