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Corelation between Sonographic Estimated Fetal Weight and Amniotic

Fluid Index in III Trimester of Pregnancies, in Healthy Women
Authors
Nishigandha Sadamate , Dr V. G. Sawant2, Dr Ganpat Sawant3,
1

Dr Madan Manmohan4
1
Assistant Lecturer, 2Professor, Department of Anatomy,
3
Professor, Department of OBG. & Gynec., 4Professor and Head
Department of Radiology, Dr. D. Y. Patil, Medical College, Nerul, Navi Mumbai
Abstract
Fetal weight (FW) estimation in late pregnancy is an important guide in obstetric care. Amniotic fluid
surrounds the fetus throughout pregnancy providing nutrition & cushion. Estimation of amniotic fluid volume
is an important part of routine obstetric USG scan and mostly it is done by the Amniotic Fluid Index (AFI).
The amniotic fluid is also a strong indicator of possible associated congenital anomalies. So the study was
carried out to find out whether there is any correlation between FW and AFI in healthy pregnant women.163
cases of healthy pregnant women were studied by an ultra-sonography in Dr. D.Y. Patil hospital, Navi
Mumbai. Fetal weight and Amniotic fluid index were estimated. The mean values of AFI and FW in I group
(26-28 weeks) of Gestational Age (GA) are 14.92 cm and 1319.3 gm, II group (29-31 weeks) are 13.8 cm
and 1550.4 gms, in III group ( 32-34 weeks) 12.24 cm and 2308.04 gms, in IV group (35-37 weeks) values
are 11.64 cm and 2960.4 gms, In V group (38-40 weeks) 10.38 cm and 3584.6 gms respectively. So there
was no statistically significant relationship between AFI and FW.
Keywords: Amniotic fluid, Gestational age, fetal weight, III trimester, Ultrasonography.

Introduction FW is also useful parameter when it is calculated

Fetal weight (FW) and Amniotic fluid index (AFI) a few days before delivery. EFW can also be used
estimation is an important guide in obstetric care earlier in gestation to monitor fetal growth and it
also important part of routine obstetric scan. is easy to understand the patients. Fetal weight
Amniotic fluid protects the fetus against traumatic (FW) and Amniotic fluid index (AFI) estimation
and infective insults. It is one of major and is an important guide in obstetric care also
deciding component of fetal biophysical profile important part of routine obstetric scan.
and by itself it can predict pregnancy outcome Amniotic fluid protects the fetus against traumatic
also a strong indicator of possible associated and infective insults. It is one of major and
congenital anomalies. Low values are associated deciding component of fetal biophysical profile
with intrauterine growth restriction and renal and by itself it can predict pregnancy outcome
anomalies, high values indicates GI anomalies, also a strong indicator of possible associated
maternal diabetes mellitus and so forth. congenital anomalies. Low values are associated
with intrauterine growth restriction and renal
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anomalies, high values indicates GI anomalies, Photograph 1: Formula for fetal weight
maternal diabetes mellitus and so forth.
In the late pregnancy, amniotic fluid production is
largely dependent on fetal micturation and renal
size, in the newborn has been shown to bear a
significant relationship to birth weight.
AFI and FW assessment by ultrasound are
important tools in assessing the fetal health in all
risk categories, especially beyond the period of
validity. It is therefore reasonable to postulate a
relationship between sonographically determined
AFI and FW.
Hence study was designed to check whether there
is any correlation between FW and AFI estimated
by USG.

Aims and Objectives

Photograph 2: Four quadrants for AFI
 To study the pattern of changing Amniotic
fluid index from 26 to 40 weeks of GA.
 To establish reference ranges of Amniotic
fluid index and fetal weight from 26 to 40
weeks of gestation.
 To find out whether any significant
relationship between Amniotic fluid index
(AFI) and Fetal weight (FW) in Indian
healthy pregnant women.

