Journal of the Scientific Society (Jan 2020)
Role of amniotic fluid echogenicities in the prediction of fetal outcome
Abstract
Background: The amniotic fluid (AF) is a highly complex and dynamic system that is studied as a data point to interpret fetal well-being. Homogeneously, echogenic AF is due to the presence of innumerable echogenic particles in the fluid and is an uncommon finding. Echogenic AF has been attributed to meconium, blood, and vernix caseosa. The current study was undertaken to evaluate the significance of echogenic AF in the assessment of fetal outcome. Objective: The objective was to study the significance of echogenic AF in the assessment of fetal outcome. Materials and Methods: The present study was a prospective observational study conducted in the Department of Obstetrics and Gynaecology, SKIMS, Soura, Srinagar, from May 2019 to December 2019. A total of 34 participants with ultrasonographic evidence of echogenic liquor were included in the study. They were followed till the delivery for the determination of the fetal outcome. The fetal outcome was studied in terms of Appearance, Pulse, Grimace, Activity, Respiration (APGAR) score; neonatal intensive care unit (NICU) admission rate; and stillbirth rate. Results: Out of 34 participants, 18 participants had vernix caseosa, 8 had meconium, 6 had blood, and 2 had clear liquor amnii. Out of 18 participants with vernix, all 18 fetuses had APGAR score >7/10 with no NICU admission and no stillbirth. Out of eight participants with meconium, six babies had APGAR score <7/10, out of which three had NICU admission, and there was one stillbirth. Out of six participants with blood-stained liquor, four babies had APGAR score <7/10, out of which one had NICU admission, and there was no stillbirth. Conclusion: Our study suggests that when abnormalities of AF exist, appropriate workup to uncover the underlying etiology should be initiated as adverse fetal outcomes are sometimes associated with these variations from normalcy. However, ultrasonography cannot reliably differentiate meconium in AF from other causes of hyperechogenicity. If meconium and blood can be reliably identified prenatally, then it has a significant impact on the fetal outcome. Hence, a change in the management of pregnancy cannot be justified simply due to the detection of hyperechogenic AF.
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