Amniotic fluid index, non-stress test and color of liquor: as a predictor of perinatal outcome

Background: The universal aim of maternity care provision is birth of a healthy baby to a healthy mother. All birth attendants strive to achieve a good standard of care during labor to prevent an outcome such as ‘birth asphyxia’. The aim was to study the role of AFI, NST and color of liquor in predicting perinatal outcome in term pregnancy in active labor. Methods: Prospective observational study of in women 18-35 years of age in active Labor admitted in department of Obstetrics and Gynecology BRD Medical College Gorakhpur, India. Results: In patient with AFI 5 cm group only 29% needed intervention (24% LSCS, 5% instrumental vaginal delivery) and only 20% newborn had APGAR <7. Normal NST (Cat.-I) group had 89% normal vaginal delivery and only 11% (9.5% LSCS, 1.5% instrumental vaginal delivery) needed intervention with 6% newborn with APGAR<7 at 1 minute (‘p’<0.00001), while pathological NST (Cat.-III) group had 16% normal vaginal delivery and 84% (8% instrumental vaginal delivery, 76% LSCS) needed intervention during labor with 92% newborn with APGAR <7 at 1 minute (‘p’<0.00001). Clear liquor group had 85% had normal vaginal delivery and only 15% needed intervention (14% LSCS, 1% instrumental vaginal delivery) with 8.3% newborn with APGAR <7 at 1 minute, while meconium stained liquor group only 6.5% had normal vaginal delivery and 93.5% needed intervention (16% instrumental vaginal delivery, 77.5% LSCS) with 87% newborn with APGAR <7 at 1 minute. Conclusions: AFI, NST and color of liquor can effectively detect fetal distress already present at admission, thereby avoiding unnecessary delay and decrease in decision to delivery time and improve fetal outcome.