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Amniotic fluid index (AFI) is a quantitative estimate of amniotic fluid [1] and an indicator of fetal well-being. It is a separate measurement from the biophysical profile. [1] AFI is the score (expressed in centimetres) given to the amount of amniotic fluid seen on ultrasonography of a pregnant uterus.
Amniotic fluid is removed from the mother by an amniocentesis procedure, where a long needle is inserted through the abdomen into the amniotic sac, using ultrasound guidance such that the fetus is not harmed. Amniocentesis is a low risk procedure, with risk of pregnancy loss between 1 in 1,500 – 1 in 700 procedures.
The volume of amniotic fluid typically increases until 36 weeks and starts decreasing after 40 weeks in post-term gestations. [4] For this reason, discrepancies between fundal height measurements and gestational age can be a clinical indication of amniotic fluid abnormality and should be evaluated by ultrasound.
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The gestational sac is spherical in shape, and is usually located in the upper part (fundus) of the uterus.By approximately nine weeks of gestational age, due to folding of the trilaminar germ disc, the amniotic sac expands and occupy the majority of the volume of the gestational sac, eventually reducing the extraembryonic coelom (the gestational sac or the chorionic cavity) to a thin layer ...
Usual follow-up steps include (1) a prenatal ultrasound exam to look for fetal abnormalities and/or (2) measurement of AFP in amniotic fluid obtained via amniocentesis. Maternal serum AFP (MSAFP) varies by orders of magnitude during the course of a normal pregnancy. MSAFP increases rapidly until about 32 weeks gestation, then decreases gradually.
Polyhydramnios is a medical condition describing an excess of amniotic fluid in the amniotic sac.It is seen in about 1% of pregnancies. [1] [2] [3] It is typically diagnosed when the amniotic fluid index (AFI) is greater than 24 cm. [4] [5] There are two clinical varieties of polyhydramnios: chronic polyhydramnios where excess amniotic fluid accumulates gradually, and acute polyhydramnios ...
The lecithin–sphingomyelin ratio is a marker of fetal lung maturity. The outward flow of pulmonary secretions from the fetal lungs into the amniotic fluid maintains the level of lecithin and sphingomyelin equally until 32–33 weeks gestation, when the lecithin concentration begins to increase significantly while sphingomyelin remains nearly the same.