Amniotic fluid index

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Amniotic fluid index (AFI) is an estimate of the amount of amniotic fluid[1] and is an index for the fetal well-being. It is a part of the biophysical profile.[1]

  • AFI is the score (expressed in cm) given to the amount of amniotic fluid seen on ultrasonography of a pregnant uterus. To determine the AFI, doctors may use a four-quadrant technique,[2] when the deepest, unobstructed, vertical length of each pocket of fluid is measured in each quadrant and then added up to the others,[3] or the so-called "Single Deepest Pocket" technique.[4]
  • An AFI between 8-18 is considered normal.[5] Median AFI level is approximately 14 from week 20 to week 35,[6] when the amniotic fluid begins to reduce in preparation for birth.
  • An AFI < 5-6 is considered as Oligohydramnios[3] The exact number can vary by gestational age. The fifth percentile for gestational age is sometimes used as a cutoff value.[7]
  • An AFI > 20-24 is considered as Polyhydramnios.[3][8]

What causes low amniotic fluid?

  • Leaking or rupture of membranes

Leaking or rupture of membranes may be caused by a gush of fluid or a slow constant trickle of fluid. This is due to a tear in the membrane. Premature rupture of membranes can also result in low amniotic fluid levels in women pregnancy.

  • Placental problems

Placental problems may cause low amniotic fluid in women pregnancy, this is because If the placenta is not providing enough blood and nutrients to the baby, then the baby may stop recycling fluid.

  • Birth defects

Birth defects may occur if the women pregnancy have a Problems with the development of the kidneys or urinary tract which could cause little urine production in women pregnancy and it can leading to low levels of amniotic fluid.

  • Maternal Complications

Maternal Complications may cause low amniotic fluid in women pregnancy, some Factors such as hypertension, diabetes, dehydration, preeclampsia, and chronic hypoxia in a women can have an effect on amniotic fluid levels.


  1. ^ a b Tom C Winter; Sanders, Roger C. (2006). Clinical Sonography: A Practical Guide. Hagerstown, MD: Lippincott Williams & Wilkins. p. 502. ISBN 0-7817-4869-0. 
  2. ^
  3. ^ a b c Carr, Phyllis L.; Ricciotti, Hope; Freund, Karen M.; Scott Kahan (2003). In a Page Ob/Gyn & Women's Health (In a Page). Cambridge, MA: Blackwell Publishers. p. 105. ISBN 1-4051-0380-9. 
  4. ^
  5. ^
  6. ^
  7. ^ Griffin M, Attilakos G, Greenwood R, Denbow M (2009). "Amniotic fluid index in low-risk, post-dates pregnancies". Fetal. Diagn. Ther. 26 (4): 212–5. doi:10.1159/000265554. PMID 20029220. 
  8. ^ Sylvia Dobo; Mitchell King; Lipsky, Martin S.; Jeff Susman (2003). Family Medicine Certification Review. Cambridge, MA: Blackwell Publishers. p. 133. ISBN 1-4051-0329-9.