Induction of labor and perinatal outcome: The impact of the amniotic fluid index

Objective: The purpose was to determine the impact of the amniotic fluid index on the perinatal outcome of patients admitted for induction of labor at term. Study design: Patients (n = 180) included in the study were those admitted for induction of labor at 37-42 weeks' gestation, with unfavorable cervix and intact membranes. The amniotic fluid index (AFI) was determined in all patients using the four-quadrant technique within 24 It of the induction of labor. Patients were divided into two groups based on their AFI: the oligohydramnios group with AFI <= 5 cm (n = 66) and a normal group with AFI > 5 cm (n = 114). The perinatal outcomes of the two groups were compared. Results: The two groups were similar with regard to maternal age, gestational age, and birth weight. Meconium staining of the amniotic fluid was significantly higher in the group with AFI <= 5 cm (p = 0.040). The number of cesarean deliveries due to fetal distress was significantly higher even after adjusting for other confounding factors in the group with AFI <= 5 cm (adjusted OR 6.52 [95% Cl 1.82, 23.2];p <= 0.0001). There was no significant difference between the two groups with regard to Apgar scores or neonatal admission. Conclusion: Induction of labor at term inpatients with oligohydramnios is associated with an increased risk of cesarean delivery due to fetal distress. (C) 2005 Elsevier Ireland Ltd. All rights reserved.