Materials and Methods

Prospective study was conducted in department of
Anatomy, Radiology, and Obstetrics and
gynecology in D.Y. Patil medical college Navi
Mumbai. 163 healthy pregnant women registered
in D.Y. Patil Hospital were studied.
AFI was assessed by four quadrant technique of
Patients with Regular past menstrual cycle, 20 to
Phelan. Uterus was divided into four quadrant
30 yrs of age group, Singleton pregnancy and
using linea nigra as a vertical line passing through
known LMP date patients were included for study.
umbilicus. The transducer was placed in each
Multiple Pregnancies and patients with suspected
quadrants in sagittal plane and maximum depth of
Anomalies were excluded.
amniotic fluid measured in centimeter. The sum of
Sonography was performed by radiologist on
measurements of four quadrants' was recorded for
MINDRAY Ultrasonographic machine with a
each subject.
convex transducer at 3.5 Mhz.
Collected data was transferred on excel sheet and
The fetal weight was automatically estimated by
analysis was done by software Stastatical Package
scanner using a combination of the BPD, FL, AC,
of Social Science.
and HC by specific formula.

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Photograph 3: Ultrasonographic estimation of AFI

Observations and Results study the minimum fetal weight 981 gm and
Table No. 1 shows that the Fetal weight (FW) maximum 4603 gm which signifies fetal well
inclines according to Gestational weeks .In this being.

Table No. 1 Fetal Weight

Name of Groups GA No. of cases F W Mean SD

Weeks (gm)

Group - A 26 – 28 12 1319.3 354.8

Group – B 29 – 31 25 1550.0 187.2
Group – C 32 – 34 25 2308.0 237.7

Group – D 35 - 37 77 2960.4 267.3

Group – E 38 - 40 24 3584.6 320.2

Table No. 2 : Amniotic Fluid Index

Name of Groups GA No. of cases AFI Mean SD
Weeks (cm)

Group - A 26 – 28 12 14.92 2.4

Group - B 29 – 31 25 13.84 2.5
Group - C 32 – 34 25 12.24 2.4
Group - D 35 - 37 77 11.64 2.9
Group - E 38 - 40 24 10.38 1.8

Table No. 2 showed gradual declines of AFI from 7 cm to 25 cm are worldwide accepted and
values as gestational age approaches the [Link] established as normal range for AFI values. So the
present study the minimum value of AFI was 7 values of this study correlates with world wide
cm and maximum was 21 cm. The values ranges range

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Discussion growth, but this relationship across the entire fetal
Amniotic fluid disorders oligohydramnios, and weight is unclear. 37 week of GA where as it is
polyhydramnios highly associated with intra significantly superior to clinical estimates of
uterine growth restriction and abnormal fetal weight for preterm birth.

Table No. 3 : Comparison of FW with previous study. (gm)

Ademola A Adeyekun Present Study

GA weeks F W (gm) G A weeks FW (gm)

27-29 1250.2 26 – 28 1319.3

30-32 1648.0 29 – 31 1550.0
33-35 2273.5 32 – 34 2308.0
36-38 2906.1 35 – 37 2960.4
39-40 3222.6 38 - 40 3584.6

Ademola A Adeyekun [Link] in 2012 found decrease wks and increase in fetal weight noticed
in mean AFI values from 17.21 cm in early throughout pregnancy.
trimester (27-29 wks group), 14.40 cm in 36-38

Table No. 4: Comparison AFI with previous study AFI (CM)

Ademola A Adeyekun This Study

GA weeks AFI (cm) GA weeks AFI (cm)

27-29 17.21 26 – 28 14.91

30-32 17.03 29 – 31 13.83

33-35 16.23 32 – 34 12.27
36-38 14.40 35 – 37 11.63
39-40 12.50 38 - 40 10.37

Ademola A Adeyekun study and present study  The implication of this is fetal size may
showed difference between AFI values which not need to be considered in variations of
shows values can be varies according to ethnic amniotic fluid volume across the
group. The result also showed AFI values gestational age.
decreases as gestational age increases. .
References
Conclusion 1 Macgregor S. Sabbagha, R, Glob, Libr.
 Study gives reference ranges of Amniotic Womens med., Assessment of Gestational
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 There is no significant relationship exists effect of amniotic fluid index on the
between Amniotic fluid index and accuracy of sonographic estimated fetal
estimated Fetal weight.

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