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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.
A biophysical profile (BPP) is a prenatal ultrasound evaluation of fetal well-being involving a scoring system, [1] with the score being termed Manning's score. [2] It is often done when a non-stress test (NST) is non reactive, or for other obstetrical indications. The "modified biophysical profile" consists of the NST and amniotic fluid index ...
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.
Amniotic fluid embolism, a condition in which amniotic fluid or other fetal debris enters the maternal circulation, is an extremely rare and catastrophic complication of amniocentesis. [1] Amniotic fluid embolism can result in cardiovascular collapse and has a poor maternal prognosis. [43]
[1] [2] [3] Macrosomia is a similar term that describes excessive birth weight, but refers to an absolute measurement, regardless of gestational age. [4] Typically the threshold for diagnosing macrosomia is a body weight between 4,000 and 4,500 grams (8 lb 13 oz and 9 lb 15 oz), or more, measured at birth, but there are difficulties reaching a ...
An amniotic fluid sample is collected via amniocentesis and the sample is spun down in a centrifuge at 1000 rpm for 3–5 minutes. Thin layer chromatography (TLC) is performed on the supernatant, which separates out the components. Lecithin and sphingomyelin are relatively easy to identify on TLC and the predictive value of the test is good. [4]
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.