Developing fetus in amniotic sac is surrounded by amniotic fluid which serves to provide several benefits to the fetus. The dynamic of amniotic fluid formation and absorption are complex. There is still unclear understanding about its reulation[1].

Many methods have been in use to monitor and survey a fetus in antepartum and intrapartum period. These include most commonly NST.CTG, BPP. doppler velocimeuy and FHR tracing.

"AMNIOTIC FLUID INDEX" of 5-8 cm defines BORDERLINE OLIGOHYDRAMNIOS as, originally described by Phelan et al'". It has been found to be associated with a variety of adverse pregnancy and perinatal outcomes including fetal doppler velocimetric abnormalities[2].

However, some studies have shown that "AMNIOTIC FLUID INDEX" is a poor predictor of ominous perinatal outcome. Some authors even question the existence of "isolated term oligohydramnios" that is in absence of other factors primarily pre eclampsia[3]. We therefore by this study attempt to find out the value of oligohydramnios in determining perinatal outcome and doppler velocimetric abnormalities in term (37-40 weeks) low risk. Pregnancies after 40 weeks have not been included as these might give confounding results due to physiological decrease in amniotic fluid volume beyond 40 weeks[4-6].

Methods: After taking written informed consent, 115 cases were enrolled on satisfaction of eligibility critcria. They were subjected to USG with AFI and umbilical artery doppler and velocimetric changes and perinatal outcomes were analysed. Inclusion Criteria: 1.Only the good dates and excellent dates women with thirty seven completed weeks of gestation were studied. Women with term singleton low risk pregnancies (37-40 weeks), borderline AFI, intact amniotic membrane and vertex presentation were included in the study. Exclusion Criteria: Women with any maternal systemic illness, vaginal bleeding, prematurely ruptured membranes, multiple gestation, malpresentation and postdated pregnancy beyond 40 completed weeks were excluded. The pregnancies with fetal malformations were also excluded from the study except for the deformities that can be caused by oligohydramnios like CTEV. The cases in which amnioinfusion was done were also excluded from the study to avoid confounding outcome.

Table 1: Age Distribution

Table 2: Gestation Age

Table 3: Amniotic Fluid Index

Table 4: Nature of Amniotic Fluid

P < 0.017-significant X° = 5.730

Table 5: Birth Weight

Table 6: Correlation of Birth Weight

Borderline amniotic fluid index (AFI), commonly defined as an AFI between 5 and 8 cm, represents an intermediate state between normal amniotic fluid volume and oligohydramnios. Although oligohydramnios is a well-established risk factor for adverse perinatal outcomes, the clinical significance of borderline AFI in otherwise low-risk term pregnancies remains controversial[7].

In the present study, pregnancies with borderline AFI demonstrated a higher incidence of adverse perinatal outcomes compared with pregnancies having normal AFI. Increased rates of labor induction, cesarean delivery for fetal distress, meconium-stained liquor, low Apgar scores, and neonatal intensive care unit (NICU) admissions were observed among women with borderline AFI. These findings suggest that even a modest reduction in amniotic fluid volume may reflect subclinical placental insufficiency and compromise fetal well-being[8].

Similar observations were reported by Gumus and colleagues, who found significantly increased rates of cesarean delivery and fetal distress among women with borderline AFI at term. Likewise, Choi et al. demonstrated that borderline AFI was associated with a greater frequency of small-for-gestational-age infants and operative deliveries[9]. The reduced amniotic fluid volume may lead to increased umbilical cord compression during labor, resulting in fetal heart rate abnormalities and subsequent operative intervention.

Several studies have suggested that borderline AFI is associated with increased neonatal morbidity. Magann et al. reported higher NICU admission rates among neonates born to mothers with reduced amniotic fluid volume. Similarly, Jandial et al. observed increased incidences of low birth weight and neonatal complications in pregnancies complicated by borderline AFI. These findings support the hypothesis that borderline AFI may be an early marker of uteroplacental insufficiency[10].

However, not all studies have demonstrated significant adverse outcomes. Rainford et al. found no substantial difference in neonatal outcomes between borderline AFI and normal AFI groups, suggesting that routine intervention based solely on borderline AFI may not be justified[11-12]. Variations in study design, population characteristics, gestational age at assessment, and management protocols may explain these conflicting results.

An amniotic fluid index of 5-8 cm leads to various adverse outcomes such as abnormal umbilical arterv doppler, non-reactive NST, thick meconium stained 1iquor, increased need for operative intervention and increased admission to NICU. However the trend was more towards lower values of AFI i.e.5-6 and 6-7 cm range. Most of the cases with AFI had good outcome.

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